RESUMO
<p><b>OBJECTIVE</b>To study the anatomy and preparation methods of an improved lateral arm free flap (LAFF) for the future clinical application.</p><p><b>METHODS</b>Twenty-two adult upper extremities from cadavers after injected with red latex through common carotid arteries were used. The course, branches, distribution and variations of the blood vessels and nerves of the improved LAFF were observed. The outer diameters of the vessels were measured.</p><p><b>RESULTS</b>The mean length of vascular pedicle of the improved LAFF was (14.85 ± 1.28) cm, significantly more than that (5.46 ± 2.60) of traditional LAFF (t = -8.483, P < 0.001). The mean outer diameters of pedicle arteries and veins in the improved LAFF were (2.24 ± 0.66) mm and (2.22 ± 0.52) mm, significantly more than those (1.15 ± 0.21 and 1.26 ± 0.23) in traditional LAFF (t = -8.690, P < 0.001; t = -15.057, P < 0.001), respectively.</p><p><b>CONCLUSION</b>The improved LAFF has a longer vascular pedicle and larger artery and vein in diameter than conventional LAFF, and is more suitable for the repair of the small and medium-sized defects of the head and neck.</p>
Assuntos
Adulto , Humanos , Braço , Retalhos de Tecido Biológico , Procedimentos de Cirurgia Plástica , Pele , Transplante de PeleRESUMO
<p><b>OBJECTIVE</b>To describe the anatomy of inferior epigastric artery and its correlation with rectus abdominis muscle in order to provide anatomical basis for reconstruction of defect in the oral and maxillofacial region.</p><p><b>METHODS</b>10 Chinese adult specimens fixed by 10% formalin were simulated for the design of inferior rectus abdominis flap, and then observing, taking a photograph during the cadavers were being operated and measuring by image analysis software in the end.</p><p><b>RESULTS</b>The original external diameters of inferior epigastric artery and length of its trunk were (2.58 +/- 0.60) mm and (85.87 +/- 14.90) mm respectively. Its perforators distribute intensively toward hilum.</p><p><b>CONCLUSION</b>Whether rectus abdominis myocutaneous flap or deep inferior epigastric perforator flap adapts to reconstruct the defect of oral and maxillofacial region due to invariable traveling of inferior epigastric artery and its wide original external diameters relatively.</p>
Assuntos
Adulto , Humanos , Cadáver , Artérias Epigástricas , Procedimentos de Cirurgia Plástica , Reto do Abdome , Retalhos CirúrgicosRESUMO
<p><b>OBJECTIVE</b>To provide anatomical basis for the internal fixation of scaphoid fractures.</p><p><b>METHODS</b>The shape and vascular lake of 48 dry scaphoids and 36 wet scaphoids were observed.</p><p><b>RESULTS</b>The data of dry bone group and wet bone group were as follows: the height of scaphoid tubercle were (11.28+/-0.94) mm and (10.35+/-1.54) mm; the thickness of scapoid waist were (12.02+/-1.90) mm and (11.21+/-1.20) mm; the width of scapoid waist were (10.59+/-1.11) mm and (11.34+/-1.47) mm; the minimal thickness of the body of scapoid were (6.51+/-1.22) mm and (8.54+/-1.07) mm; the axis length of scapoid were (25.68+/-2.21) mm and (26.50+/-2.56) mm; the width of epicondyle of scaphoid of distal portion, waist and proximal portion were (6.50+/-1.06) mm, (5.14+/-1.01) mm, (4.42+/-1.16) mm and (6.64+/-1.18) mm, (6.01+/-0.75) mm and (5.71+/-0.78) mm, respestively. The main blood vessels came from the dorsal and the radial of wrist and passed through the whole scaphoid along the crest of scaphoid.</p><p><b>CONCLUSION</b>The internal fixation of scaphoid can be designed according to the anatomical data without damaging the articular surface and blood supply.</p>
Assuntos
Adulto , Feminino , Humanos , Masculino , Fixação Interna de Fraturas , Métodos , Punho , Traumatismos do Punho , Cirurgia GeralRESUMO
OBJECTIVE: To ascertain an accurate approach to inserting the pedicle screw into C3-C7 segments of the cervical vertebra. METHODS: Anatomic morphology of lateral mass and pedicle, and their anatomic relationship with the adjacent tissue were observed on C3-C7 segments of 25 adult embalmed cadavers (50 sides). RESULTS: 1) The inferior edge of the base of the posterior tubercle of the transverse process and the inferior edge of the pedicle were connected with each other on 25 adult embalmed cadavers (50 sides). The transverse section which passed through the median point between the superior edge and the inferior edge of the base of the posterior tubercle of the transverse process, and the transverse section which passed through the central axis between the superior edge and the inferior edge of the pedicle, were in the same horizontal plane. The superior and inferior position of placing the pedicle screw was determined by this transverse section, which passed through the median point between the superior and the inferior edge of the base of the posterior tubercle of the transverse process. 2) There was a directed internal-downwards "triangular sulcule" between the base of the posterior tubercle of the transverse process and the anterolateral edge of the inferior articular process. The anterior wall of the triangular sulcule was the base of the posterior tubercle of the transverse process, the posterior wall was the anterolateral edge of the inferior articular process, and the bottom of the sulcule was connected with the interior edge of the pedicle. The vertical length between the top of triangle and the planes of inferior edge of the pedicle was (2.78+/-1.71) mm. The inferior edge of the cervical pedicle could be detected using a blunt probe along the "triangular sulcule" between the base of the posterior tubercle of the transverse process and the anterolateral edge of the inferior articular process in surgical operation. 3) The lateral fovea of the articular process was observed on all lateral masses (50 sides). The internal and external position of the entrance point could depend on anatomic landmarks: the lateral edge of the lateral fovea of the articular process. The horizontal length between the lateral fovea of the articular process and the entrance point was (3.14+/-1.45) mm. 4) The diameter of pedicle screw, about (2.78+/-1.71) mm, was the transverse diameter of the cancellous bone of the greatest narrow part of the cervical pedicle. CONCLUSIONS: The median point between the superior edge and the inferior edge of the base of the posterior tubercle of the transverse process, the lateral fovea of the articular process, and the triangular sulcule between the base of the posterior tubercle of the transverse process and the anterolateral edge of inferior articular process, are easy to be exposed and identified in surgical operation. The pedicle screw can be precisely inserted through this method.
Assuntos
Parafusos Ósseos , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/cirurgia , Adulto , HumanosRESUMO
<p><b>OBJECTIVE</b>To provide anatomic data for clinical use of reversed submental island flap in reconstruction of buccal and facial defects.</p><p><b>METHODS</b>Twenty cadavers with 40 sides of head and neck which were fixed by formalin and perfused by red emulsion, 6 fresh cadavers which were perfused by coloring agent were dissected, observed and measured.</p><p><b>RESULTS</b>The diameter of the submental artery, the superior lip artery and the inferior lip artery at their origins were respectively (1.42 +/- 0.30) mm (x +/- s, same at below), (1.34 +/- 0.35) mm and (1.34 +/- 0.27) mm respectively. The realistic distance from the origin of inferior and superior lip arteries to the origin of submental artery were (50.13 +/- 13.79) mm and (92.09 8.73) mm, respectively. However, the straight distances from the origin of inferior and superior lip arteries to the origin of submental artery were (35.19 +/- 9.18) mm, (64.99 +/- 5.24) mm, respectively. There were rich anastomoses between both facial arteries, and the facial arteries also anastomosed richly with the ophthalmic artery and the superficial temporal artery. On the marginal mandibular plane, the facial vein ran closely with the artery, the marginal mandibular branch of the facial nerve crossed superficially to the facial blood vessels; superior to this plane, the vein ran 1 cm behind the artery. The buccal branches of the facial nerve crossed superficially to the facial vein and ran into the muscles behind or across the facial artery. The facial vein anastomosed richly with the ophthalmic vein and the maxillary vein.</p><p><b>CONCLUSION</b>There is anatomic feasibility for the reconstruction of buccal and facial defects by using pedicled submental reversed island flap. The reversing point of the flap ought to be at the cheilion plane or inferiorly. Anatomy, regional</p>