显微单株毛发缝合式移植治疗眉毛缺损

目的：寻求一种简单的毛发移植修复眉毛缺损的方法。方法：先在枕后发标内切取一条带毛发的完整头皮,在显微镜下,用显微器械把每一扰毛发连同毛囊完整分离出;用普通的缝合针或特制的植毛针把带完整毛囊的毛发缝植于眉毛缺损处。结果：所有18例29只眉毛通过本方法移植 均取得成功。结论：因每根移植的毛发的带完整的毛囊,成活率高;并控制毛发生长的方向及疏密度,取得近似真眉毛的效果。     

单株毛发游离移植治疗睫毛缺损

目的：寻求一种治疗睫毛缺损的简单有效的手术方法。方法：在耳后或枕后发际内切取一条带毛发的完整头皮。利用特殊器械将毛千及毛囊完整分离，用植毛针把带完整毛囊的毛发移植于睫毛缺损处。结果：30例52只眼睫毛缺损通过本方法治疗均取得良好疗效。结论：每根移植的毛发均带完整的毛囊，成活率高，并可控制毛发的生长方向及密度，可取得近似真睫毛的效果。     

自体毛发显微移植治疗眉毛缺损

目的 探讨自体毛发显微毛囊移植治疗眉毛缺损的方法及疗效.方法 在耳后或枕部距发际线2cm内的毛发安全供区切取约8cm×1cm的头皮条,制备显微毛囊移植单位,并移植于眉部受区.自2008年10月至2010年11月,共治疗各种类型眉毛稀疏、缺损患者20例.结果 本组20例患者(32只眉毛),均Ⅰ期完成手术.随访18例患者6～12个月,移植毛发成活良好,毛发生长方向自然,密度均匀.结论 利用自体毛发显微毛囊移植治疗眉毛缺损,移植成活率高,外观自然,值得临床推广.     

毛发移植术在治疗小面积外伤性眉缺损中的应用

目的：探讨应用毛发移植技术治疗小面积眉缺损的疗效。方法：18例小面积眉缺损患者,均为单侧眉缺损,眉毛缺损面积为0.5×0.5cm～1.0×1.0cm。在局麻下从耳后发际内或颞部获取单体毛囊,按照原有眉毛的生长方向植入眉毛缺损处。结果：18例患者术后随访3～10个月。未见移植的眉毛明显脱落,植入的眉毛生长良好,需要7天左右修剪一次。两侧眉毛对称。所有患者对术后效果表示满意。结论：应用单体毛囊移植治疗小面积眉毛缺损,能再造出与对侧健康眉毛相似的眉毛,效果良好。     

自体单株毛囊种植修复眉毛部分缺损

目的:探索应用自体单株毛囊种植修复眉毛部分缺损的效果。方法:对35例女性患者,采用枕后安全区头皮,制成毛干长1cm的单株移植物,利用针头穿刺打孔将毛发移植到缺损处以修复形态,为了使形态协调一致,每侧眉毛中部种植30～40根毛发。结果:植入毛发生长良好,方向形态满意,移植毛发成活率在90%以上。结论:自体单株毛囊移植修复眉毛部分缺损是一个适宜的方法。     

毛发移植修复外伤后眉缺损的临床观察

目的 观察因外伤、烧伤等致眉毛缺损的患者,采用自体单株毛囊种植修复的临床效果.方法 对73例因外伤或烧伤造成眉弓区瘢痕,或经游离皮肤移植及皮瓣、扩张皮瓣修复后致眉毛缺损的患者,根据所需移植物大小,相应地选用21 G或22 G注射器针头穿刺打孔,在针头退出的同时,用显微镊植入制备好的单株毛囊,修复其形态.结果 本组共73例患者,其中4例术后出现毛囊炎,经用75％乙醇涂擦后痊愈.其余患者的植入毛发生长良好,方向及形态满意,成活率在90％以上.结论 对于外伤、烧伤后致眉缺损的患者,采用自体单株毛囊种植修复技术,虽然在操作上有一定难度,但仍以毛发移植修复为宜;对于眉弓区软组织条件不适合进行眉毛种植的患者,可以针对其原因进行治疗,然后采用毛发移植修复缺损,也能获得良好的效果.     

