Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applie...Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applied for coverage of the soft tissue defects over the lower one-third of the leg,the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The larges area of the soft tissue defect was 5 cm × 7 cm. The smallest was 3 cm × 4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion ThisChina Medical Abstracts(Surgery) technigue is a simple and complication are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue展开更多
Summary： In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried o...Summary： In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years （14-83 years） and with a medium followp period of 18 months （12-24 months）. Of all the cases of acute trauma, there were 10 eases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes （2 cases）, advanced age （〉65 years, 3 cases） and ciga- rette smoking （6 cases）. The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.展开更多
目的总结评估程序化松解处理内侧挛缩组织在屈曲型膝内翻患者初次全膝置换术中的临床疗效。方法回顾性分析2015年3月至2017年3月我院收治的68例(82膝)屈曲型膝内翻患者,其中男21例(26膝),女47例(56膝),年龄61~78岁,均采用全膝关节置换...目的总结评估程序化松解处理内侧挛缩组织在屈曲型膝内翻患者初次全膝置换术中的临床疗效。方法回顾性分析2015年3月至2017年3月我院收治的68例(82膝)屈曲型膝内翻患者,其中男21例(26膝),女47例(56膝),年龄61~78岁,均采用全膝关节置换术治疗。所有患者均由同一医生主刀完成,术中程序化处理内侧挛缩组织。记录术前和末次随访的膝关节功能评分(knee society score,HSS)、疼痛目测类比评分(visual analogue score,VAS)、膝关节伸屈活动度和膝关节内翻角。观察X线片表现,评估膝关节假体位置。结果均获随访,随访时间5年以上。68例患者未出现感染、松动和假体周围骨折等并发症。与术前比较,末次随访时的KSS、VAS、膝关节伸屈活动度和膝关节内翻角有明显改善,差异均有统计学意义(P<0.05)。末次随访X线片显示假体位置良好。结论在初次全膝关节置换治疗屈曲型膝内翻患者中,程序化处理内侧挛缩组织可达到创伤适度、有效平衡、并发症少和重建理想的膝关节功能的目的。展开更多
文摘Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applied for coverage of the soft tissue defects over the lower one-third of the leg,the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The larges area of the soft tissue defect was 5 cm × 7 cm. The smallest was 3 cm × 4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion ThisChina Medical Abstracts(Surgery) technigue is a simple and complication are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue
文摘Summary： In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years （14-83 years） and with a medium followp period of 18 months （12-24 months）. Of all the cases of acute trauma, there were 10 eases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes （2 cases）, advanced age （〉65 years, 3 cases） and ciga- rette smoking （6 cases）. The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.
文摘目的总结评估程序化松解处理内侧挛缩组织在屈曲型膝内翻患者初次全膝置换术中的临床疗效。方法回顾性分析2015年3月至2017年3月我院收治的68例(82膝)屈曲型膝内翻患者,其中男21例(26膝),女47例(56膝),年龄61~78岁,均采用全膝关节置换术治疗。所有患者均由同一医生主刀完成,术中程序化处理内侧挛缩组织。记录术前和末次随访的膝关节功能评分(knee society score,HSS)、疼痛目测类比评分(visual analogue score,VAS)、膝关节伸屈活动度和膝关节内翻角。观察X线片表现,评估膝关节假体位置。结果均获随访,随访时间5年以上。68例患者未出现感染、松动和假体周围骨折等并发症。与术前比较,末次随访时的KSS、VAS、膝关节伸屈活动度和膝关节内翻角有明显改善,差异均有统计学意义(P<0.05)。末次随访X线片显示假体位置良好。结论在初次全膝关节置换治疗屈曲型膝内翻患者中,程序化处理内侧挛缩组织可达到创伤适度、有效平衡、并发症少和重建理想的膝关节功能的目的。
