膝上外侧骨皮瓣的临床应用

目的 介绍以膝上外侧动脉或膝最上外侧动脉为蒂的股骨远端皮瓣、骨瓣、骨皮瓣游离移植修复手、前臂远端皮肤软组织、骨及复合组织缺损的方法。方法 在３０侧红色乳胶灌注的下肢标本上，解剖观察了膝上外侧动脉及膝量上外侧动脉的起始、走行、分支、分布及吻合情况，在此基础上设计了以膝上外侧动脉或膝最上外侧动脉为蒂的股骨远端骨皮瓣。结果：应用膝上外侧动脉蒂骨皮瓣３例、皮瓣、例、骨瓣１例，膝最上外侧动脉蒂骨皮瓣１例、皮     

Sclerosing therapy: an alternative treatment for popliteal cyst in children

During a 6-year period 31 patients with popliteal cyst were treated by sclerosing therapy with ethoxysclerol 1%. The injection was repeated after 3–4 weeks. In 14 patients 3 interventions were necessary. Four patients required more than three treatments, but 3 of them had been operated upon previously. In our patients, the ethoxysclerol sclerotherapy produced good results without recurrences. Offprint requests to: P. Németh     

腓肠肌瓣在腘血管损伤并大面积皮肤撕脱伤中的应用

目的:探讨胭动静脉损伤并同侧下肢大面积皮肤撕脱伤的治疗方法。方法:对6例胭动静脉损伤并下肢大面积皮肤撕脱伤者,在修复血管后用以腓肠内或外侧血管为蒂的腓肠肌瓣逆向旋转覆盖外露的腘动静脉,再行游离植皮修复创面。结果:6例经上述方法处理后均得以保肢。随访0.6-3.2年,患者能正常行走,上下楼梯无影响,患踝跖屈肌力无明显下降,膝关节伸0°,过伸5-10°,屈曲可达90-110°,患者对治疗满意。结论:利用腓肠内(外)侧血管为蒂的旋转腓肠肌瓣覆盖损伤外露的胭动静脉联合游离植皮修复创面是处理胭动静脉损伤并下肢大面积皮肤撕脱伤的一种简单、省时、实用的治疗方法,适合急诊处理,可获得良好的功能恢复。     

Popliteal artery pseudoaneurysm after a revision of total knee arthroplasty: endovascular treatment with a stent graft

Injury to the popliteal artery during total knee arthroplasty is a very rare but dangerous complication. Several mechanisms are capable of generating a direct trauma to the vessel, like posterior retractor and oscillating saw. We report a case of popliteal artery pseudoaneurysm in a 52-year-old woman that occurred during revision of total knee arthroplasty, requiring emergency repair by means of percutaneous endovascular covered stenting.     

Revascularisation later than 24h after popliteal artery trauma: is it worthwhile?

BACKGROUND: Traumatic popliteal artery injury carries heavy morbidity. Ischaemic time is an important factor affecting limb survival. In developing countries most patients present late for repair and there are no distinct guidelines in deciding for revascularisation. PATIENTS AND METHODS: Patients with popliteal artery trauma who had presented at least 24h after injury were included in the study. Individuals with dead foot were excluded; participants underwent either amputation or revascularisation. RESULTS: Among 30 patients entered in the study, 3 underwent amputation; of these, 2 had complete paralysis with partial sensory loss and 1 had complete sensory and motor loss. The rate of amputation was significantly higher among patients with motor deficit (p=0.008) but not among those with sensory deficit. CONCLUSIONS: Revascularisation can be successful for patients who retain only one foot movement. We recommend revascularisation also for cases presenting late and with complete motor deficit below the knee, but without mottling.     

Popliteal artery pseudo-aneurysm secondary to femoral osteochondroma: a case report and literature review

A case of pseudo-aneurysm of the popliteal artery secondary to an osteochondroma of the femur in a young adult is described.     

腘动脉瘤治疗方法的探讨与分析

目的 探讨腘动脉瘤有效的治疗方法.方法 回顾分析2008年3月至2011年3月26例腘动脉瘤患者的临床资料和随访情况.结果 所有患者经B超、CTA或DSA检查确诊,20例接受外科手术治疗、6例接受覆膜支架腔内隔绝术.其中腘动脉瘤切除并自体大隐静脉移植术11例;腘动脉瘤切除并人造血管移植术5例;动脉瘤壁部分切除并补片修补术4例.随访6个月～3年,11例行自体大隐静脉移植术患者移植血管通畅性良好;5例行人造血管移植术的患者3例通畅性良好,2例管腔闭塞;4例动脉瘤壁部分切除并补片修补术患者管腔通畅良好;6例行覆膜支架腔内隔绝术患者4例通畅良好,2例术后1年管腔闭塞.结论 外科手术是治疗腘动脉瘤的首选方法.自体静脉移植和补片修补术是最为有效的.身体状况较差的患者可考虑腔内治疗.     

Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: a comparative study

The objectives of the present work were (1) to establish the prevalence of the abnormalities detected by magnetic resonance imaging (MRI) and ultrasonography (US); and (2) to compare these imaging techniques in detail. The study group consisted of 58 patients with symptomatic knee OA and 16 volunteer control subjects. Knee joint was evaluated for femoral condylar cartilage changes, effusion, synovial thickening and popliteal cysts using MRI and US. All knees with OA had cartilage abnormalities on US examinations and normal cartilage was detected in less than 3% of these knees by MRI. Majority of the knees with OA had effusion using US (70%) or MRI (85%). Synovial thickening observed on US (34%) and MRI (50%) were common in the knees with OA. Popliteal cysts were detected in 40% of the knees with OA using US and 35% using MRI. This study confirmed that there was a significant correlation between the MRI and US techniques for evaluating the cartilage and soft tissue changes in the patients with knee OA. There were more significant differences between the controls and the symptomatic knees which had Kellgren-Lawrence (K-L) grade 2 or more OA for the cartilage and soft tissue abnormalities on MRI and US. The prevalence of cartilage changes, effusion, synovial thickening and popliteal cyst using MRI and US were increased as the radiographic grade of OA increased. US examinations could be an alternative to initial evaluation tool to MRI in patients with knee OA.