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pedicle complex tissue flap transfer for reconstruction of duplicated thumbs with unequal size

World Journal of Clinical Cases 2021年第35期9卷 10909-10918页

作者： De-Hua Wang Gui-Ping Zhang Zeng-Tao Wang Meng Wang Qin-Yi Han Fan-Xiao Liu Department of Hand and Foot Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Anesthesiology The Affiliated Hospital of Shandong University of Traditional Chinese MedicineJinan 250000Shandong ProvinceChina Department of Hand and Foot Shandong Provincial Hospital Affiliated to Shandong UniversityJinan 250021Shandong ProvinceChina Department of Orthopaedics Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina

BACKGROUND Thumb polydactyly is one of the most common congenital hand deformities,and the Bilhaut-Cloquet procedure or a modified one is often used.However,controversy remains over the rare instances in which both thumbs are not of similar length or far apart in distance.AIM To evaluate the clinical outcomes of pedicle complex tissue flap transfer in the treatment of duplicated thumbs with unequal size.METHODS From January 2014 to December 2020,15 patients underwent duplicated thumb reconstruction by pedicle complex tissue flap transfer at our hand surgery center.The technique was used when it was necessary to combine different tissues from both severed and preserved thumbs that were not of similar length or far apart in distance.Subjective parents’evaluations and functional outcomes(ALURRA and TATA criteria)were obtained.The alignment deviation,instability,range of motion(percent of opposite thumb)of the interphalangeal and metacarpophalangeal joints,and the aesthetic aspects,including circumference,length,nail size,and nail deformity,were used to assess the clinical outcomes.RESULTS The average age of patients at the time of surgery was 13 mo,and the mean final follow-up occurred at 42 mo.An appropriate volume with a stable joint and good appearance was obtained in 14 reconstructed thumbs.An unstable interphalangeal joint occurred in one thumb.The flexion-extension arc at the metacarpophalangeal joint was good,while that at the interphalangeal joint was poor.Most of the parents were satisfied with the cosmetic and functional results of the reconstructed thumbs.The mean ALURRA score was 21.8(range:20-24),and the Tada score was 6.9(range:5-8).Compared with the non-operated side,the length of the operated thumb was approximately 95%,the girth was 89%,and the nail width was 82.9%.The mean ranges of motion were 62.1%of that of the unaffected thumb in the interphalangeal joint and 78.3%in the metacarpophalangeal joint.CONCLUSION Harvesting a pedicle flap from a severed thumb is a safe and reliable procedure.Defects

关键词： Thumb duplication Deformity pedicle flap pedicle

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Dual pitch titanium-coated pedicle screws improve initial and early fixation in a polyetheretherketone rod semi-rigid fixation system in sheep

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Chinese Medical Journal 2019年第21期132卷 2594-2600页

作者： Wen-Tao Wang Chi-Hua Guo Kun Duan Min-Jie Ma Yong Jiang Tuan-Jiang Liu Ji-Jun Liu Ding-Jun Hao Department of Orthopedics The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710054China Department of Spine Surgery Honghui HospitalXi’an Jiaotong UniversityXi’anShaanxi 710054China Department of General Surgery The 417th HospitalChina National Nuclear Corporation(CNNC)Xi’anShaanxi 710064China.

