Objective To evaluate the effectiveness of interference screw and flexor hallucis longus tendon as augmentation material in repair of chronic Achilles tendon rupture. Methods From October 2004 to June 2007, 32 patients (35 feet) with chronic Achilles tendon rupture were treated, including 21 males (22 feet) and 11 females (13 feet) and aging 32-85 years. The disease course was 4-132 days. There were 29 patients with hoofl ike movements history and 3 patients withoutobvious inducement. The result of Thompson test was positive in 31 cases (33 feet). The score was 56.09 ± 7.25 according to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scoring system (AOFAS). MRI indicated that the gap of the chronic Achilles tendon rupture was 0.5-5.0 cm. Medial foot incision associated with medial heel incision or only medial heel incision was made to harvest flexor hallucis longus tendon. The tendon should be 3 cm longer than the end of the Achilles tendon, then fix the tendon to the calcaneus. Results Wound dehiscence occurred and wound healed after dressing change in 1 case; wound healed by first intention in other patients. Thirty-two patients were followed up for 12-32 months (mean 19.4 months). The AOFAS score was 94.22 ± 4.63, showing statistically significant difference when compared with that before operation (P lt; 0.01). The results were excellent in 28 cases, good in 3 cases and fair in 1 case. No sural nerve injury, posterior tibial nerve injury, plantar painful scar, medial plantar nerve injury and lateral plantar nerve injury occurred. Conclusion Flexor hallucis longus tendon transfer offers a desirable outcome in operative recovery, tendon fixation and compl ications.
ObjectiveTo explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect.MethodsBetween January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years (range, 11-72 years). The primary tumor included pigmented nevus in 18 cases, basal cell carcinoma in 4 cases, and squamous cell carcinoma in 1 case. The defect location was nose in 8 cases, cheek in 4 cases, malar in 6 cases, forehead in 2 cases, and upper lip in 3 cases. The defect ranged from 0.8 cm×0.8 cm to 3.9 cm×3.9 cm. According to the location and size of facial tumors, the resection area of square lesions was designed. According to the mobility of surrounding tissues and the direction of dermatoglyphic lines, the rhomboid flaps with an angle of 45–60° was designed to repair the defect by tension-free rotation.ResultsAll the flaps survived and the incision healed by first intension. All patients were followed up 3-15 months (mean, 7.3 months). During follow-up, no tumor reoccurred; the color and texture of the flaps were similar with surrounding tissue. There was no obvious scar hyperplasia, nor traction of adjacent normal tissues, and patients were satisfied with the appearance.ConclusionThe application of modified rhomboid flaps in repairing facial skin and soft tissue defects caused by resection of round facial tumor has the advantages of flexible design, simple manipulation, and less trauma.