ISSN:0738-1085    

DOI:10.1002/micr.1920150102

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

年代:1994

数据来源: WILEY

ISSN:0738-1085    

DOI:10.1002/micr.1920150103

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe results of surgical treatment for facial paralysis are still difficult to compare as there is no universal scoring method. The purpose of this communication is to review the results of reconstruction of the extratemporal facial nerve with nerve grafts using our own evaluation system. Fifty‐nine patients were operated on during the period 1981–1991. They had lacerations or other trauma to the face which resulted in loss of continuity of the facial nerve or branches.Three groups were considered: (a) 12 patients had injuries involving the trunk and extending up to the main branches of the facial nerve; (b) 32 patients had parotid laceration or contusion on the parotid area with resulting nerve defects extending from a main branch up to distal branches; and (c) 15 patients had injuries on the distal branches: frontal, zygomatic, or mandibular.The sural nerve was used as the graft in all instances. The grafting procedure was performed from three weeks to six months after the trauma.The method of evaluation compares the normal with the paralyzed side. A score is given of 0 (no motion), 1 (weak motion), or 2 (strong motion), for each of six voluntary contractions: forehead, closure of eyelids and lips, traction, elevation, and depression of the lips. The assessment of involuntary mimic actions was done while observing blinking, speaking, smiling, and laughing. Mass movements were scored negatively. The numbers were recorded and the ratio between the paralyzed and normal side gave an estimate of the lack of symmetry. Differences between the preoperative and postoperative scores showed that improvement had been achieved by surgery. Nerve grafting provided a significant improvement of function in patients with traumatic injuries to the extratemporal facial nerve. © 1994 Wiley‐Lis

ISSN:0738-1085    

DOI:10.1002/micr.1920150104

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe authors describe their experience in treating 24 patients who underwent resection of tumors involving anterior, middle or posterior cranial fossa with immediate reconstruction. All were reconstructed with free flaps, 15 rectus abdominis, 4 radial forearm, 3 latissimus dorsi, 2 great omentum, and one scapular flap.There was one latissimus dorsi flap loss due to arterial thrombosis in a heavily irradiated patient.Three patients presented with a temporary cerebrospinal fluid leak, one of them with meningitis which resolved after intravenous antibiotics and continuous lumbar drainage.Fifteen patients were followed (mean 2 years). Five died of recurrence. Four presented local recurrence. Six patients are alive with no signs of recurrence.Free flaps, especially the rectus abdominis flap and the latissimus dorsi, are versatile flaps and may be easily positioned to cover several structures or anatomical surfaces. © 1994 Wiley‐Liss, I

ISSN:0738-1085    

DOI:10.1002/micr.1920150105

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe authors report their experience with free radial forearm flaps for oropharyngeal reconstruction.Fifteen patients who submitted to intraoral reconstruction with this flap were followed for periods ranging from 3 to 36 months, with a mean of 14 months. Ages ranged from 15 to 58 years with a mean of 41. The defects were secondary to tumor ablation (11 patients), complications of conventional treatment for congenital deformities (3 patients) and trauma resulting from a gunshot wound to the upper lip and palate (1 patient).Total necrosis of 1 flap occurred and 1 patients required reoperation on the first postoperativeday for revisionof the anastomoses.Our results enable us to recommend the radial forearm flap as the flap of choice for reconstruction of extensive oropharyngeal defects. © 1994 Wiley‐Liss, I

ISSN:0738-1085    

DOI:10.1002/micr.1920150106

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

年代:1994

数据来源: WILEY

摘要:

AbstractImmediate survival and functional results were studied in 60 finger replants performed from 1980 to 1990. The follow‐up ranged from 1 to 5 years with the mean of 2 years and 8 months. The survival rate achieved was 70% and was not related to the patient's age, the mechanism of injury, the level of amputation, the total ischemia time, the number of arteries and veins repaired or the type of vascular reconstruction. Sensory return was related to the mechanism of amputation and the total active motion was strongly correlated with the level of amputation.Of the 16 digits that had only one artery anastomosed, there were 10 survivals (62.5%), and in 15 digits with anastomosis of two arteries, the success rate was 86.66% (P= 0.1244). The success rate in those cases in which vascular grafts were employed was 62.96% (P= 0.4161). In replantations with one, two or three veins anastomosed, the survival rate was 50%, 79.16% and 100%, respectively (P= 0.1324). © 1994 Wiley‐Liss,

