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find Keyword "复合组织缺损" 12 results
  • 第二指蹼动脉蒂复合组织瓣修复示中指指背组织缺损

    目的总结应用第2指蹼动脉蒂复合组织瓣修复示、中指指背复合组织缺损的疗效。 方法2007年6月-2013年7月,采用第2指蹼动脉蒂复合组织瓣修复7例机器绞伤导致的示、中指指背复合组织缺损。男5例,女2例;年龄18~55岁,平均36岁。中指3例,示指1例,示、中指均有缺损3例。受伤至入院时间6~36 h,平均15 h。软组织缺损范围2.5 cm×1.0 cm~4.5 cm×1.5 cm。第2指蹼动脉皮瓣切取范围为3.0 cm×1.5 cm~6.0 cm×2.0 cm。供区均直接缝合。 结果术后7例皮瓣均完全成活,供、受区切口均Ⅰ期愈合。患者均获随访,随访时间11~13个月,平均12个月。皮瓣外形良好,末次随访时根据中华医学会手外科学会上肢部分功能评定试用标准评定手指总主动活动度均达优。供区遗留线性瘢痕。 结论第2指蹼动脉蒂复合组织瓣修复示、中指指背复合组织缺损具有手术操作简便、疗程短、皮瓣血供可靠等优点,术后手指外观及功能良好。

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • 游离腓骨皮瓣修复前足复合组织缺损

    目的 总结游离腓骨皮瓣修复前足复合组织缺损的疗效。 方法2000年6月-2011年11月,应用游离腓骨皮瓣修复前足复合组织缺损12例。致伤原因:交通事故伤8例,压砸伤4例。伤后至入院时间6 h~21 d。创面范围8 cm × 6 cm~30 cm × 18 cm。均伴跖骨缺损,缺损长度5~14 cm。切取腓骨皮瓣范围10 cm × 8 cm~16 cm × 12 cm,腓骨长度6~16 cm。 结果术后1例发生静脉危象,其余皮瓣全部成活。12例均获随访,随访时间1~3年,平均2年5个月。移植骨愈合时间4~6个月。末次随访时采用美国足踝外科协会(AOFAS)评分,为70~92分,平均81分。 结论游离腓骨皮瓣可一期修复前足复合组织缺损,是较理想的治疗方法。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • ANTEROLATERAL THIGH FLAP FOR REPAIR OF TOE EXTENSOR TENDON AND DORSAL FOOT WOUND

    Objective To summarize the method and the cl inical outcome of repairing both toe extensor tendon and dorsal foot wounds with anterolateral thigh flap. Methods Between February 2007 and May 2009, 11 patients with toe extensor tendon and dorsal foot defect were treated with anterolateral thigh flap. There were 8 males and 3 females with a medianage of 45 years (range, 10-60 years). The causes of injury were sharp injury in 3 cases, machine crush injury in 3 cases, and traffic accident injury in 5 cases, including 7 cases of fresh wounds with a disease duration of 2-8 hours and 4 cases of old wounds with a disease duration of 3-15 days. The size of wound ranged from 6 cm × 5 cm to 25 cm × 15 cm. All cases compl icated by toe extensor tendon defect, which were located at the 2nd-5th toes in 1 case, 3rd-5th toes in 1 case, 2nd-4th toes in 2 cases, 2nd and 3rd toes in 3 cases, 1st and 2nd toes in 1 case, and 1st toe in 3 cases. In the first stage, the anterolateral thigh flap ranged from 8 cm × 7 cm to 27 cm × 15 cm was used to repair defect and fascia lata was used to bridge two ends of digitorum longus tendon; the donor site was sutured or repaired with the skin graft. The second stage was performed after 2-3 months, tenolysis for tendon was performed, and fascia lata was spl it into tendon-l ike shape; and the toe functional exercises were done. Results All flaps survived completely after the first stage, wounds healed by first intention; the donor skin graft survived and incisions healed by first intention. At 7 days after the second stage, marginal necrosis occurred in 3 flaps (0.5-2.0 cm in width), and healed after 15-20 days of dressing change; the other flaps survived, and incisions healed by first intention. Eight patients were followed up 12-18 months (mean, 15 months). Excepts 4 sl ight bulky flaps, the other flaps had satisfactory appearance and soft texture with two points discrimination of 1-3 cm. During the follow-up, part of the dorsiflexion function recovered in 5 patients (5-40°), andflexion function was normal; 3 dorsiflexion function disappeared without effect on the function of toe flexion, and the patients could walk normally. No toe ptosis occurred. Conclusion Appl ication of the anterolateral thigh flap can repair toe extensor tendon and dorsal foot wounds with short treatment time and less damage at the donor site, so it can avoid toe ptosis after surgery and achieve excellent cl inical results.

