Objective To assess the long-time results of reconstruction of the extensor pollicis longus (EPL) function by transfer of the extensorindicis(EI). Methods From August 1978 to March 2003, 46 cases of loss of the EPL function were treatedby transfer of the extensor indicis. Of 46 cases, there were 32 males and 14 females, aged 16-51 years with an average of 36 years; there were 24 cases of oldtraumatic rupture and 22 cases of secondary rupture. The disease course was 2 days to 5 months, averaged 74 days. A specific EIEPL evaluation method (SEEM) wasused to measure the EPL function after transfer.Results Fortyone cases were followed up 9 years and 3 months on average (7 months to 23 years). Based on the SEEM, the results were excellent and good in 39 of 41 patients. The elevation deficit and combined flexion deficit were 0-2.2 cm (1.8 cm on average) and 0-3 cm (1.6 cm on average); the independent extension deficit was 0°-8° (5° on average). Conclusion Restoration of the extensor pollicis function by transfer of the extensor indicis is an effective and safe treatment option and the SEEM is a valid method for assessing EPL function.
Objective To investigate the clinicalvalue of modified Weaver-Dunn technique in repair of acute acromioclavicular dislocation. Methods From January 1993 to December 1998, 18 cases of acromioclavicular dislocation were treated bymodified Weaver-Dunn technique, and other 17 cases of the same suffering were treated by tension band fixation of the acromioclavicular joints. All of the patients were followed up for 12-36 months before clinical evaluation of the functionof shoulder joints, according to University of Pennsylvanian Shoulder Score System. Results In short term, the shoulder joints recovered much more rapidly in the cases repaired by modified Weaver-Dunn technique; 12, 24 and 36 months after operation, the scores of the cases repaired by modified Weaver-Dunn technique were (1897±67), (193.7±3.6) and (194.7±3.4) respectively according to the Shoulder Score System, while those of the cases treated by tension band fixation were (167.3±7.8), (170.2±6.3) and (165.6±5.9) respectively. The above data indicated that there was significant difference between two groups (P＜0.05). Conclusion The modified Weaver-Dunn technique was a better surgical approach than tension band fixation for repair of acute acromioclavicular dislocation.
A new method of transfer of the nasolabial skin flap, the myocutaneous flap with pediculated guadratus labii superioris muscle was introduced. It was applied in 9 cases mid-face defects with satisfactory results. The applied anatomy and the its operative technique were briefly discussed.
Since February 1987, reconstruction of the brest by transposition of the contralateral half-brest with myocutaneous flap of pectoralis major muscle was used in 4 cases with successful results. The operation was suitable for those patients having radical mastectomy for early carcinoma of brest, and it was particularly feasible in those patients having benign lesions, trauma or other disorders causing absence of brest, and especially for those patients who had a huse brest of the contralateral side.
Objective To study the method and effect of free rectusabdominis muscle flaps with intermediate split thickness skin graft in repairing defects on legs and ankles.Methods From May 1998 to December 2002, 11 cases of defects on legs(2 cases) and on ankles( 9 cases) were repaired by use of unilateral free rectus abdominis flap with skin graft. The soft tissue defects were accompanied by osteomyelitis or the exposure of bone or tendon.The disease course was 1 month to 10 years. The defect size ranged 3 cm×4 cm to 8 cm×14 cm. The area ofrectus abdominis muscle flaps was 4 cm×6 cm to 8 cm×15 cm. Results All patients were followed up 6 months to 4 years after operation. All rectusabdominis flaps survived with good appearances and functions.The primary healing was achieved in 8 cases, intermediate split thickness skin graft necrosed in 3 cases and the wound healed after skin re-graft.Conclusion Free rectus abdominis flap is a proper option for repair of the soft tissue defects or irregular woundson legs and ankles. It has the advantages of abundant blood supply, b anti-infection ability, good compliance and satisfied appearance.
