Abstract:
BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery perforator flaps and 3 dual paddle flaps were performed in 16 patients. Among the patients, eight had defects in the metacarpal bones and eight had defects in the phalanx bones. The flaps were created with a skin paddle and humeral bone segments by using independent perforators. The flaps ranged in size from 5.5 × 2.0 to 7.5 × 4.5 cm, whereas the humeral fragments ranged in size from 1.5 × 0.5 to 4.0 × 1.5 cm. The pedicle of the flaps was divided and ligated below the level at which the radial collateral artery separates into anterior and posterior branches. The recipient vessels were the proper digital artery, the palmar subcutaneous vein (n = 12), the deep branch of the palmar ulnar artery (n = 4), and the venae comitantes. The cosmetic appearance of both donor and recipient sites was evaluated during a follow-up visit. RESULTS:Postoperative venous congestion occurred in two cases. The venous obstruction was reanastomosed after venous thrombectomy. The procedures were successful in both cases upon examination. All the flaps survived and all the donor sites were closed directly, leaving only a linear scar. Follow-up time ranged from 12 to 28 months. Bone components achieved union in all cases at an average of 5.4 months (ranging from 3 to 6 months). In two cases, the flap was defatted during the late postoperative period. Cosmetically acceptable results were achieved for the rest of the patients. CONCLUSION:The modified chimeric radial collateral artery perforator flap is a good alternative for reconstructing complex bone and soft tissue defects of the hands. LEVEL OF EVIDENCE:This is a level IV, retrospective series.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Liu J,Song D,Wu S,Li J,Deng X,Li K,Lv H,Xu Jdoi
10.1055/s-0034-1390324subject
Has Abstractpub_date
2015-03-01 00:00:00pages
171-8issue
3eissn
0743-684Xissn
1098-8947journal_volume
31pub_type
杂志文章abstract::Anatomic variations in branching pattern of axillary artery (AxA) are common and typically involve subscapular artery (SsA) and posterior circumflex humeral artery (PCHA). Several skin and muscle flaps are based on the branches of AxA. Furthermore, these branches are frequently used as recipient vessels in functioning...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1351354
更新日期:2013-10-01 00:00:00
abstract::Twenty-eight vascularized toe-joint transfers performed on 25 patients were reviewed. A number of different techniques were used: proximal interphalangeal joint or metacarpophalangeal joint reconstruction, one-stage double joint transfer, and interphalangeal thumb or trapezometacarpal joint replacement. Using these ty...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006819
更新日期:1990-07-01 00:00:00
abstract::The authors treated 14 patients (13 men and one woman), using a sensate radial forearm flap. Their ages at operation ranged from 27 to 67 years (mean: 52 years). Preoperative conditions were amputations in 10 cases, degloving injury in three, and crush injury in one. Reconstructive sites involved the thumb in nine cas...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-9375
更新日期:2000-11-01 00:00:00
abstract::The reconstruction of the flexor tendon in zones I and II of a ring finger in a single stage, using a free vascularized tendon graft, is reported in a single clinical case. The flexor digitorum superficialis (FDS) tendon of the same finger was freely transferred based on a vascular branch off the ulnar vessels. The ul...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-931905
更新日期:2006-01-01 00:00:00
abstract::This study compares the acute intraoperative arterial elongation technique with the interposition vein-graft method for the closure of small arterial gaps that cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were divided into two groups: a vein graft interposition group and an acute expans...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006523
更新日期:1995-03-01 00:00:00
abstract::Although often a life-saving therapeutic maneuver, there is minimal data available that details the effects of intraoperative packed red blood cell transfusion (IOT) after microvascular free tissue transfer. The National Surgical Quality Improvement Program database was queried to identify all patients who underwent m...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0033-1357275
更新日期:2014-02-01 00:00:00
abstract::This study quantified arterial anastomotic tension, evaluated subsequent patency rates, and examined the degree of tension reduction with vessel mobilization. The study was divided into two components. In part I, a mechanical analysis was undertaken to evaluate tension, based on the determination of the force required...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006464
更新日期:1996-02-01 00:00:00
abstract::Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078691
更新日期:2008-04-01 00:00:00
abstract::Peripheral nerve injury may result in injury without gaps or injury with gaps between nerve stumps. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. The clinical employment of tubes as an alternative to autogenous nerve grafts is mainly j...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1333316
更新日期:2013-03-01 00:00:00
abstract::Controversy surrounds the question whether free flaps remain dependent for blood supply on their vascular pedicle or if there is an autonomization by neovascularization from the surrounding wound bed. This becomes important when flap shaping or repositioning are performed. Our study involved 23 patients who received a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0028-1103500
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND: The use of caffeine is not recommended prior to elective microsurgery due to its demonstrated negative effects on vessel anastomosis by the presumed sympathomimetic induction of vasoconstriction. In this study, we aimed to elucidate the systemic and local effects of caffeine on vessel diameter, anastomosis ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1672130
更新日期:2019-05-01 00:00:00
abstract::The spinal cord cannot heal after severance because the central nervous system is "non-permissive" to the advancement of axons that regrow from presynaptic motoneurons. With the aim of overcoming paraplegia, the author has carried out extensive experimental research since 1980, first in rats and subsequently in monkey...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-18873
