以第二掌背动脉近、远端为双轴点的掌背部岛状皮瓣

目的　介绍一种改良的第二掌背动脉皮瓣的手术方法和适应证。方法　将以第二掌背动脉起点为轴点的中指背岛状皮瓣 ,改良为带有近、远端二个轴点的第二掌背部岛状皮瓣。远端轴点旋转180°即可使覆盖、斜跨于示指伸肌腱浅面掌背部皮瓣的近端翻至远端 ,延长了该皮瓣自第二掌背动脉起始部至皮瓣远端的距离 ;通过近端轴点的旋转使皮瓣能横向转移至拇指 ,经皮下隧道达到拇指指端。临床修复 7例拇指指端创面 ,皮瓣面积 1cm× 3cm～ 2cm× 5cm ,血管蒂长 6～ 7cm。结果　 7例皮瓣全部成活 ,修复的拇指外形满意、指关节伸屈同健侧。结论　该皮瓣的最佳适应证是修复拇指指端创面。     

游离股前外侧皮瓣修复肢体软组织缺损15例

目的 探讨游离股前外侧皮瓣修复肢体软组织缺损的临床效果。 方法 从１９９５年３月￣１９９６年１２月，应用股前外侧皮瓣治疗肢体组织缺损１５例。 结果 除１例术后放弃移植外，１４例皮瓣全部存活，没有出现血管危象，术后经６￣１８个月随访，２例手部修复者术后外形功能欠满意需作再次修整，其余１２例效果均满意。 结论 股前外侧皮瓣血供充分，部分隐蔽，血管口径粗，可切取面积大，有感觉神经，是修复除手部以外其它部     

A new technique for the correction of syndactyly of the toes

A new technique is described for the correction of complete syndactyly of the toes. In this technique, a distally-based dorsal metatarsal artery flap is used to cover one side of the released toes. The other side of the toe is covered with a laterally based dorsal toe flap. A case of complete syndactyly between the second toe and and the third toe is presented. Received: 11 May 1999 / Accepted: 12 August 1999     

The cascade flap for nasal tip repair

Summary A two flap repair of nasal tip and bridge defects is presented. The nasal bridge flap transposes down over the tip while a lower forehead or glabella flap hinges to the upper nose. These are random myocutaneous flaps and the design may be varied for different defects.     

上臂内外侧轴型皮瓣间血供的显微外科解剖学

在手术显微镜下,上臂内外侧轴型皮瓣间供血可分为三层:真皮下血管网;浅筋膜深层血管网和深筋膜表面血管网。其中浅筋膜深层血管网吻合支丰富,血管口径粗,是调节皮瓣间血运的主要血管网,在皮瓣的扩大切取中具有很重要的作用。     

Tongue Reconstruction with Free Forearm Radial or Ulnar Flap and Vascular Anastomosis:A Clinical Study of 21 Cases

Surgical treatment of tongue tumors usually results in a tongue defect half or more thanhalf of its original size which not only interferes with speech, swallow and mastication functions butalso creates contour deformity and induces mental suffering In order to restore the contour and func-tions of the tongue 21 cases of tongue defects were repaired and reconstructed with forearm radialor ulnar cutaneous or myocutaneous flaps All the transplanted flaps survived and the restored con-tour and functions were satisfactory. The surgical procedure of tongue reconstruction was intro-duced and how to have a satisfactory recovery of the tongue functions and raise the rate of successof the operation were discussed.     

尿道下裂手术适应症的选择及阴囊隔岛状皮瓣解剖学的研究

本文报道应用阴囊隔神经血管蒂岛状皮瓣一次修补尿道下裂63例,获得满意效果。由于发现了阴囊隔血管丛,并为解剖学研究证实,这与过去应用阴囊任意皮瓣有原则的不同。又对皮瓣设计因型而异进行了讨论。     

Craniofacial resection for anterior skull base tumours

Summary This study presents a series of 10 patients with anterior skull base tumours, treated by a team of neurosurgeons and head- and neck surgeons. The series included 7 malignant tumours of the nose and paranasal sinuses and 1 retinoblastoma, all with intracranial extension through the lamina cribrosa. There were also 2 patients with an anterior base meningioma, growing into the ethmoid sinus and the nasal cavity.8 tumours were resected by a combined bifrontal craniotomy and uni- or bilateral rhinotomy. In 2 cases a bifrontal craniotomy alone without facial incision sufficed. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath.There were no postoperative problems of wound infection, CSF-leakage or meningitis. Recurrent tumour growth or systemic metastasis occurred in 5 out of 7 patients with malignant tumours, 6 months to 2 years postoperatively.The related literature and especially questions of operative indications and technique, including different possibilities of closure and reconstruction of the skull base, are discussed.     

耳后游离皮瓣移植修复鼻部分缺损

目的 应用能携带耳廓软骨，色泽与鼻部相近的小型游离皮瓣修复鼻部分缺损。方法 采用以耳后动、静脉为血管蒂的耳后游离皮瓣行吻合血管的移植，对5例鼻部缺损进行了修复。结果 3例术后皮瓣血运完全正常，2例术后1－4d内有不同程度的静脉回流障碍。5例皮瓣最终全部成活，术后效果较为满意。结论 本手术供区隐藏，皮瓣不臃肿，色泽与鼻部相近，1次手术即可达到较满意的修复效果，是修复鼻尖、鼻翼大部缺损可供选择的一种方法。     

临床应用带血管蒂各种骨(膜)瓣治疗创伤性股骨头缺血坏死205例

目的为探讨创伤性股骨头缺务性坏死的治疗效果。方法作者从1986年4月至2003年11月,应用各种带血管蒂的骨(腊)瓣移植方法,对创伤性骨股头缺血性坏死者,进行股骨头修复、重建和再造。结果临床应用203例,以3年至20年随访观察,取得满意疗效,优良率在91%以上。结论作者体会到这些方法有解剖学基础,可根据不同缺血状况,彩不同方法,手术安全、有效、易行。