Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor sit...Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.展开更多
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
文摘Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.
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.