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:We present the clinical application of the sixth internal mammary artery perforator (IMAP) and superior epigastric artery perforator (SEAP) flaps for the treatment of defects resulting from the excision of large lower sternal and upper abdominal keloids. Perforator selection and flap design were based solely...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0035-1556078
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND: There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. METHODS: We selected a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1627445
更新日期:2018-07-01 00:00:00
abstract::The etiopathology, clinical features, and treatment of carpal tunnel syndrome (CTS) in long-term hemodialyzed patients, are discussed in the light of new clinical findings. Conclusions summarizing the specific characteristics of CTS in hemodialyzed patients include the following. 1) There is a relatively equal sex rat...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006856
更新日期:1989-04-01 00:00:00
abstract::Nerve transection using rat sciatic nerves was employed to observe morphologic changes in the periodic denervation of Pacinian corpuscles. During periods of from 1 to 20 weeks after surgery, a total of 15 corpuscles were obtained under the operating microscope and processed for morphologic analysis using light and ele...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000101
更新日期:1999-05-01 00:00:00
abstract::Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate le...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0036-1579541
更新日期:2016-06-01 00:00:00
abstract::In recent years microvascular free tissue transfer has become a well accepted reconstructive technique. The current trend in flap research seems to be the development of more refined flaps to meet specific needs with minimal donor site morbidity. The internal oblique muscle provides a broad, thin, well-vascularized fl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007012
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND: The Allen test (AT) is a widely used clinical tool for the preoperative assessment of sufficient dual vessel hand perfusion although the impact of a pathological AT on tissue perfusion of the hand is not entirely clear. This study reveals perfusion changes of the hand in patients with pathological and physi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1668159
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND: In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning obj...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1716320
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND: With the technological advances, microsurgery has evolved to the era of supermicrosurgery since its inception. With the popularization of these flaps, proficiency in using tools such as color Doppler ultrasound (CDU) has become crucial. Despite the increased interest, studies regarding the role of ultrasoun...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1709479
更新日期:2020-09-01 00:00:00
abstract::From 1991 to 1996, four free vascularized fibular grafts (FVFG) and four callus distraction (CD) techniques were performed for post-traumatic tibial defects at the authors' institute. They attempted to discern any differences of results between FVFGs and CDs for post-traumatic tibial defects. The mean defect length of...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-12684
更新日期:2001-01-01 00:00:00
abstract::A model of chronic entrapment neuropathy in the rabbit sciatic nerve was developed to try to elucidate the pathogenesis of chronic nerve entrapment. A non-compressive Silastic cuff was wrapped around the nerve at the mid-thigh level in eight rabbits. A sham operation that only elevated the sciatic nerve was performed ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000070
更新日期:1999-01-01 00:00:00
abstract::Aberrant reinnervation of target organs caused by misdirected axonal growth at the repair site is a major reason for the poor functional outcome usually seen after peripheral nerve transection and repair. This study investigates whether the criss-crossing of regenerating rat sciatic nerve axons between tibial and pero...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-861524
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND: The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin sur...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1649508
更新日期:2019-01-01 00:00:00
abstract::To assist nascent microsurgeons in the initial practices of handling instruments and tying knots before using an animal model, the authors discuss surgical gauze, which will be of benefit to all trainees. In this model, the nascent microsurgeon can familiarize himself or herself with the operating microscope, correct ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2003-42634
更新日期:2003-08-01 00:00:00
abstract::The use of growth factors in inducing angiogenesis and enhancing flap viability has provided promising results. Targeted gene therapy has evolved in hopes of increasing the longevity and effectiveness of these growth factor treatments. The purpose of this study was to examine the effect of preoperative treatment by va...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-915207
更新日期:2005-08-01 00:00:00
abstract::In this paper the authors describe and illustrate a rare anatomic variation of the ulnar artery, a superficial ulnar artery. The possible embryologic events responsible for this variation are discussed. In addition, they describe the surgical considerations that should be kept in mind when this abnormality is encounte...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000120
更新日期:1999-08-01 00:00:00
abstract::Multiple level amputation has been described as a contraindication to replantation. This is a case report of a patient with a double level amputation through the palm and forearm that was successfully replanted. Because of the need for multiple stages of reconstructive surgery, it was not clear until the end result th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007016
更新日期:1986-04-01 00:00:00
abstract::Local anesthetic drugs with prolonged nerve-block effect would have clinical application for postoperative or neuromatous pain relief. This study evaluated the possibility of peripheral nerve neurotoxicity by injection of 10 percent ammonium sulfate. Both intrafascicular and extrafascicular injection of 10 percent amm...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006418
更新日期:1997-08-01 00:00:00