ISSN:0738-1085    

DOI:10.1002/micr.1920140602

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractIn this retrospective analysis, we present our experience with two groups of patients who had long bone defects secondary to trauma or tumor resection and who were treated with a free vascularized fibular graft for skeletal reconstruction. Both groups were comparable in number and average age of patients, length of bone defect, and mean follow‐up (average 3 years both groups). The number of surgical procedures prior to microvascular grafting was significantly higher for the traumatic defects. Primary bone union in a mean period of 6 months occurred at a higher rate in the tumor patients; the trauma patients had a significantly higher nonunion rate, which required multiple additional surgical procedures. The latter did not, significantly, improve the rate of success in the trauma group. Residual limb shortening was present in one‐half of the patients with traumatic defects. On the basis of this review, it appears that the scarred and relatively avascular soft tissues surrounding the long bone defects secondary to trauma affect the course and the final outcome of the microvascular fibular grafting. A similar procedure applied for limb salvaging after tumor resection is better. © 1993 Wiley‐Li

ISSN:0738-1085    

DOI:10.1002/micr.1920140603

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractMandibular resection, following surgery for tumor or osteoradionecrosis, leaves a patient with a swallowing, speech, and cosmetic disability. Repair of the oromandibular defect is difficult and various prostheses and grafts have been used and reported. The most popular form of mandibular reconstruction is the use of the free, vascularized bone transfer. We report our experience with the free vascularized fibula bone transfer in eight patients. © 1993 Wiley‐Liss I

ISSN:0738-1085    

DOI:10.1002/micr.1920140604

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractReplantation of small parts often results in failure. The impractical size and the frequent absence of veins suitable for anastomosis, together with venous congestion and thrombosis, are the main problems. A case is described of an amputated nasal tip and successful replantation by means of microsurgical arterial repair and open venous drainage due to absence of suitable veins in the specimen. In cases in which there is no possibility of repairing the venous system, open venous drainage may be an easy and feasible method to prevent venous congestion and replant failure. © 1993 Wiley‐Liss I

ISSN:0738-1085    

DOI:10.1002/micr.1920140605

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractA series of 208 digital replantations from the frigid zone within the People's Republic of China is presented. The extremely cold climate (often −20M‐0C to −30M‐0C) presents the problem of warming exposed amputated digits prior to replantation without causing further damage. An overall replantation survival rate of 94% is reported, and this includes 45 cases of multiple digit amputation. Longer periods of ischemia seem to be tolerated under these unusually frigid conditions. Problems encountered within the series and suggestions for successful outcomes are discussed. © 1993 Wiley

ISSN:0738-1085    

DOI:10.1002/micr.1920140606

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractWith reconstructive microsurgical techniques, some previously hopelessly mutilated hands have become reconstructable. The functional and esthetic results of such hands can be improved to an acceptable degree with thorough prereconstruction evaluation and planning. This case report demonstrates the approach to reconstruction of a mutilated hand using the following: a pedicle groin flap for soft tissue reconstruction of the first web space and the amputation stump of the thumb; a combined second and third toe transfer for reconstruction of opposable fingers at the amputated index and middle finger stumps; a single second toe for reconstruction of the thumb, and an iliac osteocutaneous flap for reconstruction of the ulnar border of the palm. © 1993 Wiley‐Liss I

ISSN:0738-1085    

DOI:10.1002/micr.1920140607

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractCirculatory crisis, attributed to cigarette smoking, in three microvascular cases (two toe transfers, one musculocutaneous flap) is reported. After anticoagulation and antispasm treatment only one transfer survived. Coordinated experimental studies in the rat demonstrated that cigarette smoking delayed anastomotic healing. Five days after anastomoses were performed, endothelial cells completely covered the sutures in the experimental smoking group in only 16–19% of sutures, while the control group had a 75% coverage rate. Mechanisms and characteristics of circulatory crisis caused by cigarette smoking are discussed. © 1993 Wiley‐Liss

ISSN:0738-1085    

DOI:10.1002/micr.1920140608

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractIt is possible to seal nerve ends together with the laser, and this can be effective for sharp injuries that are repaired relatively acutely or primarily. The possibility of utilizing the laser for secondary nerve repair after resection of a lesion in continuity was investigated in a rat sciatic nerve model. After baseline recording of nerve and muscle action potentials (MAP), a 3‐mm‐long crush injury of the sciatic nerve was performed bilaterally in 12 rats. Two weeks later, the crushed segment was resected, and the nerve on one side was repaired by end‐to‐end anastomosis using epineurial sutures and on the other side by sealing the nerve ends together with the CO2laser. At reexploration 50 days postoperatively, all 12 suture repairs were anatomically in continuity and conducted a nerve action potential (NAP), while 10 of the 12 laser‐repaired nerves had distracted. Laser repairs not distracted showed electrical and histologic evidence of regeneration. It is concluded that laser repair is not effective for delayed repair of lesions in continuity unless tension at the repair site can be lessened. © 1993 Wile

ISSN:0738-1085    

DOI:10.1002/micr.1920140609

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0738-1085    

DOI:10.1002/micr.1920140610

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractGroup fascicular vein grafts with interposition of nerve slices were designed for reconstruction of three ulnar nerves with defects of 2.5–4.5 cm. The veins were taken from superficial veins in the forearm and reversed to bridge the fascicles in both stumps. Normal nerve slices were sectioned from fascicles in the proximal stump and inserted inside the corresponding vein conduits. Postoperatively, the Tinel's sign was detected across the vein conduits, and electromyography showed reinnervation of intrinsic muscles of the hands. Follow‐up for more than 2 years revealed motor recovery to M4 and sensory recovery to S3–S4 in these three cases. This technique may be a promising alternative to group fascicular nerve grafting for long defects in peripheral nerve trunks. © 1993 Wiley‐

ISSN:0738-1085    

DOI:10.1002/micr.1920140611

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY