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141.
Abstract Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient
implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age.
In the last few years the locking plates and locking nails have been introduced into clinical practice with varying results.
The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality,
biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature. 相似文献
142.
143.
Uta Kraus-Tiefenbacher Lelia Bauer Antonella Scheda Carola Schoeber Joerg Schaefer Volker Steil Frederik Wenz 《BMC cancer》2007,7(1):178
Background
For patients suffering of recurrent breast cancer within the irradiated breast, generally mastectomy is recommended. The normal tissue tolerance does not permit a second full-dose course of radiotherapy to the entire breast after a second breast-conserving surgery (BCS). A novel option is to treat these patients with partial breast irradiation (PBI). This approach is based on the hypothesis that re-irradiation of a limited volume will be effective and result in an acceptable frequency of side effects. The following report presents a single center experience with intraoperative radiotherapy (IORT) during excision of recurrent breast cancer in the previously irradiated breast. 相似文献144.
145.
Mehmet Oguz Yenidunya Mustafa Erol Demirseren Serdar Gorkem Bulent Adil Tasbas Candemir Ceran 《European journal of plastic surgery》2007,29(7):327-330
Nonunion in the forearm following a radioulnar fracture is one of the nightmares of the orthopedic surgeon. Fortunately, it
is rare. We treated a large bone defect of the forearm, using a vascularized fibular graft after excision of the unhealed
bone segment in a 10-year-old boy with neurofibromatosis. This situation followed a double fracture that had been operated
on several times using conventional methods. Following the debridement of the unhealthy tissues in the pseudoarthrotic region,
the vascularized fibula was placed on the dorsal surface of the proximal radius fragment. The distal fragment of the radius
was inserted into the fibular cavity and fixation was established with a Kirschner wire distally and with a plate proximally.
Only two screws were used to fix the plate. The peroneal artery was anastomosed with the radial artery; one of its venae comitantes
was anastomosed with the cephalic vein in an end-to-end fashion. After surgery, the elbow was immobilized at 90 degrees of
flexion with a splint for 6 weeks. One year after surgery, forearm stabilization and elbow and hand functions were very satisfactory.
However, because the distal epiphyses of the bones were destroyed following the repeated surgery and the original trauma itself,
a very prominent difference between the two forearms occurred, suggesting the need for bone lengthening in the future. By
presenting this case we would like to conclude that one can expect good bone healing with a vascularized bone transfer in
these cases when there is not enough space to place screws, but support can be provided by an external splint and K wire. 相似文献
146.
Lee L. Q. Pu 《European journal of plastic surgery》2007,30(1):19-24
A soleus flap as a local reconstructive option for soft-tissue coverage of a tibial wound in the distal third of the leg has
never been well recognized. In a 2-year period, seven patients underwent reconstruction of a less extensive tibial wound (4 × 3
to 10 × 4 cm) in the distal third of the leg after orthopedic trauma with the laterally extended medial hemisoleus flap. The
flap was elevated with emphasis on the preservation of the most distal perforators from the posterior tibial vessels to the
flap as possible while allowing adequate rotation of the flap to cover the exposed tibia and/or hardware and on the possible
preservation of foot planter flexion by reconstruction of the proximal Achilles’ tendon. In this series, there was no total
or partial flap loss. All patients healed their tibial wounds primarily with reliable soft-tissue coverage, evidenced fracture
healing, and good cosmetic outcome during follow-up. Thus, the laterally extended medial hemisoleus flap described by the
author can be a reliable option for soft-tissue coverage of a less extensive tibial wound in the distal third of the leg.
It offers a more cost-effective approach for managing this unique problem and can be performed by most reconstructive surgeons
without microsurgical expertise. 相似文献
147.
Henri A. H. Winters Dorothea K. G. van Loenen 《European journal of plastic surgery》2007,29(5):205-208
Nowadays the vascularized free fibula flap and the free iliac crest flap are the methods most frequently used to reconstruct
the mandible. This is also the case in our clinic. A retrospective nonrandomized study was performed to compare both flaps.
The vascularized fibula free flap and the iliac crest free flap were compared in terms of logistics, flap failure, revisionary
surgery, donor site morbidity, and recipient site morbidity. No significant differences in flap failure and revision surgery
were found between the fibula group and the iliac crest group. Recipient site and donor site complications (major and minor)
were significantly less in the fibula group compared to the iliac crest group. In mandibular reconstruction, the free vascularized
fibula flap appears to be superior to the free vascularized iliac crest flap in terms of both recipient site and donor site
morbidity. 相似文献
148.
Birol Civelek H. İbrahim Inal Kubilay Ozdil Selim Celebioglu 《European journal of plastic surgery》2007,30(1):25-28
Skin is the most commonly used tissue for the transplantation. A meticulous care of the donor site is needed to prevent scarring,
delayed healing, and pain. Various agents and dressing materials have been reported to help healing of skin graft donor sites.
Sucralfate is an extensively used agent, which provides acute gastroprotection and acceleration of chronic ulcer healing.
In this study, we assessed the effects of topical sucralfate on the healing of the split thickness skin graft donor sites
in a prospective comparative way. The study was carried out on 32 randomly chosen patients undergoing surgery for various
causes and requiring split thickness skin graft resurfacing. The upper halves of the skin graft donor sites on the thighs
were simply covered with paraffin gauze and the lower half was covered with sucralfate-soaked paraffin gauzes. The day of
full epithelization varied from 6 to 9 days and 8–12 days on the sucralfate-applied areas and on the control sites, respectively.
The mean value of the healing was 7.01 days in the studied lower halves and 10.8 days in the upper halves. The healing rate
was strikingly faster and less painful on the sucralfate-applied areas. We were able to discharge patients earlier than usual,
and patients’ comfort increased. It seems that sucralfate is a promising topical agent to increase the healing rate and decrease
the incidence of associated problems such as pain and hypertrophic scar. 相似文献
149.
Evren Isci Halil Ibrahim Canter Abdullah Kecik 《European journal of plastic surgery》2007,30(1):45-46
Rabbits are the experimental animals of choice in many studies including flaps, wounds, and topical trials for new pharmacological
agents. Because the topical drugs and other materials used for dressing are irritating to the animal, they tend to remove
dressings, bandages, drapes, insensate flaps, and also topical drugs by scratching, licking, and biting if they are within
the reach of the animal. In this study, we report an easy to prepare, user-friendly, comfortable, and cheap dressing protector
called a dressing shield to prevent these problems. 相似文献
150.