Fifty cases of adult cadaveric subscapular arteries and its circumflex scapulae branches and from 102 of adult skelet on the axillary border of scapulae were measured. The results were that: the external diameter of the subscapular artery was 4.3cm with the length of 2.9cm; the axillary border of the scapula was 13.4cm; the thicknesses of the upper 1/3, middle 1/3, and lower 1/3were 13.9cm,11.0cm, and 7.4cm respectively. From the results of measurement, the subscapular artery pedicled graft of axillary border of scapular could be designed for repair the defects of upper or middle ments of humerus.
Seven cases with bone tumor in upper limb were reported. Five cases were treated by using free vascularized fibular graft, 2 cases by using fusion between humorus and clavicle. A follow-up study of six patients showed that the graft bone was united within 3 months in 5 cases, in 6 months in one case. Partial function of upper limb in 6 patients have been restored.
Deloyers method was pcrformed in 17 cases from 1968-1991 with satisfactory results. Some technical problems were discussed. The author recognized that the technique was excellent because the ileocecal valve and part of the ascending colon were preserved. Thus ensuring the absorption of water, the electrolyses and the nutrition. This method were used for the long type Hirchsprung s disease, however, could also be used in some common types and the cases equiring resection part of the rect, sigmoid colon, descending colon and the transverse colon.
This paper reported the use of superficial temporal vessels pedicled postauricular island flap for the reconstruction of eye socket. Six cases were treated by this method since 1988 with universal satisfactory results. The disign of the flap was diseribed. The operative procedure was detailed, and the advantages of the flap were evaluated: 1. The donor defect was hidden behind the ear; 2. The flap has a relatively long pedicle, hence easy for distant transfer, and 3. the blood supply was highly reliable.
This article reported 4 cases of reconstrution of the superficial palmar arch from transplantation of the vein arch of the dorsalis pedis by microsurgery. This technique was best reserved for those having significant damage of the palmar vesels. There were no arterial failures in these patients. The operative indications and some problems about the arterialized vein arch were discussed.
It was a difficult clinical problem to repair the defects of the distal part of the foot. Since 1987, We had used the reversed first dorsal metatarsal artery island flap in 4 cases, the results were satisfactory. The surgical anatomy, design and harvest of the flap were introduced, and it s blood supply and circulation, indication and main advantages were also discussed.
Eighteen cases with hand injury were repaired by 20 pediclcd over-thin skin flaps with success. The area of pedicled skin flap is from 1.5×1.2 to 12×8.5cm. The pedicles of skin flap were divided at 5-7 days postoperation after clamp training of the pedicle, and the flap all survived. The operative method is introduced and the mechanism of skin flap survival is discussed.
Objective To explore an improved method of surgical operation for reposition of the articular surface with Type Ⅲ Pilon fractures. Methods From January 1999 to December 2005, 20 patients (22 sides) with Type Ⅲ Pilon fractures were treated with the delayed open reduction and the internal fixation, which took the superior articular surface of the talus as a templet so as to reposition the lower articular surface of the tibia, strengthen the bone transplantation, fasten the internal fixation, and make an early functional exercise possible. Complete data were obtained from 16 of the patients with 18 sides (13 males,15 sides; 3 females, 3 sides; age, 14-48 years). The injury due to a fallingaccident was found in 12 patients (14 sides), and due to a traffic accident in 4patients (4 sides). Results The healing of the first intention was achieved in 14 sides, the delayed healing in 3 sides, and the infection in 1 side. The follow-up of all the 16 patients for 971 months (average, 22 months) including the X-ray examinations revealed that no screw for the internal fixation entering the articular cavity. According to the Teeny’s judging standards of radiology evaluating the result of the surgery for Pilon fractures, the anatomical reduction of the related articular surface was found in 77.8% of the sides (14/18) and thehealing of the first intention (stage Ⅰ) in 94.4% (17/18). According to the Mazur’s criteria, an excellent result was obtained in 5 sides, good in 7, fair in 5, and poor in 1. The excellent and good result was 66.7%. Conclusion Propermanagement of the injured soft tissues, prompt recovery of the tibial distant plateau height, and accurate reposition of the articular surface, enough transplant bone for the solid support, b internal fixation for the distant tibial anatomical structure, and early functional exercise are the key points to the successful operation.