基于眶周形态及组织特点设计毛发移植治疗烧伤后眉缺损

目的总结基于眶周形态及组织特点设计毛发移植治疗烧伤后眉缺损的经验。方法回顾性分析2011年1月至2023年9月于中国医学科学院整形外科医院毛发移植中心治疗的烧伤后眉缺损患者的临床资料。根据烧伤后患者眶周形态和组织特点对眉毛的位置和形态进行设计:以枕部靠近后发际线处或耳后发际处为供区, 使用头皮条切取法或毛囊单位切取术(FUE)获取毛囊, 有头皮瘢痕需要切除或曾行头皮扩张手术有"猫耳"畸形需要修整的头皮也可以作为供区, 将毛囊分为含单根毛发的毛囊单位(FUs);用规格为21或22 G针头在受区穿刺打孔直至皮下浅层, 然后用显微镊夹持毛干部, 将毛发移植到受区, 以修复眉毛形态。术后对患者眉毛密度、形态和方向以及供区瘢痕情况进行观察和随访。结果共纳入197例患者(282条眉毛), 其中男133例, 女64例;年龄9～62岁, 平均33.7岁;眉弓区皮片移植术后17例, 皮瓣及扩张皮瓣修复术后33例, 眼睑部皮片移植术后36例, 烧伤创面瘢痕愈合111例;双侧眉完全缺失51例、部分缺损34例, 单侧眉完全缺失65例、部分缺损47例。282条眉毛的植发量为53～600 FUs, 其中采用头皮条...     

植皮区单株毛发移植修复眉毛缺损的观察

目的：观察单株毛发移植在植皮区的存活情况及再造眉毛的效果。方法：选择植皮区皮下软组织的厚度在3mm以上的患者,在枕后毛发安全供区（SDA）内局麻下切取一条带毛发的完整头皮。助手利用刀具分离出单株毛发,种植区肿胀麻醉后,术者用注射器针具按眉毛生长方向在植皮区上打孔,15～25孔／cm^2,将单株毛发种植于毛发缺损区。结果：2007～2009年间4例眉区植皮患者6只眉毛通过本方法治疗,术后随访9个月～2年,4只眉毛一次手术效果满意,2只眉毛需二次加密。所有毛发存活良好,毛发单次种植存活率接近90％,眉毛形态自然、美观。结论：在植皮区皮下软组织厚度3mm以上,密度15～25孔／cm^2的情况下,单株毛发移植在植皮区上的存活率接近90％,再造眉毛形态自然、美观。近似于真实眉毛效果。     

毛发单元移植行眉毛美容性修复再造

目的 探索应用毛发单元移植技术治疗各种原因所引起的眉毛永久性缺损。方法 切取后近发际区域处含有完整毛发毛囊的条形头皮组织，在手术放大镜下，将其分割，制备成毛发单元（每单元含1-3根毛发）即显微毛发移植物。然后，将这些植物按眉的自然走向植入到眉毛脱失区内预制的洞穴中。结果 自1998年4月至2000年2月，共完成了32例48侧眉的美容性再造。所有患者一期手术均取得满意的美容效果。经1年以上的临床随访再造眉毛生长良好。即使在瘢痕区域内，成活率也可达到95%，再造的眉形态走向较自然，接近于正常的眉毛。结论 毛发单元移植技术再造的眉毛与其它方式相比，手术方法简便，创伤小，更加自然，是目前眉毛美容性再造的理想方法。     

采用FUE技术提取耳后发际缘毛囊行眉毛移植

目的探讨采用毛囊单位提取术提取耳后发际缘处毛囊进行眉毛移植的临床效果。方法对眉毛稀疏或眉毛部分缺失的25例患者采用直径为0.8 mm或0.9 mm的毛囊单位提取术提取针转取患者耳后发际缘处毛囊,4~6倍显微镜下将获取的毛囊分离成含有单根毛发的毛囊,采用23 G针具依照眉毛的自然生长方向打孔并将毛囊植入孔内。眉毛四周应用较细毛囊,眉中部应用较粗毛囊。结果 21例患者术后随访6个月以上,其中8例患者早期生长的毛发出现部分卷曲或方向不佳情况,但脱落后再次进入生长期的毛发生长良好;4例患者因眉毛移植密度不高进行了二次加密。6个月后,患者眉毛形态较佳,供区瘢痕基本难以察觉,所有患者对术后效果均较满意。结论采用毛囊单位提取术提取耳后发际缘处毛囊进行眉毛移植,具有方便挑选直径合适毛囊、供区创伤小和瘢痕不明显的优点,是眉毛种植的较佳选择。     