    Release date:2016-08-31 05:43 Export PDF Favorites Scan
  • 延长血管蒂的逆行掌背动脉复合组织瓣修复手指复合组织缺损

    目的 总结采用延长血管蒂的逆行掌背动脉复合组织瓣修复手指近侧指间关节以远复合组织缺损的方法及疗效。 方法 2001 年2 月- 2008 年2 月,收治外伤所致手指近侧指间关节以远复合组织缺损17 例19 指。男13 例15 指,女4 例4 指;年龄17 ~ 59 岁,平均33 岁。示指7 指,中指8 指,环指4 指。伴肌腱缺损18 指,指骨缺损2 指。皮肤缺损范围为2.2 cm × 0.8 cm ~ 6.0 cm × 2.8 cm。受伤至手术时间为2 ~ 120 h。术中根据指背动脉在手指近节中段及远1/3 处与指掌侧固有动脉背侧分支相交通的解剖特点,设计延长血管蒂(蒂长1.0 ~ 1.5 cm)逆行掌背动脉皮瓣修复缺损,其中携带肌腱15 例17 指,骨瓣2 例2 指。皮瓣切取范围1.8 cm × 1.0 cm ~ 6.5 cm × 3.0 cm。供区直接缝合或全厚皮片游离植皮。 结果 术后4 例复合组织瓣发生静脉危象,对症处理后成活;其余复合组织瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合,植皮成活。术后患者均获随访,随访时间3 ~ 12 个月,平均5 个月。皮瓣质地佳、外形良好,颜色接近正常皮肤。手部功能按手外科功能评价标准评定:优16 指,良2 指,可1 指,优良率为94.7%。 结论 延长血管蒂的逆行掌背动脉复合组织瓣具有切取简便、损伤小的优点,是修复手指近侧指间关节以远皮肤、肌腱及骨复合组织缺损的一种理想方法。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损

    目的 总结胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损的方法及疗效。 方 法 2006 年8 月- 2009 年3 月,采用胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损8 例。男6 例,女2 例;年龄5 ~ 69 岁。压砸伤3 例,交通事故伤5 例。左足3 例,右足5 例。皮肤缺损范围7 cm × 6 cm ~ 10 cm × 8 cm,跟腱缺损范围4.0 cm × 3.0 cm ~ 5.0 cm × 3.5 cm,跟骨缺损范围3 cm × 2 cm × 2 cm 和3 cm × 1 cm × 1 cm。受伤至手术时间为3 ~ 5 周。术中切取皮瓣范围为8 cm × 7 cm ~ 11 cm × 8 cm,肌腱瓣5 cm × 4 cm ~ 6 cm × 4 cm,骨瓣约5 cm × 1 cm × 1 cm 和4 cm × 1 cm × 1 cm。供区游离植皮修复。 结果 术后复合组织瓣及植皮均顺利成活,创面Ⅰ期愈合。8 例均获随访,随访时间8 ~ 15 个月,平均10 个月。皮瓣色泽、质地良好,跟后皮肤无破溃,患肢无提踵功能障碍,能自由行走。 结论 胫后动脉穿支蒂网状供血复合组织瓣可一期修复跟后皮肤、跟腱、跟骨复合组织缺损,手术操作简便,血供可靠。

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • CURATIVE EFFECT ANALYSIS OF SKIN FLAP AND ALLOGENEIC TENDON IN RECONSTRUCTING LIMBS FUNCTION OF COMPLEX SOFT-TISSUE DEFECT

    Objectives To investigate the curative effect of skin flap and allogenic tendon in reconstructing l imbs function of complex soft-tissue defect. Methods From May 2001 to December 2007, 43 cases of complex soft-tissue defect of l imbs were repaired by pedicled skin flaps, free skin flaps, cutaneous nerve nutrient vessel skin flaps and arterial island skin flaps for primary stage, then the function of the l imbs were reconstructed with allogeneic tendon after 2-3 months of skin flapoperation. There were 31 males and 12 females, aged 5-53 years(mean 25 years). Injury was caused by machine in 28 cases, by traffic accident in 14 cases and others in 1 case. There were 27 cases in upper l imb, 16 cases in lower l imb. Twenty-six cases compl icated by bone fracture, dislocation and bone defect, the most of bone defect were cortical bone defect. The sizes of skin and parenchyma defect were 9 cm × 4 cm to 37 cm × 11 cm, the length of tendon defect was 6 to 26 cm. The sizes of skin flaps were 10 cm × 5 cm to 39 cm × 12 cm. Allogeneic tendons were used 2-6 strips(mean 4 strips). Results Forty-three cases were followed up for 5-56 months (16 months on average), all flaps survived. The donor area healed by first intention, the incision healed by first intention in second operation, and no tendon rejection occurred. The cl inical heal ing time of fracture was 3-8 months, and the cl inical heal ing time of allograft was 6-8 months. Six cases were given tenolysis for adhesion of tendon after 3-5 months of tendon transplantation. The postoperative flexion of wrist joint was 20-50°, the extension was 20-45°. Articulatio metacarpophalangea and articulatio interphalangeae could extend completely. The flexion of articulatio metacarpophalangea of thumb was 20-45°, the flexion of articulatio interphalangeae was 30-70°. The flexion of articulatio metacarpophalangea and articulatio interphalangeae of the other fingers was 60-90°. The postoperative ankle can extend to neutral position, the neutral position of ankle was 30-50°. The flexion of articulatio metatarsophalangeae and articulatio interdigital was 20-40°. Theextension of articulatio metatarsophalangeae was 30-60°. Conclusion Through designing systematically treatment plan,practicing operation by stages, preventing adhesion of tendon actively and exercising function reasonably, the functions of l imbs reconstructed by allogenic tendon and skin flap can leads to satisfactory effect.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • ONE STAGE REPAIR AND RECONSTRUCTION FOR SEVERE DEEP BURNS WITH COMPOUND TISSUE DEFECTS OF UPPER LIMB

    In order to solve the difficult problems of repair and reconstruction for severe deep burns with compound tissue defects of upper limb, 26 cases were treated with transplantation of compound tissue flap, vascularized by anastomosis of blood vessel or by vascular pedicle. Several kinds of reparative and reconstructive procedure could be performed simultaneously. Not only the tissue defect was repaired, but also the upper limb function was reconstructed in one stage operation. Owing to the presence of abundant vascular supply from the vascularized compound tissue and primarily closing the wounds, the anti-infection potency was high, then it was suitable for such conditions as fresh severe deep burn with infection and compound tissue defects. As a result, this technique provided the best chance to save upper limb from amputation. The duration required for treatment could be markedly shortened. All the cases successed. The long-term functional recovery was satisfactory. This method provided the possibility to solve effectively the difficult problem dealing with the severe deep burns with compound tissue defects of upper limb.

    Release date:2016-09-01 11:07 Export PDF Favorites Scan
  • 膝上外侧动脉嵌合穿支皮瓣修复第一掌背复合组织缺损

    目的总结膝上外侧动脉嵌合穿支皮瓣修复第1掌背复合组织缺损的疗效。 方法2008年3月-2012年12月,采用膝上外侧动脉嵌合穿支皮瓣修复第1掌背复合组织缺损5例。男4例,女1例;年龄16~42岁,平均29岁。机器挤压伤2例,机器压砸伤3例。皮肤软组织缺损范围4 cm×3 cm~7 cm×6 cm;骨缺损范围1.4 cm×1.3 cm~2.4 cm×1.6 cm;肌腱缺损长度2~4 cm。术中骨瓣切取范围1.5 cm×1.4 cm~2.5 cm×1.8 cm,皮瓣切取范围5 cm×4 cm~8 cm×7 cm;髂胫束切取长度3~5 cm。1例同时行环指屈指浅肌腱转移重建拇外展功能。供区直接缝合。 结果术后皮瓣均成活,创面Ⅰ期愈合;供区切口均Ⅰ期愈合。5例均获随访,随访时间6~12个月,平均8个月。皮瓣质地柔软;骨愈合时间3~5个月,平均4个月。术后6个月,根据中华医学会手外科学会上肢部分功能评定试用标准评定:优3例,良2例。供区无瘢痕挛缩,无活动障碍。 结论膝上外侧动脉嵌合穿支皮瓣可一期修复第1掌背复合组织缺损,有利于早期功能锻炼,促进手部功能恢复,供区损伤小。