Background:Reports on the efficacy of modifications to the thread design of pedicle screws are scarce.The aim of the study was to investigate initial and early fixation of pedicle screws with a plasma-sprayed titanium coating and dual pitch in the pedicle region(dual pitch titanium-coated pedicle screw[DPTCPS])in a polyetheretherketone(PEEK)rod semi-rigid fixation system.Methods:Fifty-four sheep spine specimens and 64 sheep were used to investigate initial(“0-week”controls)and early(postoperative 6 months)fixation,respectively.Sheep were divided into dual pitch pedicle screw(DPPS),standard pitch pedicle screw(SPPS),DPTCPS,and standard pitch titanium-coated pedicle screw(SPTCPS)groups.Specimens/sheep were instrumented with four screws and two rods.Biomechanical evaluations were performed,and histology at the implant-bone interface was investigated.Results:At 0-week,mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS(557.0±25.2 vs.459.1±19.1 N,t=3.61,P<0.05;622.6±25.2 vs.459.1±19.1 N,t=3.43,P<0.05).On toggle-testing,the DPTCPS was significantly more resistant than the SPPS and SPTCPS(343.4±16.5 vs.237.5±12.9 N,t=3.52,P<0.05;343.4±16.5 vs.289.9±12.8 N,t=3.12,P<0.05;124.7±13.5 vs.41.9±4.3 cycles,t=2.18,P<0.05;124.7±13.5 vs.79.5±11.8 cycles,t=2.76,P<0.05).On cyclic loading,maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS(1.8±0.13 vs.3.76±0.19 mm,t=2.29,P<0.05;1.8±0.13 vs.2.46±10.20 mm,t=2.69,P<0.05).At post-operative 6 months,mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS(908.4±33.6 vs.646.5±59.4 N,t=3.34,P<0.05;925.9±53.9 vs.646.5±59.4 N,t=3.37,P<0.05).On toggle-testing,the DPTCPS was significantly more resistant than the SPPS and SPTCPS(496.9±17.9 vs.370.3±16.4 N,t=2.86,P<0.05;496.9±17.9 vs.414.1±12.8 N,t=2.74,P<0.05;249.1±11.0 vs.149.9±11.1 cycles,t=2.54,P<0.05;249.1±11.0 vs.199.8±7.2 cycles,t=2.61,P<0.05).On cyclic loading,maximum displacement was significantly lower for the DPTCPS than the

关键词： Dual pitch titanium coating pedicle screws Axial pull-out Toggle testing Cyclic loading

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Effect of surgical factors on the augmentation of cementinjectable cannulated pedicle screw fixation by a novel calcium phosphate-based nanocomposite

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Frontiers of Medicine 2019年第5期13卷 590-601页

作者： Haolin Sun Chun Liu Shunlun Chen Yanjie Bai Huilin Yang Chunde Li Lei Yang Department of Orthopedics Peking University First Hospital Beijing 100034China Orthopedic Institute Department of OrthopedicsFirst Affiliated HospitalSoochow UniversitySuzhou 215006China School of Public Health Medical CollegeSoochow UniversitySuzhou 215100China International Research Center for Translational Orthopedics Suzhou 215006China School of Materials Science and Engineering Hebei University of TechnologyTianjin 300130China

Bone cement-augmented pedicle screw system demonstrates great efficacy in spinal disease treatments. However, the intrinsic drawbacks associated with clinically used polymethylmethacrylate (PMMA) cement demands for new bone cement formulations. On the basis of our previous studies, a novel injectable and biodegradable calcium phosphate-based nanocomposite (CPN) for the augmentation of pedicle screw fixation was systematically evaluated for its surgical feasibility and biomechanical performance by simulated and animal osteoporotic bone models, and the results were compared with those of clinical PMMA cement. ASTM-standard solid foam and open-cell foam models and decalcified sheep vertebra models were employed to evaluate the augmentation effects of CPN on bone tissue and on the cement-injected cannulated pedicle screws (CICPs) placed in osteoporotic bone. Surgical factors in CICPs application, such as injection force, tapping technique, screw diameter, and pedicle screw loosening scenarios, were studied in comparison with those in PMMA. When directly injected to the solid foam model, CPN revealed an identical augmentation effect to that of PMMA, as shown by the similar compressive strengths (0.73 ± 0.04 MPa for CPN group vs. 0.79 ± 0.02 MPa for PMMA group). The average injection force of CPN at approximately 40-50 N was higher than that of PMMA at approximately 20 N. Although both values are acceptable to surgeons, CPN revealed a more consistent injection force pattern than did PMMA. The dispersing and anti-pullout ability of CPN were not affected by the surgical factors of tapping technique and screw diameter. The axial pullout strength of CPN evaluated by the decalcified sheep vertebra model revealed a similar augmentation level as that of PMMA (1351.6 ± 324.2 N for CPN vs. 1459.7 ± 304.4 N for PMMA). The promising results of CPN clearly suggest its potential for replacing PMMA in CICPs augmentation application and the benefits of further study and development for clinical uses.

关键词： bone cement pedicle screw degenerative spinal diseases calcium phosphate injectable

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Clinical outcomes with large macular holes using the tiled transplantation internal limiting membrane pedicle flap technique

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International Journal of Ophthalmology(English edition) 2019年第2期12卷 246-251页

作者： Li-Ping Wang Wen-Tao Sun Chun-Ling Lei Jin Deng Department of Ophthalmology Shaanxi Ophthalmic Medical Center Xi'an Fourth Hospital Affiliated Guangren HospitalSchool of Medicine Xi'an Jiaotong University

AIM: To report the surgical technique and efficacy of the tiled transplantation internal limiting membrane(ILM) pedicle flap technique after vitrectomy for 33 patients with large macular hole(MH).

