[Surgical repair of major vascular injuries in the extremities complicated by other injuries: retrospective analysis of 67 cases].

OBJECTIVE: To retrospectively analyze the surgical repair of injured major vessels in the extremities complicated by multiple other injuries. METHODS: According to different time lengths of sustaining ischemia, sites of the major vascular injuries and conditions of other injuries, 91 operations for end-to-end anastomosis, vessel grafting and repair, ligation and shunting respectively were performed on the 67 patients. RESULTS: Except for 2 fatal cases (one due to preoperative brain hernia and hemorrhagic shock, the other to thyroid crisis during operation), all other cases survived the operations. Vascular crisis occurred in 3 cases (2 arterial spasm and 1 venous crisis) 6, 7 and 12 h respectively after the operations, which were relieved by appropriate treatments and surgical explorations. One patient developed pneumonia and acute renal failure with polyuria at postoperative days 7 and 4 respectively, but full recovery was achieved. CONCLUSIONS: For patients with major vascular injuries in the extremity complicated by multiple other injuries, timely revascularization of the extremities should be performed during or immediately after emergency operations of the vital organs. Particular attention should be given to the diagnosis and repair of closed major vascular injuries in such patients, who need to be monitored for blood coagulation during operation and should receive due post-operative anti-coagulation treatment.

[An experimental study of treatment of comminuted distal femur fracture with locked double- plating].

OBJECTIVE: To explore new techniques for the treatment of comminuted distal femoral fractures to promote functional restoration and reduce the complications of the fracture. METHODS: Sixteen adult canines were selected for this study, and the experimental and control hindlimb for each canine were randomly determined. Distal comminuted fracture (AO/ASIF Type C2) was induced in both sides of the canine's femurs, and one side was fixed with the double plates (steel plate and polyethylene plate), whereas the other with a single steel plate. By the end of 3, 6, 9 and 12 weeks respectively after surgery, 4 of the dogs were used for weight-bearing observation and radiological and histological examination of the limbs. RESULTS: In comparison with dogs in single plate group, double plate fixation resulted in earlier recovery of weight bearing, more abundant and better callus, finer callus moulding and quicker healing. There were slightly more inflammatory cells, however, in the tissues under the polyethylene than those under the steel plate. CONCLUSION: Locked double-plate internal fixation is an excellent alternative for treating comminuted fractures of the distal femur, and may have its potential use in clinical settings.

[Microsurgical repair of syndactyly of the fingers in children].

OBJECTIVE: To evaluate the effectiveness of microsurgical technique for repairing syndactyly of the fingers in children. METHODS: Microsurgical repair of syndactyly of the fingers was performed in 32 children. The skin joining the syndactyly was incised and relaxed under microscope, and dorsal metacarpal flap of comparable size was used to repair the lateral skin defect of the finger and also to reconstruct the finger web. RESULTS: All the flaps survived without scar leaving on the lateral skin of the fingers, and the reconstruction of the finger web was satisfying. CONCLUSION: Microsurgical technique is applicable in the surgical repair of syndactyly of the fingers in children.

[Biomechanical study of double-plate fixation for comminuted fractures of the distal femur].

OBJECTIVE: To explore the new treatment approach for comminuted fractures of the distal femur. METHODS: Supra- and intercondylar comminuted fractures were induced in the femurs of 20 fresh adult cadavers, 10 of which received fixation with lateral steel plates and medial polyethylenes plates while the rest with single plate in the lateral only. Biomechanical tests of bending, torsion and compression were performed. RESULTS: Biomechanical test demonstrated that double-plate fixation provided better resistance to compression (P<0.05) as well as bending and torsion (P<0.01) than single-plate fixation did. CONCLUSION: Double-plate fixation is effective and may have potential clinical value in treating comminuted fractures of the distal femur.