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  • REPAIR OF COMPOSITE TISSUE DEFECTS OF DORSAL THUMB INCLUDING INTERPHALANGEAL JOINT BY TRANSPLANTATION OF MODIFIED HALLUX TOE-NAIL COMPOSITE TISSUE FLAP

    ObjectiveTo explore a new improved technique and its effectiveness to repair dorsal thumb composite tissue defects including interphalangeal joint by transplantation of modified hallux toe-nail composite tissue flap. MethodsThe hallux toe-nail composite tissue flap carrying distal half hallux proximal phalanx, extensor hallucis longus, and interphalangeal joint capsule were designed and applied to repair the dorsal skin, nails, and interphalangeal joint defect of thumb in 14 cases between January 2007 and June 2013. They were all males, aged from 19 to 52 years (mean, 30 years). The time from injury to hospital was 0.5-2.0 hours (mean, 1.2 hours). The area of the thumb nail and dorsal skin defects ranged from 2.5 cm×1.5 cm to 5.0 cm×2.5 cm. The dorsal interphalangeal joint had different degrees of bone defect, with residual bone and joint capsule at the palm side. The length of bone defect ranged from 2.5 to 4.0 cm (mean, 3.4 cm). The hallux nail flap size ranged from 3.0 cm×2.0 cm to 6.0 cm×3.0 cm. The donor sites were repaired by skin grafting in 5 cases, and retrograde second dorsal metatarsal artery island flap in 9 cases. ResultsAfter operation, arterial crisis occurred in 1 case and the flap survived after relieving pressure; the other flaps survived, and wounds healed by first intention. Liquefaction necrosis of the skin grafting at donor site occurred in 3 cases, and the other skin grafting and all retrograde second dorsal metatarsal artery island flaps survived. The follow-up ranged from 9 months to 3 years and 6 months (mean, 23 months). The secondary plastic operation was performed in 4 cases at 6 months after operation because of slightly bulky composite tissue flaps. The other composite tissue flaps had good appearance, color, and texture. The growth of the nail was good in 12 cases, and slightly thickened in 2 cases. At last follow-up, X-ray examination showed that bone graft and proximal phalanx of the thumb had good bone healing in 12 cases. Good bone healing was obtained at the donor site. According to the Hand Surgical Branch of Chinese Medical Association standard for thumb and finger reconstruction function, the results were excellent in 12 cases and good in 2 cases, and the excellent and good rate was 100%. No pain at donor site was observed, with normal gait. ConclusionTransplantation of modified hallux toe-nail composite tissue flap to repair dorsal thumb composite tissue defects including interphalangeal joint can effectively improve the appearance and function of the impaired thumb.

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  • 吻合血管腓骨皮瓣移植修复第一跖骨复合组织缺损

    目的总结以腓动脉为蒂的腓骨嵌合皮瓣移植修复第1跖骨复合组织缺损的疗效及其临床应用意义。 方法2010年5月-2014年4月,采用游离以腓动脉为蒂的腓骨嵌合皮瓣移植修复第1跖骨复合组织缺损8例。男6例,女2例;年龄34~47岁,平均38岁。致伤原因:交通事故伤4例,重物砸伤2例,骨肿瘤1例,骨髓炎1例。跖骨缺损范围4.2~7.3 cm,软组织缺损范围5 cm×3 cm~10 cm×5 cm;腓骨切取范围5~9 cm,皮瓣切取范围6 cm×4 cm~9 cm×6 cm。供区拉拢缝合3例,植皮修复5例。 结果术后皮瓣全部成活,受区及供区切口均Ⅰ期愈合。8例患者均获随访,随访时间5~18个月,平均11.5个月。皮瓣外形良好,质地耐磨;皮瓣两点辨别觉为3~5 mm。供区踝关节功能活动及稳定性良好。X线片及CT示术后3~6个月获骨性愈合;移植腓骨皮质逐渐增厚,直径增粗,9~18个月(平均13个月)后接近健侧第1跖骨直径。末次随访时根据Maryland足功能评定标准,优6例,良2例。 结论采用以腓动脉为蒂的腓骨嵌合皮瓣移植修复第1跖骨复合组织缺损,具有操作简便、恢复快等优点,是重建足部负重区及周围软组织缺损的有效方法。

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