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find Author "董俊文" 5 results
  • 双Endobutton双环套锁内固定术治疗Tossy Ⅲ型肩锁关节脱位及Neer ⅡB型锁骨远端骨折

    目的总结双Endobutton双环套锁内固定术治疗TossyⅢ型肩锁关节脱位和NeerⅡB型锁骨远端骨折的疗效。 方法2010年4月-2013年4月采用双Endobutton双环套锁内固定术治疗17例Tossy Ⅲ型肩锁关节脱位和7例Neer ⅡB型锁骨远端骨折患者。男16例,女8例;年龄18~47岁,平均34岁。受伤至手术时间1~7 d,平均3.5 d。 结果术后患者切口均Ⅰ期愈合,无感染、臂丛神经及血管损伤等并发症发生。21例获随访,其中14例脱位患者随访时间12~20个月,7例骨折患者为12~24个月。锁骨远端骨折均获骨性愈合,愈合时间4~8个月,平均6个月。随访期间肩锁关节脱位无复发。术后12个月,Constant-Murley评分:脱位患者为(89.3±3.2)分,骨折患者为(87.2±2.6)分;按Karlsson标准评定:脱位患者获A级14例,B级3例;骨折患者获A级5例,B级2例。 结论双Endobutton双环套锁内固定术治疗Tossy Ⅲ型肩锁关节脱位和Neer ⅡB型锁骨远端骨折创伤小,手术操作简便,近期疗效满意。

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  • 携带隐神经终末支的游离足内侧皮瓣在手部高压注射伤中的应用

    目的总结携带隐神经终末支的游离足内侧皮瓣治疗手部高压注射伤的疗效。方法 2014 年 3 月—2018 年 6 月,收治 16 例 16 指高压注射伤患者。其中男 12 例,女 4 例;年龄 21~58 岁,平均 42 岁。拇指 3 例,示指 6 例,中指 5 例,环指 2 例。高压乳胶漆注射伤 10 例,高压油枪注射伤 6 例。受伤至入院时间为 1 h~2 d,平均 6.5 h。急诊行显微外科清创;亚急诊行携带隐神经终末支的游离足内侧皮瓣修复创面,皮瓣范围 4.5 cm×3.0 cm~8.0 cm×5.0 cm。结果术后皮瓣全部成活,未发生指端坏死或部分坏死。患者均获随访,随访时间 8~24 个月,平均 15 个月。末次随访时患指外观满意,皮瓣弹性、血运良好,指端指体饱满,远、近指间关节处横纹初显,无指体冷耐受差发生。皮瓣两点辨别觉为 5~10 mm,平均 7.5 mm。手功能采用手指关节总活动度(TAM)法评定,获优 10 指,良 4 指,可 2 指。供区无并发症发生。结论携带隐神经终末支的游离足内侧皮瓣是治疗手部高压注射伤的一种有效方法,术后手指外形、感觉及功能恢复良好。

    Release date:2020-02-20 05:18 Export PDF Favorites Scan
  • Effectiveness of dorsal perforator flap of cross-finger proper digital artery in treatment of high-pressure injection injuries of the finger

    Objective To investigate the effectiveness of dorsal perforator flap of cross-finger proper digital artery in the treatment of finger soft tissue defect caused by high-pressure injection injury. MethodsBetween July 2011 and June 2020, 14 cases of finger soft tissue defect caused by high-pressure injection injury were repaired with dorsal perforator flap of cross-finger proper digital artery. All patients were male, with a mean age of 36 years (range, 22-56 years). The defects were located on the index finger in 8 cases, middle finger in 4 cases, and ring finger in 2 cases. The causes of injury include 8 cases of emulsion paint injection, 4 cases of oil paint injection, and 2 cases of cement injection. The time from injury to debridement was 2-8 hours, with a mean time of 4.5 hours. The soft tissue defects sized from 4.0 cm×1.2 cm to 6.0 cm×2.0 cm. The flaps sized from 4.5 cm×1.5 cm to 6.5 cm×2.5 cm. The donor site of the flap was repaired with skin graft. The pedicle was cut off at 3 weeks after operation, and followed by functional exercise. ResultsAll flaps and skin grafts at donor sites survived, and the wounds healed by first intention. Twelve patients were followed-up 16-38 months (mean, 22.6 months). The texture and appearance of all flaps were satisfactory. The color and texture of the flaps were similar to those of the surrounding tissues. The two-point discrimination of the flap was 10-12 mm, with a mean of 11.5 mm. There were different degrees of cold intolerance at the end of the affected fingers. At last follow-up, the finger function was evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association, 3 cases were excellent, 8 cases were good, and 1 case was poor. Conclusion The dorsal perforator flap of cross-finger proper digital artery can effectively repair finger soft tissue defect caused by high-pressure injection injury. The operation was simple, and the appearance and function of the finger recover well.

