A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the ...A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the poste- rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dots myocutaneous flap was elevated with a T-shaped vascular pedicle and was in- terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto- moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap＇s T-shaped vascularpedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur- vived completely. After 3-years＇ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery ofcontralateral leg was demonstrated patent by clinical and Doppler examinations.展开更多
A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolu...A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.展开更多
Objective： To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods： The statistical analysi...Objective： To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods： The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results： Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant （106, 52.5%）, followed by suicide （49, 24.3%） and accident （44, 21.8%）. The majority of suicide-induced death were byfalling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion： Studies on the morphology and its forma- tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.展开更多
文摘A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the poste- rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dots myocutaneous flap was elevated with a T-shaped vascular pedicle and was in- terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto- moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap＇s T-shaped vascularpedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur- vived completely. After 3-years＇ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery ofcontralateral leg was demonstrated patent by clinical and Doppler examinations.
文摘A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.
文摘Objective： To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods： The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results： Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant （106, 52.5%）, followed by suicide （49, 24.3%） and accident （44, 21.8%）. The majority of suicide-induced death were byfalling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion： Studies on the morphology and its forma- tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.
