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find Author "寿奎水" 40 results
  • 第一掌骨一期延长联合虎口加深成形术治疗拇指缺损远期疗效

    目的 总结第1掌骨一期延长联合虎口加深成形术治疗拇指Ⅱ~Ⅲ度缺损的远期疗效。 方法回顾分析1985年8月-1988年8月收治并获24年以上随访的8例拇指Ⅱ~Ⅲ度缺损患者临床资料。男5例,女3例;年龄20~53岁,平均38岁。拇指残端创面愈合至拇指再造时间为4个月~2年,平均9个月。采用第1掌骨截骨后一期延长1.8~2.0 cm再造拇指,同时作虎口“Z”字成形加深术。 结果术后切口均Ⅰ期愈合。随访时间24~26年。再造拇指感觉无异常改变,均能完成对指和握持,不能完成对掌。虎口无继发挛缩,拇指内收、外展活动度30~90°,肌力5~6 级。根据中华医学会手外科学会上肢部分功能评定试用标准评定,均获优良。 结论第1掌骨一期延长联合虎口加深成形术治疗拇指Ⅱ~Ⅲ度缺损,具有手术操作简便、成功率高、远期疗效好等优点。

    Release date:2016-08-31 05:39 Export PDF Favorites Scan
  • RECONSTRUCTION OF AVULSED INJURIES OF HEEL WITH A SENSORY PREFABRICATED FLAP

    ObjectiveTo investigate the effectiveness of using a sensory prefabricated flap to repair the heel avulsion injury. MethodsBetween August 2012 and August 2013, 6 cases of heel avulsion injury were treated. There were 4 males and 2 females, aged 16-54 years (mean, 29 years). The causes were crush injury in 4 cases and wheel twist injury in 2 cases. The injury to admission time was 2-6 hours (mean, 4 hours). The size of skin avulsion ranged from 5 cm×3 cm to 15 cm×8 cm. Avulsion skin had no replanted condition. At one stage operation, the avulsed heel skin soft tissue was made the full thickness skin graft which was fostered on the anterolateral thigh with lateral circumflex femoral artery perforator, and the lateral femoral cutaneous nerve was put beneath the skin to prefabricate the prefabricated flap; at two stage operation, the prefabricated skin flap pedicled with lateral circumflex femoral artery was used to repair the wound, and the lateral femoral nerve was anastomosed with the calcaneal nerve to reconstruct the feeling. ResultsSix prefabricated flaps all survived, and re-plantation flaps survived after operation. The wounds healed by first intention at donor site and recipient site. The patients were followed up 1-2 years (mean, 1.5 years). The flaps had satisfactory appearance and soft texture. At 1 year after operation, the sensation of the flaps was S3, with two-point discrimination of 22-27 mm (mean, 24.3 mm). According to ZHANG Ming's evaluation standards, the results were excellent in 5 cases, and good in 1 case. The patients could walk normally or with weight-bearing; only linear scar formed at the donor site. ConclusionFor patients with heel soft tissue avulsion injury without replantation qualification, a sensory prefabricated flap by the avulsed heel skin soft tissue can transplanted to repair the heel defect. Satisfactory effectiveness can be obtained in heel appearance and function recovery.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • 掌部及跖部撕脱皮肤异位寄养后回植的临床研究

    目的 总结掌、跖部撕脱皮肤异位寄养后回植的方法及临床疗效。 方法2007年3月-2012年3月,收治8例掌、跖部皮肤撕脱伤患者。男5例,女3例;年龄18~50岁,平均34岁。致伤原因:交通事故伤4例,重物砸伤2例,机器绞伤2例。损伤部位:手掌2例,足跟3例,前足2例,足底1例。伤后至入院时间为1~7 h,平均4 h。皮肤撕脱范围为5 cm × 3 cm~20 cm × 10 cm。一期手术将掌、跖部撕脱皮肤寄养在股前外侧区域的深筋膜层(即预制皮瓣);二期切取预制皮瓣原位回植修复创面。 结果一期寄养术后2周3例切口有渗液,应用红光理疗仪治疗后,寄养皮片成活;其余5例寄养皮片均顺利成活。二期原位回植术后皮瓣均顺利成活,寄养部位及回植修复创面均Ⅰ期愈合。患者均获随访,随访时间6~12个月,平均7.5个月。皮瓣外形满意,质地柔软。术后6个月,皮瓣感觉达S3;两点辨别觉为20~25 mm,平均22.5 mm。手功能基本恢复,足部恢复正常行走及负重。 结论对于掌、跖部皮肤撕脱伤,经一期寄养撕脱皮肤、二期原位回植后,成活率高,保存了原掌、跖部皮肤,是重建掌、跖部功能的较好手术选择。

