Objective To study the operative procedure and effect of arthroscopic reconstruction of both anterior cruciate l igament (ACL) and posterior cruciate l igament (PCL) with anterior tibial is tendon allograft. Methods From February 2005 to July 2006, 10 cases of both ACL and PCL rupture were reconstructed with anterior tibial is tendon allograft, including 7 men and 3 women, aging 18-45 years with an average of 30.2 years. The locations were left knee in 6 cases and right knee in 4 cases. All of them had identified trauma history. The disease course was about 1-3 weeks (mean 1.8 weeks). Both ACLand PCL were reconstructed under arthroscope with allograft anterior tibial is tendon of 26-28 cm in length and immobil ization with extention position brace was given for 4 weeks after operation. The active flex knee exercise was done from 0-90° at 4 weeks and more than 90° at 6 weeks. Results All operations were finished successfully, there were no blood vessel and nerve injury. The operative time was 90-110 minutes (mean 100 minutes). The wound healed by first intention and no early compl ication occurred. Ten cases were followed up for 12 months to 15 months with an average of 13.5 months. Thier gait was normal, knee activity degree was 0-135°. The anterior drawing tests and media and lateral stress tests were negative after operation in 10 cases; and the posterior drawing tests were negative in 8 cases and 2 cases was at grade I. Hydra arthrosis of knee occurred in 2 cases and was cured after remove of fluid and injection of sodium hyaluronate. The Lysholm knee function score was increases from 24.89 ± 5.39 before operation to 96.00 ± 4.59 at 12 months after operation, showing significant difference (P lt; 0.05). Conclusion Arthroscopic reconstruction of both ACL and PCL with anterior tibial is tendon allograft has the advantages of short operation time, less compl ications and good cl inical effects.
Objective To introduce the free multiple flaps of lowerextremity based on the anterior tibital vascular pedicle for primary repair of the complex burned hand deformities.Methods From September 2000 to February 2003, the lateral leg flap, dosalis pedis flap and trimmed first toe based on the anterior tibial vascular pedicle were utilized to reconstruct the thumb and repair the first web, thenar, wrist or palmar scar contracture simultaneously in 6 patients. The flap size of lateral leg and dosalis pedis ranged from 4 cm×10 cm to 7 cm×10 cm and from 5 cm×10 cm to 9 cm×12 cm, respectively.Resutls Six cases were treated and followed up for 6 weeks to 1 year. The transplanted flaps survived with satisfactory recovery in function and appearance of theburned hand. The function of donor lower extremity was not damaged. Conclusion The procedure of the free multiple flaps of lower extremity based on the anterior tibial vascular pedicle is reliable and effective for primaryrepair of burned hand.
In order to investigate the blood supply of osteo-periosteal flap of lateral inferior part of tibia, 40 lower limbs of adult cadavers were observed. The result showed that the superior malleolar branch was the biggest branch on the lateral inferior part of tibia and served as the main blood supply to the above area. It originated from the anterior tibial artery, 3.1 +/- 0.8 cm above the intermalleolar line. During its way to the anterior border of the tibia, it gave out the ascending and descending branches. The ascending branch was along the anterior border upward and anastomosed with the musculo-periosteol branch of the anterior tibial artery at the level of 6.3 +/- 1.3 cm above the intermalleolar line. The decending branch was anastomosed with the anterior medial malleolar artery. For the anastomosis between the superior malleolar branch with the peripheral vessels, the osteo-periosteol flap could be designed at the lateral side of the lower part of tibia in size of 8-10 cm x 4-6 cm. This was a new donor area of osteo-periosteol flap for repair of non-union of bone in lower end of tibia or arthrodesis of the ankle joint.