Objective To report the operation method and the cl inical effect of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery for cubital tunnel syndrome. Methods From September 2005 to May 2006, 25 cases of cubital tunnel syndrome were treated by the method of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery. There were 19 males and 6 females with an average of 60 years (20-72 years). The disease course was 2 months to 3 years (mean 6.7 months). The causes were ostesarthritis in 23 cases, cubital tunnel cyst in 1 case and ulnar nerve ol isthy in 1 case. According to Pasque grading system for cubital tunnel syndrome, 19 cases were graded as good and 6 cases were graded as poor. Electrophysiological examination showed the motor nerve conduction velocity of the ulnar nerve around the elbow joint was less than 42 m/s. Results All wounds healed by first intention and no operative compl ications and recurrences occurred. All patients were followed up for one year to two and half years (13.9 months on average). According to Pasque grading system for cubital tunnel syndrome, 15 cases were graded as excellent, 9 cases as good and 1 case as fair. The excellent and good rate was 96%, indicating a significant difference compared with the results before operation (P lt; 0.05). Electrophysiological examination showed the motor nerve conduction velocity of the ulnar nerve around the elbow joint was more than 42 m/s. Conclusion The method of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery is safe and effective for the treatment of cubital tunnel syndrome.
ObjectiveTo investigate the effectiveness of radial-lateral forearm free perforator flap on repairing of soft tissue defects in the finger.MethodsBetween January 2017 and May 2018, 26 cases of finger skin defects were treated with radial-lateral forearm free perforator flap based on the radial branch of the posterior interosseus artery. There were 21 males and 5 females, with an average age of 26.6 years (range, 19-56 years). The cause of injury included the cutting injury in 16 cases and crush injury in 10 cases. The interval between injury and admission was 30 minutes to 4 hours (mean, 1.5 hours). The injury located at thumb in 6 cases, index finger in 8 cases, middle finger in 6 cases, ring finger in 3 cases, and little finger in 3 cases; and at the dorsum of finger in 6 cases, the lateral side in 6 cases, and the palm in 14 cases. All wounds were accompanied with the tendon and bone exposures, and phalangeal fractures occurred in 10 cases. The size of the defects ranged from 2.0 cm×1.0 cm to 4.0 cm×2.5 cm. And the size of the flap ranged from 2.5 cm×1.5 cm to 4.5 cm×3.0 cm. All wounds at donor sites were sutured directly.ResultsAll the 26 cases were followed up 4-12 months (mean, 7 months). The 24 flaps survived uneventfully after operation, and the wounds healed by first intention. Partial necrosis occurred at the distal part in 2 flaps, and secondary healing achieved after debridement and dressing. All incisions at donor sites healed by first intention. The appearance and texture of all flaps were satisfactory. The two-point discrimination of the flaps was 5-10 mm (mean, 8 mm) at 4 months after operation. Sensory of the flaps was grade S3. Only linear scar was noted at the donor site.ConclusionThe radial-lateral forearm free perforator flap in repairing of the soft tissues in finger can shorten the disease duration, reduce the damage of the donor site, and improve the patients’ quality of life.