关键词： tiled transplantation ILM pedicle flap macular hole vitrectomy

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Accuracy of pedicle screw placement in the thoracic and lumbosacral spines using O-arm-based navigation versus conventional freehand technique

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Chinese Neurosurgical Journal 2019年第3期5卷 137-143页

作者： Linkai Jing Zhenze Wang Zhenxing Sun Huifang Zhang James Wang Guihuai Wang School of Clinical Medicine Tsinghua UniversityBeijing 100084China Department of Neurosurgery Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China

The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade. This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique. Methods: We reviewed the accuracy of 341 thoracic (n = 173) and lumbosacral (n = 168) pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018. Patient-specific characteristics, treatment-related characteristics, and screw-specific accuracy were analyzed. The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable. Results: One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group. One hundred eighty-three (95.81%) clinically acceptable screws were placed in the navigation group and 135 (90.00%) in the freehand group (p = 0.034). Twenty-three (6.74%) screw revisions were performed in the two groups (8 screws in the navigation group and 15 screws in the freehand group) and significant difference was observed in thoracic spine (p = 0.018), while no statistical significance was presented in lumbosacral spine (p >0.05). Twenty-four (12.57%) screws in the navigation group and 24 (16.00%) in the freehand group violated the cortex (p > 0.05). Medial screw deviation was the most common problem in the two groups. Conclusion: The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.

关键词： Accuracy Freehand Navigation O-arm pedicle screw

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Liver injury after intermittent or continuous hepatic pedicle clamping and its protection by reduced glutathione

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Hepatobiliary & Pancreatic Diseases International 2004年第2期3卷 209-213页

作者： Li Zhou JingAn Rui RouLi Zhou XueMin Peng ShaoBin Wang ShuGuang Chen Qiang Qu YuPei Zhao Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100032 China. lizhou02@***

BACKGROUND:The debate is still going on about selection of several clamping patterns during hepatectomy. The aim of this study was to assess the safety and preference of normothermic intermittent or continuous hepatic pedicle clamping and confirm the protective effect of reduced glutathione (GSH).;METHODS:Thirty-two adult male healthy Sprague-Dawley (SD) rats were divided into groups of intermittent clamping and GSH absent (IA), continuous clamping and GSH absent (CA), intermittent clamping and GSH present (IP) and continuous clamping and GSH present (CP). The clamping manners were successively 40 minutes in continuous clamping groups and two cycles of 20 minutes with an interval of 5 minutes in intermittent clamping groups, and reperfusion periods were 60 minutes. Experimental parameters included levels of malonaldehyde (MDA) and Cu/Zn superoxide dismutase (SOD), pathological and ultrastructural changes in liver tissues, activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in sera.;RESULTS:In the same group, the activities of ALT and AST were significantly higher in post-clamping rats than in pre-clamping rats (P0.05). The differences of all values between post-reperfusion rats and pre-clamping rats were significant (P0.05). The values were significantly different between the GSH absent and present groups after reperfusion (Ppedicle clamping could cause reversible liver ischemia/reperfusion injury when the clamping time lasts 40 minutes. The injury extent seems to be similar. Continuous clam

关键词： hepatic pedicle clamping hepatic ischemia/reperfusion injury reduced glutathione protection

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SUPEKFICIAL RADIA L BRANCH GRAFT WITH VASCULARIZED pedicle TO REPAIRLONGDEFECTOFTHERADIALNERVE：AREPORTOF8CASE

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中华创伤杂志 1994年第6期 305-306页

作者：倪爱民陈中伟

ＳＵＰＥＫＦＩＣＩＡＬＲＡＤＩＡＬＢＲＡＮＣＨＧＲＡＦＴＷＩＴＨＶＡＳＣＵＬＡＲＩＺＥＤＰＥＤＩＣＬＥＴＯＲＥＰＡＩＲＬＯＮＧＤＥＦＥＣＴＯＦＴＨＥＲＡＤＩＡＬＮＥＲＶＥ：ＡＲＥＰＯＲＴＯＦ８ＣＡＳＥＳＮｉＡｉ－ｍｉ... 详细信息

ＳＵＰＥＫＦＩＣＩＡＬＲＡＤＩＡＬＢＲＡＮＣＨＧＲＡＦＴＷＩＴＨＶＡＳＣＵＬＡＲＩＺＥＤＰＥＤＩＣＬＥＴＯＲＥＰＡＩＲＬＯＮＧＤＥＦＥＣＴＯＦＴＨＥＲＡＤＩＡＬＮＥＲＶＥ：ＡＲＥＰＯＲＴＯＦ８ＣＡＳＥＳＮｉＡｉ－ｍｉｎ倪爱民ＣｈｅｎＺｈｏｎｇ－ｗｅｉ...