OBJECTIVE: To evaluate the clinical application of primary transfer of pectoralis major to reconstruct the elbow flexion and shoulder abduction. METHODS: 12 cases of old injury of branchial plexus with dysfunction of both elbow and shoulder joints were received surgical operation to reconstruct the palsy joints by primary transfer of pectoralis major, shoulder abduction was reconstructed by clavicular head and elbow flexion by sternal head respectively. All cases were followed up for 5 to 18 months. RESULTS: The function of both joints recovered obviously, the total superior rate is 91.7%. CONCLUSION: Only if the palsy joints, shoulder or elbow, remained normal or almost normal passive motion, and the muscle power of pectoralis major over 4 degrees, the primary transfer of pectoralis major should be a simple, reliable and convenient technique to reconstruct the palsy joints.
OBJECTIVE: To investigate surgical reconstruction of stability of lower cervical spine in children suffering trauma, tuberculosis and tumor. METHODS: From January 1998 to September 2001, 8 cases of unstable lower cervical spine were treated by operations, of anterior decompression, massive iliac bone grafting, posterior fixation with spinous process tension band wiring, and fusion with heterogeneous iliac bone grafting. RESULTS: With an average following up of 1 year and 9 months (6 months to 4 years and 3 months), 3 cases recovered excellently, 4 cases recovered well and 1 case died of pulmonary infection. CONCLUSION: The above results indicate that anterior decompression, massive iliac bone grafting, posterior fixation with spinous process tension band wiring and fusion with heterogeneous iliac bone grafting can be used as one of the methods to reconstruct the stability of lower cervical spine in children.
Objective To investigate the feasibility of reconstruction of the contracted eye socket by an application of the expanded forehead island skin flap with the supratrochlear and supraorbital arteries. Methods From June 2002 to June 2005, 6 patients with the eye socket defects were treated with an expanded forehead island skin flap with the supratrochlear and supraorbital arteries.There were 4 males and 2 females, aged 16-42 years. The defects were caused bytumors in 2 patients, by trauma in 3, and by chemical burns in 1; the defects were in the left eyes of 4 patients and in the right eyes of the remaining 2 patients, with the illness course of 1 year to 4 years.All the patients first underwent the skin and soft tissue expanding operation on the donor forehead skin area; 1 month later, the transplant of the expanded forehead island skin flap with the supratrochlear and supraorbital arteries was performed to reconstruct the eye sockets. The flaps ranged in size from 8 cm×5 cm to 10 cm×6 cm.The appearance and functional recovery of the reconstructed eye sockets were observed after operation. Results The follow-up of all the patients for 1-3 years revealed that the skin flaps survived, with no visible contracture, and the fine sensory function was still present. The artificial eyes could be steadily placed in the reconstructed eye sockets. The donor areas were healed with no visible hyperplastic scars. Conclusion Reconstruction of the eye socket with an expanded forehead island skin flap with the supratrochlear and supraorbital arteries is a feasible, effective and simply method, and the patient can have a concealed incision, a satisfactory appearance, and a fine sensory function.
From 1979 to 1994, reparative and recons tructive surgery were used to repair the war injuries of skins, bones, blood vessels and nerves of the limbs in 800 cases. A systematic clinical study was carried out. Many new operative methods were used and the results of treatment were good. Innovations and modifications were made in technique. In 120 cases of warin juries having soft tissues defects including skin and muscles, various tissue transplantations were used with the hope to accomplish onestaged repair of the defect and reconstruction of motor function of muscle. To those infections of bone and joint in war injuries, following early eradication of infected focus, transplantation of musculocutaneous flap or omental graft was immediately carried out with the aim to obtain primary healing of the wound. In the treatment of bone defects from war wounds with loss of skin and muscles, the vascularized skeletocutaneous graft was used. In the treatment of 150 cases of injury of peripheral nerve from forearms, the result of good to fair rated 68.8 percent for upper extremity and that for lower extremity, it was 62.2 percent. Following the early repair of 500 cases of injury of peripheral blood vessels, the patency rate of the blood vessel was 90 percent. The result following by pass vascular graft in the treatment of forearms injury of blood vessels even with very poor local condition was still very successful.
For the reconstruction of lacrimal passage in obligue facial cleft, three methods were performed in 4 cases. According to the difference in local pathology canaliculorhinestomy, transfer of vein or oral mucosa, or modified dacryocystorhinostomy was performed. The patients were followed for 6 to 12 months with satisfacting results.