ISSN:0738-1085    

DOI:10.1002/micr.1920150107

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe authors analyzed 14 patients with severe osteomyelitis of the upper extremity between 1985 and 1992, managed with the vascularized fibular graft. Eleven radii, two humeri and one ulna were reconstructed. Bone loss after resection ranged from 6 to 12 cm (mean 8.14 cm). Follow‐up ranged from 8 months to 7 years and 10 months (mean 3 years and 3 months). The therapeutic applications of the vascularized fibular graft in severe bone infections of the upper extremity were discussed and the good results of this surgical procedure established it as a good option for treatment. Morbidity at the donor site was minimal. © 1994 Wiley‐Liss,

ISSN:0738-1085    

DOI:10.1002/micr.1920150108

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe authors reviewed 62 neurotizations of the brachial plexus in 71 patients performed between 1974 and 1989. The nerves used were the accessory, the motor or sensory branches of the cervical plexus, and the intercostals. Twenty‐five suprascapular nerves, 19 musculocutaneous, 4 medial roots of the median nerve, and 12 lateral roots of the median nerve were neurotized. The authors concluded that useful results can be achieved using extraplexual neurotizations. © 1994 Wiley‐Liss,

ISSN:0738-1085    

DOI:10.1002/micr.1920150109

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

年代:1994

数据来源: WILEY

摘要:

AbstractReconstruction of the foot using microvascular flaps has been widely performed in the last 15 years but the choice of flap to repair some areas in the foot remains controversial. We present a series of 128 free flaps to the foot performed during the period of 1975–1990. One hundred and seventeen had a successful outcome (91%). The etiology of the problem was traumatic in 94, congenital in 10, tumor in 9, and chronic ulcerations due to vascular problems in 15. The indications for a specific flap depended on the site and extension of the foot problem, and were divided into four groups:1Dorsum of the foot. Cutaneous parascapular flap was the best choice.2The sole‐weight‐bearing area. We favored the use of the latissimus dorsi muscle flap covered with a split thickness skin graft, done immediately. A proper tailoring of the flap and postoperative care by the patient are very important to maintain the result without ulceration. Tactile sensation does not seem to be essential.3The area over the calcaneus tendon. We have used cutaneous flaps such as the parascapular and lateral arm flap or fascial flaps covered by split thickness skin grafts (STSG). The fascia used were the serratus or the parascapular.4Complex trauma problems with extensive skin loss or chronic ulcerations due to vascular diseases: the latissimus dorsi musculocutaneous or muscle plus STSG was mostly used.The overall number of donor areas were 5 groins, 48 parascapular, 2 gluteal fold flaps, 4 lateral arm, 61 latissimus dorsi, and 8 fascial flaps. © 1994 Wiley‐L

ISSN:0738-1085    

DOI:10.1002/micr.1920150110

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

年代:1994

数据来源: WILEY

摘要:

AbstractConventional methods for the treatment of congenital pseudarthrosis of the tibia (CPT) often lead to unsatisfactory results and so microsurgical fibula transfer (MFT) has appeared as an option to treat this challenging problem.In this series of 27 patients with CPT, we obtained satisfactory results in 23 as assessed by the timing of bone union and bone hypertrophy of the fibular transplant.The overall functional results were also good; in 18 patients, the residual shortening was less than 2 cm (with no limb shortening in 4) and in 7, shortening ranged between 2 and 4 cm. All 25 patients resumed normal walking without the help of braces after an average of 12 months. This report suggests that microvascular fibula transfers provide superior results in the treatment of CPT, especially when considering that many of such cases represented previous surgical failures. © 1994 Wiley‐Liss, I

ISSN:0738-1085    

DOI:10.1002/micr.1920150111

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

年代:1994

数据来源: WILEY