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • 大鱼际微型穿支皮瓣在拇指近节指腹挛缩修复中的应用

    目的 总结大鱼际微型穿支皮瓣修复拇指近节指腹挛缩的方法及疗效。 方法2010年8月-2011年9月,收治拇指近节指腹挛缩患者9例。男6例,女3例;年龄17~60岁,平均45岁。致伤原因:再植术后挛缩 4例,机器绞伤3例,压砸伤2例。瘢痕挛缩3个月~2年。先行挛缩指腹开大,开大后指腹缺损范围为8 mm × 2 mm~30 mm × 15 mm;然后采用大小为25 mm × 10 mm~35 mm × 15 mm的大鱼际微型穿支皮瓣移位修复缺损。供区直接缝合。 结果术后皮瓣完全成活,创面Ⅰ期愈合;供区切口Ⅰ期愈合。患者均获随访,随访时间6~12个月,平均9个月。皮瓣外形良好,质地柔软。拇指背伸80~90°及外展90°。瘢痕无复发;大鱼际切口无瘢痕挛缩,拇指关节活动正常。末次随访时手功能按中华医学会手外科学会上肢部分功能评定试用标准评定,获优8指,良1指。 结论大鱼际微型穿支皮瓣具有不损伤主干动脉的优点,是修复拇指近节指腹挛缩的理想方法之一。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 足跟皮肤撕脱再植一例

    对于足跟皮肤撕脱临床多采用原位缝合或修薄打包回植,成活率低。目前国内少见关于足跟皮肤撕脱再植成活的报道。我们于2008 年12 月7 日收治1 例足跟皮肤撕脱患者,行再植术后成活。报告如下。

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
  • 残存环指掌指关节远尺侧半关节修复中指尺侧半关节一例

    详见正文

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 双蒂腹部真皮下血管网皮管修复2 ~ 5 指双指脱套伤

    目的 总结双蒂腹部真皮下血管网皮管修复2 ~ 5 指双指脱套伤的临床效果。 方法 2003 年2 月- 2006 年8 月,采用双蒂腹部真皮下血管网皮管修复6 例双指脱套伤。男4 例,女2 例;年龄17 ~ 45 岁。示、中指2 例,中、环指3 例,环、小指1 例。撕脱平面均于近节指横纹以远,伴不同程度肌腱及关节囊损伤、骨外露。损伤至手术时间为40 min ~ 5 d。术中设计7 cm × 5 cm ~ 12 cm × 7 cm 双蒂腹部真皮下血管网皮管修复缺损。 结 果 1 例2 指术后2 周断蒂,术后2 d 皮管远端表皮坏死,经换药后愈合;余5 例10 指术后3 周断蒂,皮管均顺利成活,伤口Ⅰ期愈合。腹部供区Ⅰ期愈合。6 例术后均获随访,随访时间3 ~ 12 个月。皮瓣外形恢复较满意,手功能按ATM 标准评分:优2 例,良3 例,中1 例。 结论 双蒂腹部真皮下血管网皮管具有手术操作简便、术后患者对手功能及外形恢复满意的优点,是修复2 ~ 5指双指脱套伤的理想方法之一。

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
  • REPLANTATION OF COMPLEX THUMB MUTILATION WITH LOCAL ISLAND FLAP

    Objective To investigate the cl inical effect and operative method of local island flap for complex thumb mutilation with soft tissue and blood vessel defect. Methods From May 2003 to March 2006, 6 cases of complex thumb mutilation with soft tissue and blood vessel defect were treated with local island flap. There were 4 males and 2 females aged 14-48 years, with an average of 23.5 years, among whom 2 cases were caused by triangular bandage twist, 3 cases by machinesavulsion and 1 case by explosion. Five cases suffered thumb mutilation of soft and blood vessel defect only, and 1 case was combined with middle and ring finger injures. The defect was located in pulp soft tissue in 4 cases and in dorsal soft tissue in 2 cases, ranging 2.0 cm × 1.2 cm-2.5 cm × 1.8 cm in size. The time from injury to operation varied from 30 minutes to 6 hours. Two cases were replanted with bridging index finger radial is digital artery island, 2 cases were repaired by ring finger radial is digital artery island and 2 cases by index finger near dorsi-flap. The flap was 2.0 cm × 1.4 cm-2.5 cm × 1.8 cm in size. Free-skin graft from forearm was conducted. Results All flaps free skin and replanted thumbs in 6 cases survived completely, following up for 6-24 months after operation. The flaps and thumb had good texture and color match, two-point discrimination was 10-12 mm on thumb pulp and 8-10 mm on flap. All replanted thumb recovered satisfied function, there were no donor site dysfunction. According to the criteria for function assessment of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association:4 cases were regarded as excellent and 2 as good. Conclusion Local island flap is capable of repairing complex thumb mutilation with soft tissue and blood vessel defect, maximizing the recovery of thumb appearance and function.

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
  • 环指血管神经肌腱一期移位再植拇指

    Release date:2016-09-01 09:33 Export PDF Favorites Scan
  • 腹部同蒂双层筋膜皮瓣修复手部皮肤缺损

    Release date:2016-09-01 11:34 Export PDF Favorites Scan
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