Minimally invasive retrocalcaneal bursa pressure measurement: development and pilot application

Up to now diagnosis of Haglund’s disease is based on patient’s history and clinical findings. There is no valid diagnostic tool described to functionally detect retrocalcaneal bursitis. Retrocalcaneal bursa pressure may be increased in these patients. We hypothesized that retrocalcaneal bursa pressure can directly be measured. In this pilot investigation we tested the feasibility of a system which is already in clinical use for arterial blood pressure monitoring to quantitatively assess retrocalcaneal bursa pressure in a human and a swine cadaver specimen and in vivo. Using the presented system retrocalcaneal bursa pressure measurement is demonstrated to be feasible. Moreover, intrabursal pressure is reproducibly and validly quantified. In an uninjured subject increasing ankle dorsiflexion was not associated with increasing pressure in the retrocalcaneal bursa. Experimental liquid injection in the retrocalcaneal bursa was associated with increased intrabursal pressure and increasing pain. Feasibility of the tested setup could be proven. The question, if retrocalcaneal bursitis can be distinguished from further heel pathologies by different pressures in the retrocalcaneal bursa has to be addressed in a subsequent in vivo study.     

Neurohistology of the subacromial bursa in rotator cuff tear

This study was undertaken to identify and quantitate neural elements in the human subacromial bursa. Biopsy specimens of subacromial bursae were obtained from patients with rotator cuff tears and from cadavers of patients with no history of shoulder disorder (controls). We used a modified gold chloride method to characterize neural elements within the subacromial bursa. The population of intrabursal neural elements was calculated by computerized image analysis. The subacromial bursa demonstrated an extensive neural network: four morphological types of mechanoreceptors and many free nerve endings were identified. In general, there was an inverse relationship between the population density of neural elements and the extent of cuff tear. The population density of neural elements of the subacromial bursa associated with massive cuff tear was significantly lower than that observed in control shoulders. With regard to clinical symptoms, a significant correlation was established between the population density of neural elements in the subacromial bursa and shoulder pain at rest. Our investigation strongly suggests that the subacromial bursa is intimately involved in the perception of shoulder pain, providing an anatomical basis for afferent neural input in proprioceptive reflex ares.     

Pressure recording in the subacromial bursa

The microcapillary infusion (MCI) technique was evaluated in monitoring pressure in the subacromial bursa in 30 shoulders in healthy volunteers. The total pressure in the bursa was studied as the volunteers held their arms at rest and as they lifted their arms and held them lifted with or without a weight of 1 kg in the hands. The pressure in the bursae at rest averaged 8 mm Hg and was found stable during a 40-min period. When the arms were lifted, the average bursa pressure increased from 8 to 39 mm Hg. As the arms were held up, the weights were put in the hands, and the average bursa pressure then further increased to 56 mm Hg. When the infusion catheters were repeatedly flushed, during a period of 5 min and with a total of 1.2 ml of saline, the average bursa pressure doubled regardless of arm position and load in the hands. The compliance of the bursae decreased from 0.09 to 0.04 ml/mm Hg when the arms were lifted and from 0.04 to 0.02 ml/mm Hg when the arms were lifted and the hands were loaded. The MCI method was found suitable for recording pressure in the subacromial bursa during exercise.     

Persistent congenital isolation of the suprapatellar pouch mimicking patellofemoral disease

A patient with congenital isolation of the suprapatellar bursa presented with pain suggestive of patellofemoral joint disease. At arthroscopy, injection filled only the bursa. The diagnosis of congenital isolation of the suprapatellar bursa was made by the injection of radiopaque material into the bursa. Excision of the bursa eliminated the symptoms. This case is instructive, as it documents an unusual congenital anomaly that can complicate arthroscopic technique and can be a rare cause of knee pain.     