关键词： CASE 陈中伟 BRANCH GRAFT pedicle RADIA L SUPEKFICIAL TO VASCULARIZED WITH

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Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models

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World Journal of Stem Cells 2016年第3期8卷 101-105页

作者： Pericles Foroglou Vasileios Karathanasis Efterpi Demiri George Koliakos Marios Papadakis Department of Plastic Surgery Papageorgiou General HospitalAristotle University of Thessaloniki Department of Biological Chemistry Medical School Aristotle University of Thessaloniki Department of Surgery Helios Clinic University Hospital Witten-Herdecke

The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adiposederived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.

关键词： pedicle skin flap Adipose stromal cells Flap survival Stem cell Skin defect Reconstructive surgery

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Threatened Aortic Injury by Thoracic pedicle Screw: A Case Report

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Open Journal of Orthopedics 2018年第2期8卷 51-56页

作者： Amadou Ndiassé Kassé Souleymane Diao Magatte Gaye Jean Claude Sané Jean Marie Vianey Hope Karim Hemmam Babacar Thiam Pape Adama Dieng Mouhamadou Habib Sy Orthopedics and Trauma Surgery Department of Grand-Yoff General Hospital Dakar Sénégal Neurosurgery Department of Grand-Yoff General Hospital Dakar Sénégal Thoracic and Vascular Surgery Department of FANN University Teaching Hospital Dakar Sénégal

Iatrogenic vascular injury during posterior spinal surgery is a rare but potentially serious complication with treatment challenges. We report the case of threatened aortic injury by pedicle screw impingement during posterior fixation of thoracic spine T7 - T8 fracture dislocation. The removal of the conflicting screws was done posteriorly after a visual control of the absence of adventitious break-in by a thoracotomy.

关键词： Thoracic Spine pedicle Screw Aorta Thoracotomy

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The Effects of Moufarrege Total Posterior pedicle Reduction Mammaplasty on Breast Cancer Incidence

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Surgical Science 2017年第3期8卷 133-144页

作者： Charles Maalouf Richard Moufarrege Department of Plastic Surgery Montreal University Hospital Center (CHUM) Montreal Canada

Introduction: The Moufarrege total posterior pedicle breast reduction involves complete denudation of the breast offering free access to all breast quadrants. This allows a total resection of the upper outer quadrant which is most implicated in breast cancer. The objective was to assess the postoperative incidence of breast cancer in the cohort of women who underwent the Moufarrege technique. Methods: Retrospective chart review was performed for patients operated on between 1981 and 1997, and a written questionnaire was sent to all patients in 2008. Patients were asked about the date of their last mammogram and any diagnosis of breast cancer. Expected numbers of cancers were calculated from rates in the general population. Age standardization at the time of surgery was done and the incidence of breast cancer was calculated in relation to age at time of surgery and age at last follow-up. Results were presented as standardized incidence ratios (SIR) with their corresponding 95% confidence interval (CI). Results: We included 924 patients. The response rate was 60.38% (n = 558). Mean patient age at the time of the surgery was 32.8 years (14 to 82). Mean resection weight was 620 grs per breast (250 - 1600). Breast cancer was significantly reduced by nearly 64 percent in patients who responded to our questionnaire and were aged 35 years or more at the time of surgery ([SIR] = 0.36;95 % [CI] 0.09 - 0.93). No difference in breast cancer incidence was observed in patients aged less than 25 years at the time of the surgery. Conclusion: The Moufarrege Total Posterior pedicle breast reduction is a reliable and safe procedure that may offer a superior breast cancer risk reduction based on the results of our retrospective chart review and patient questionnaire.

关键词： Moufarrege Total Posterior pedicle Breast Reduction Reduction Mammoplasty Breast Cancer

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