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find Author "倪国骅" 3 results
  • TEMPORARY ECTOPIC IMPLANTATION OF AMPUTATED FINGERS AND DORSALIS PEDIS FLAPS FOR THUMB RECONSTRUCTION AND SKIN DEFECT REPAIR OF HANDS

    Objective To investigate the feasibility of temporary ectopic implantation of amputated fingers and dorsalis pedis flaps for thumb reconstruction and skin defect repair of the hand. Methods Between February 2006 and February 2012, 9 patients with thumb amputation having no replanted condition were treated. There were 7 males and 2 females with an average age of 35 years (range, 20-45 years). The injury causes included explosive injury in 1 case, puncher injury in 1 case, stiring machine injury in 1 case, gear injury in 3 cases, and heavy pound injury in 3 cases. At 2-5 hours after injury, one-stage temporary ectopic implantation of amputated finger to foot was performed. After debridement, thumb defect was rated as degree III in 1 case, as degree IV in 3 cases, and as degree V in 5 cases. When amputated fingers survived completely after 1-4 months, the amputated finger was replanted to its anatomic position, skin defect was repaired with dorsalis pedis flap. The area of skin defect ranged from 5 cm × 4 cm to 7 cm × 6 cm. The area of flaps ranged from 6 cm × 5 cm to 8 cm × 7 cm. The donor site was repaired by the skin grafting. Results Arterial crisis occurred in 1 case after 1 day of one-stage operation, and was cured after vascular exploration, and the amputated fingers survived in the others. The reconstructed thumbs and flaps survived after two-stage operation, and the skin graft at donor site survived. The patients were followed up 1-4 years (mean, 2.8 years). The reconstructed thumbs had good appearance and satisfactory opposition and finger-to-finger functions. According to the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association, the scores of survival fingers were 73-91 (mean, 84); the results were excellent in 7 cases and good in 2 cases with an excellent and good rate of 100%. Conclusion Temporary ectopic implantation of amputated finger to foot combined with dorsalis pedis flap can be used to reconstruct thumb and repair skin defect of the hand.

    Release date:2016-08-31 04:12 Export PDF Favorites Scan
  • 废弃手指远位寄养二期回植再造手

    目的 总结废弃手指远位寄养二期回植再造手、重建手功能的方法。 方法 2005 年2 月- 2008 年12 月,将5 例远断端完整而近断端毁损无法一期再植的废弃拇指远位寄养,将拇指一侧指固有动脉与健侧腕部尺动脉腕上皮支下行支或足背跗外侧动脉吻合,并吻合2 条浅静脉,成活后1.5 ~ 3.0 个月将拇指二期回植于手部再造手。男3 例,女2 例;年龄7 ~ 43 岁。受伤至就诊时间1 ~ 3 h,拇指缺血时间3 ~ 6 h。 结果 5 例均获随访,随访时间11 个月~ 4 年。废弃手指远位寄养回植再造手均成活,回植拇指外观饱满,色泽红润。两点辨别觉8 ~ 10 mm。2 例行拇对掌功能重建术者恢复对掌功能;3 例未行拇对掌功能重建术者中1 例恢复部分对掌功能,2 例无对掌功能。手部功能依据中华医学会手外科学会拇、手指再造功能评定试用标准评分为7 ~ 13 分,平均9.2 分;其中优1 例,良4 例。 结论 废弃指远位寄养二期回植再造手是一种可行且有效的手术方法。

    Release date:2016-08-31 05:49 Export PDF Favorites Scan
  • 远端蒂足内侧皮瓣在儿童足母趾皮肤缺损中的应用

    目的 总结应用远端蒂足内侧皮瓣逆向移位修复儿童足母趾皮肤缺损的临床效果。 方法 2003 年3 月- 2007 年10 月,采用远端蒂足内侧皮瓣修复足母趾皮肤缺损7 例。男5 例,女2 例;年龄2 ~ 13 岁。撕脱伤4 例,重物砸伤3 例。足母趾末节趾腹缺损1 例,近节腹侧缺损4 例, 趾残端皮肤缺损2 例。软组织缺损范围为2.5 cm ×2.0 cm ~ 6.0 cm × 4.0 cm。病程2 h ~ 1 个月。术中切取皮瓣范围3.0 cm × 2.5 cm ~ 6.5 cm × 4.5 cm,供区中厚皮片植皮修复。 结 果 5 例皮瓣及供区植皮均成活;2 例皮瓣远端分别于术后2 d 和3 d 出现0.5 cm × 1.0 cm 水疱,均于2 周后脱痂皮愈合。供受区切口均Ⅰ期愈合。7 例均获随访,随访时间6 个月~ 4 年7 个月。皮瓣外观、血运、弹性好,两点辨别觉为5 ~ 12 mm,无溃疡或磨损,行走无影响。 结论 采用远端蒂足内侧皮瓣修复儿童足母趾皮肤缺损是一种较好的手术方法。

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
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