The popliteal bursa (Baker's cyst): An arthroscopic perspective and the epidemiology

The purpose of this study was to establish the incidence of the anatomic structure, the popliteal bursa, in patients undergoing arthroscopy and to determine the relationship to associated clinical and pathological factors. Diagnostic arthroscopy was used to identify the presence of the popliteal bursa in 187 consecutive patients (195 knees). Thirty-seven percent of knees had a popliteal bursa identified by the communication with the posterior medial compartment. The cause of the popliteal bursa was not established by this study. This study refuted the causes proposed by others. The existing erroneous conclusions concerning the cause of the popliteal bursa were probably attributable to the failure to recognize the common continuity of the bursa and the knee joint. When the popliteal bursa is present (37%), it becomes symptomatic by responding to the intraarticular disease because of its continuity with the knee joint.     

Externe synoviale Fistel der Bursa infrapatellaris nach arthroskopischer meniskusresektion. Klinischer Fallbericht und topographisch-anatomische Studie

Following arthroscopic meniscectomy a 41-year old patient developed an external synovial fistula in the area of the central joint approach with a communication to the deep intrapatellar bursa. Anatomical preparations performed on 20 knee joints revealed extraordinary variations in the dimension of the infrapatellar bursa with a mean longitudinal diameter of 24 mm and a transversal diameter of 38 mm. The distance between bursa and the distal margin of the patella measured 15 to 39 mm. These topographic conditions lead to the assumption that the bursa is exposed to iatrogenic lesion by placing a central joint approach. Therefore a proximal incision is recommended for the central portal to avoid a lesion of the bursa with the potential risk of a postoperative fistula formation.     

Treatment of ischial pressure sores by means of sclerotherapy using absolute ethanol

The ischial region is a common site of pressure sore. The ischial pressure sore with a large subcutaneous bursa is resistant to conservative treatment and tends to require radical surgical treatment. In this article the authors describe their experience with a simple surgical treatment on 8 ischial pressure sores in 7 patients with subcutaneous bursa by means of sclerotherapy using absolute ethanol. This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. This alternative method has a possibility of treating pressure sores as well as other fistulous diseases in various areas.     

Enlarged iliopsoas bursa. An unusual cause of thigh mass and hip pain

Iliopsoas bursa enlargement, a rare cause of pelvic or inguinal mass, can be identified on computed tomography (CT) either incidentally or during clinical examination of a groin mass. When CT examination is equivocal, hip arthrography can establish the diagnosis. Iliopsoas bursa enlargement is frequently associated with preexisting hip arthrosis. In three cases of iliopsoas bursa enlargement, two had preexisting arthritis. A third patient showed no roentgenographic sign of hip disease. Iliopsoas bursa enlargement may be more common than previously reported and should be considered in patients with unexplained hip pain who demonstrate a soft tissue mass in the region of the iliopsoas bursa.     

An operation for chronic prepatellar bursitis.

An operation for chronic prepatellar bursitis is described in which only the posterior wall of the bursa is excised, thus preserving, undamaged, healthy and normally sensitive skin. This procedure is easier and less traumatic than complete excision of the bursa and results in fewer complications. It is suggested that removal of tha anterior wall of the bursa results in unnecessary and harmful interference with the underlying skin. The operation described gives a good functional and structural result; leaving the anterior wall of the bursa does not predispose to recurrence.     

Recalcitrant bicipital radial bursitis

Three of 12 nonrheumatoid patients with bicipital radial bursitis had recurrent and recalcitrant symptoms and underwent operative treatment. Preoperative computed tomogram showed an anterior distended synovial cyst at the level of the radial tubercle. Magnetic resonance imaging provided a superb demonstration of a bicipital radial bursa which communicated with the elbow joint below the annular ligament. Surgical exploration revealed a valvular mechanism between the distended bursa and the joint cavity. Excision of the distended bursa and closing the capsular defect lead to excellent results. An antecubital cyst resulting from an acute or chronic tear of the anterior capsule at the sacciform recess may communicate with the bicipital radial bursa and become the cause of recurrent and recalcitrant symptoms. Received: 24 September 1997