对耳轮过度前突畸形的整复

对耳轮过度前突为对耳轮的角度过锐，致使耳轮的位置相应后移，表现为与招风耳完全相反的畸形。畸形虽不十分明显，但影响美观。自１９９２年４月开始应用患侧耳廓软骨和耳后皮瓣对５例患者８只外耳进行治疗得到满意效果。认为文中所述方法是矫正对耳轮过度前突畸形的良好方法。     

A new technique for the division of syndactyly

Summary This paper describes a new technique for the division of syndactyly. The commissure is reconstructed by a dorsal trilobed flap and a zig zag incision which produces triangular flaps for the side of the digits. This technique does not require use of a skin graft. Seventeen syndactylies in fourteen children, nine incomplete (six congenital and three secondary to burn) and eight complete syndactylies were treated by this technique. The results after a maximum of twelve months follow-up and the advantages of the technique are discussed.[/ab]     

前锯肌下部肌皮瓣移植的应用解剖

目的：为前锯肌下部肌皮瓣移植提供解剖学基础。方法：在２５具（５０侧）成人尸体标本上，对前锯肌下部的形态、血供和神经支配进行了应用解剖学观测。结果：前锯肌下部的血供主要来自胸背动脉的前锯肌支，外径１．３±０．２ｍｍ，伴行静脉外径１．５±０．２ｍｍ，长４．９±１．１ｃｍ；由胸长神经支配，其横径为１．７±０．４ｍｍ，神经干长７．７±１．４ｃｍ。结论：以胸背血管及前锯肌支为血管蒂和胸长神经为蒂可切取前锯肌下部１２．０ｃｍ×９．０ｃｍ的肌皮瓣，修复较大创面或重建肌动力     

The middle collateral artery: anatomic basis for the “extreme” lateral arm flap

The vascularization of the posterolateral area of the arm is supplied by the terminal branches of the deep brachial artery [middle collateral artery (MCA) and posterior radial collateral artery]. Their anatomy has been a field of confusion for a long time. An extended lateral arm flap, named the extreme lateral arm flap, supplied by these branches and dissected as a retrograde island flap has been proposed as an alternative for large compound defects of the distal forearm. We carried out an extensive anatomic study of the extreme lateral arm flap on 69 upper limbs: 54 fresh injected with colored latex, 10 embalmed and 5 radiographed after Micropaque injection. Two origin levels of the MCA were found: a proximal one (37%) above the radial groove, and a distal one (63%) at the level of the groove. The deep brachial artery always bifurcated after the origin of the MCA into a posterior radial collateral artery (PRCA) and anterior radial collateral artery (ARCA). Indeed in our dissections, after the origin of the MCA from the deep brachial artery, there was always a common trunk named the radial collateral artery (RCA) which bifurcated into the ARCA and PRCA. In all dissected arms we always found the MCA anastomosed in a transverse pattern with the inferior ulnar collateral artery (IUCA), contributing to the anastomotic circle of the elbow. This circle represents the unique vascularization source of the reverse extreme lateral arm flap.     

Anatomosurgical study of the superficial and deep circumflex iliac arteries

Summary An anatomical study of the superficial and deep circumflex iliac arteries in 43 formalin-fixed cadavers is presented. The origin, calibre, course, branches, symmetry and variations of the vessels are pointed out as well as their special features related to surgical applications.

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Etude anatomochirurgicale des artères circonflexes iliaques superficielle et profonde: bases anatomiques de la confection du lambeau libre iliaque composé cutanéo-osseux

Résumé Une étude anatomique des artères circonflexes iliaque superficielle et profonde est effectuée sur 43 cadavres formulés. L'origine, le calibre, le trajet, les branches, la symétrie et les variations des vaisseaux sont mis en évidence ainsi que leurs caractères particuliers en vue d'une application chirurgicale.

     

远端蒂腓肠神经营养血管皮瓣与肌皮瓣的临床应用与改进

目的:报道应用远端蒂腓肠神经营养血管皮瓣,肌皮瓣修复小腿下段及足踝部软组织缺损的可行性安全性和临床效果。方法:对42例以远端蒂腓肠神经营养血管(肌)皮瓣修复小腿下段及足踝部不同原因所致软组织缺损病例进行总结分析。本组男36例,女6例;年龄最大75岁、最小6岁;皮瓣最大面积17.0cm×15.0cm,最小6.0cm×5.0cm,其中12例皮瓣面积在10.0cm×10.0cm以上;6例设计为肌皮瓣(腓肠肌外侧头),肌瓣最大为10.0cm×7.0cm×2.0cm,最小为6.0cm×5.0cm×1.0cm。结果:所有病例术后皆出现不同程度的皮瓣肿胀,暗道较明道者明显。2例大皮瓣经行小隐静脉远端结扎仍出现肿胀、色暗,皮瓣近侧1/3坏死。皮瓣边缘坏死3例,换药治愈。部分坏死需行植皮者3例。36例术后伤口I期愈合,骨外露软件组织缺损覆盖修复满意,6例II期愈合,其中糖尿病,地中海贫血各一例。结论:(1)远端蒂腓肠神经营养血管皮瓣转位修复小腿下1/3及足踝部缺损创面,极有临床实用价值;(2)设计切取腓肠神经营养血管肌皮瓣修复小腿及足踝填充感染创腔是可行的;(3)但对其皮瓣及所携带的肌瓣究竟切取多大面积是安全的、肌瓣的血运机理以及远端蒂筋膜皮瓣中小隐静脉干是否结扎,何处结扎等问题仍有待进一步研究。     

Reconstruction of the foot and lower leg by a fasciocutaneous cross-leg flap after traumatic amputation and circumferential soft-tissue loss

Summary The use of a fasciocutaneous cross-leg flap in two cases to cover severe soft-tissue injuries with circumferential degloving of the lower leg and foot is presented. This was preceded by local treatment with topical agents and debridement, followed by application of a mesh skin graft. The functional and aesthetic defect of the donor site is minimal.     

Prostacyclin formation in undelayed and delayed pig flank flaps

Summary A specific 6-keto-prostaglandin PGI₂ radioimmunoassay (R.I.A.) was used to follow tissue prostacyclin formation in a series of acute and delayed pig flaps. Each flap measured 12×5 cm and four white, female ehester pigs, averaging 21 kgs in weight, were used. Flap tissue samples were taken at day 0 (control) 1–8, 10, 14, 17 and 21 using 0.4 mm diameter cork borer. Prostacyclin formation started to rise on day 4 and extended until the 10th day in both types of flaps. The hyperemic circulation that occurred following delay procedure is associated with a rise in prostacyclin production whereas the higher rise in prostacyclin in the undelayed flap is due to the reactive inflammation.