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  • 游离髂腹股沟皮瓣修复踇甲皮瓣供区

    目的探讨游离髂腹股沟皮瓣修复踇甲皮瓣供区的疗效。方法2017 年 1 月—2018 年 12 月,收治 12 例手指软组织缺损患者。男 10 例,女 2 例;年龄 27~50 岁,平均 36.8 岁。损伤指别:拇指 8 例,示指 3 例,中指 1 例。手指软组织缺损范围为 2.5 cm×1.6 cm~5.0 cm×3.5 cm。4 例合并骨缺损。受伤至入院时间为 2~9 h,平均 4.9 h。术中切取大小为 3.0 cm×2.0 cm~6.0 cm×4.5 cm 的踇甲皮瓣修复手指缺损后,以旋髂浅动脉为血管蒂的游离髂腹股沟皮瓣接力修复供区创面,皮瓣切取范围为 4.0 cm×3.0 cm~7.0 cm×5.0 cm。游离髂腹股沟皮瓣供区直接拉拢缝合。结果手术时间 300~500 min,平均 353.3 min。除 1 例游离髂腹股沟皮瓣术后出现血管危象,经对症处理后成活外,其余皮瓣均顺利成活。供区切口均Ⅰ期愈合。患者均获随访,随访时间 3~18 个月,平均 9 个月。游离髂腹股沟皮瓣质地、颜色与周围皮肤相似,随访期间无破溃发生。患者对足部外观及功能均满意。结论游离髂腹股沟皮瓣供区隐蔽、损伤小,是修复踇甲皮瓣供区的可选方案之一。

    Release date:2021-04-27 09:12 Export PDF Favorites Scan
  • Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand

    ObjectiveTo investigate the effectiveness of combined tissue transplantation for repair of serially damaged injuries on radial side of hand and function reconstruction. MethodsBetween May 2013 and May 2017, 34 cases of serially damaged injuries on radial side of hand were treated. There were 29 males and 5 females; aged 17-54 years, with an average of 32.1 years. There were 23 cases of crushing injuries, 5 cases of bruising injuries, 4 cases of machine strangulation injuries, and 2 cases of explosion injuries. The time from injury to admission was 40 minutes to 3 days, with an average of 10 hours. According to the self-determined serially damaged injuries classification standard, there were 1 case of typeⅠa, 2 cases of typeⅠb, 10 cases of typeⅡa, 5 cases of type Ⅱb, 3 cases of type Ⅱc, 1 case of type Ⅱd, 7 cases of type Ⅲa, 3 cases of type Ⅲb, 1 case of type Ⅲc, and 1 case of type Ⅲd. According to the classification results, the discarded finger, nail flap, the second toe, anterolateral thigh flap, ilium flap, fibula flap, and other tissue flaps were selected to repair hand wounds and reconstruct thumb, metacarpal bones, and fingers. ResultsAfter operation, 2 cases of flaps developed vascular crisis and survived after symptomatic treatment; the other transplanted tissue survived smoothly. All cases were followed up 1 to 7 years, with an average of 2.4 years. The average fracture healing time was 7.4 weeks (range, 5.3-9.0 weeks). At last follow-up, the reconstructed fingers and the grafted flaps recovered good sensory function, with a two-point discrimination of 5 to 11 mm (mean, 9 mm). According to the evaluation standard of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society, the reconstructed thumb was rated as excellent in 24 thumbs, good in 8 thumbs, and fair in 2 thumbs; the reconstructed finger was rated as excellent in 18 fingers, good in 2 fingers, and fair in 1 finger. ConclusionFor the serially damaged injuries on radial side of hand, according to its classification, different tissues are selected for combined transplantation repair and functional reconstruction, which can restore hand function to the greatest extent and improve the quality of life of patients.

    Release date:2021-06-07 02:00 Export PDF Favorites Scan
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