Body of abstract:There are round-, rectangular - and crescent -shaped tissue expanders;of which the most efficient expander is the rectangular shaped, which expands the skin to form a *** cover a skin defect effective...
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Body of abstract:There are round-, rectangular - and crescent -shaped tissue expanders;of which the most efficient expander is the rectangular shaped, which expands the skin to form a *** cover a skin defect effectively,it is necessary to cut the expanded skin and to spread it out as a *** Object:We introduce the use of lambda incisions of the lateral walls of such rectangular ***:A long incision to expand the lateral wall results in a long *** we perform one lambda incision on each parallel lateral wall (a?total of two lambdas).The lambda incision should be made only on the lateral walls and not at the base of the flap to avoid interfering with the blood *** the defect is triangular,we use only one lambda on one side,and if the defect is trapezoid,we use one lambda on one side and two on the opposite ***:Lambda incisions were used in 11 *** six patients,one rectangular tissue expander was used for one lesion,and most of the lesions could be *** all expanders had base areas equal to those of the skin *** nine of the 11 patients,nearly the entire lesion could be resected. Conclusion:The lambda incision is very useful for face and extremity lesions,where room for expanders is limited.
Backgr ound:The superficial cervical artery (SCA)musculocutaneous flap was first reported by Nakajima et *** 1984;the present authors developed it for use as a skin flap in 1990,and in 1993,we succeeded in harvesting ...
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Backgr ound:The superficial cervical artery (SCA)musculocutaneous flap was first reported by Nakajima et *** 1984;the present authors developed it for use as a skin flap in 1990,and in 1993,we succeeded in harvesting it as a free *** 1986,we have harvested over 50 superficial cervical artery perforator (SCAP) flaps of various types for the reconstruction of head and neck scar contractures or intractable ***: In a retrospective clinical study,flaps were classified into 4 types;*** pedicled SCAP flap,*** SCAP flap,3. free SCAP flap,*** SCAP flap(ipsi-lateral or contra-lateral).In an clinical anatomical study,MDCT was useful to detect ***:Flaps almost survived,and both the aesthetical and functional results were good. Conclusions:We have fully confirmed from our clinical and anatomical studies that the SCAP flap is useful for the reconstruction of the head and neck *** each flap, the SCAP was found to be a "transverse cervical perforator" or "trapezius perforator" and was large enough to be employed as a vascular pedicled flap.
目的:肘关节后外侧旋转不稳定(PosterolateralRotatory Instability,PLRI)是指肘关节在承受外翻和外旋应力时,肱尺关节半脱位、肱桡关节旋转脱位的状态。本研究旨在探讨Ⅰ、Ⅱ型冠突骨折合并肘关节内侧副韧带损伤是否会造成肘关节后外侧旋转不稳定,为临床Ⅰ、Ⅱ型冠突骨折合并MCL损伤的治疗方法提供理论支持。材料和方法:取新鲜冷冻成人上肢标本10具,近端在肱骨中上段三角肌粗隆处截骨,远端桡腕关节处行离断,保留下尺桡关节,制成骨-关节囊韧带标本。将标本保持在前臂极度旋后位固定,使用INSTRON 8874液压伺服生物力学测试系统实施100N单轴压缩实验,分别在屈肘90°、60°和45°时测量标本在下列情况下的负荷一位移曲线:①完整的肘关节;②Ⅰ型冠突骨折后的肘关节;③Ⅰ型冠突骨折合并内侧副韧带前束(anteriorbundle of the medial collateralligament complex,AMCL)损伤后的肘关节;④Ⅱ型冠突骨折合并AMCL损伤后的肘关节。实验数据用SPSS16.0统计软件作方差分析,分别比较"损伤情况"和"角度"对于肘关节"位移"的影响有无统计学意义。结果 :1.屈肘90°时损伤程度对肘关节后外侧稳定性的影响:①完整肘关节后方位移2.17±0.42mm,在四种损伤条件下最小,肘关节后外侧旋转稳定性最好;②Ⅰ型冠突骨折后肘关节后方位移2.20±0.41mm,与完整组位移相比P=0.866,差异无统计学意义;③Ⅰ型冠突骨折合并AMCL损伤后肘关节后方位移2.31±0.34mm,与完整组比较P=0.447,差异无统计学意义;④Ⅱ型冠突骨折合并AMCL损伤后肘关节后方位移2.65±0.38mm,与完整组比较P=0.013,差异有统计学意义,但是在实验中并未发现肉眼可见的肱尺关节脱位或桡骨头脱位。2.Ⅱ型冠突骨折合并AMCL损伤后,各屈肘角度对肘关节后外侧稳定性的影响:①屈肘90°(后方位移2.65±0.38mm)与屈肘60°(后方位移2.37±0.49mm)相比,P>0.05,差异无统计学意义;②屈肘45°(后方位移1.66±0.50mm)分别与屈肘90°及屈肘60°相比,P<0.05,差异有统计学意义。结论 :单纯Ⅰ型冠突骨折和Ⅰ型冠突骨折合并AMCL损伤不会造成肘关节后外侧旋转不稳定,这类损伤不需要行冠突修复或重建,但是对于AMCL的损伤,由于其是首要的抗外翻稳定结构,故仍需修复或重建AMCL以恢复外翻稳定性。Ⅱ型冠突骨折合并AMCL损伤会造成肘关节后外侧旋转不稳定,故需要行冠突+AMCL的修复或重建以改善肘关节后外侧旋转稳定性及外翻稳定性。
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