Endoscopic Surgery for Delayed Wound Healing After Achilles Tendon Suture Repair: A Report of Three Cases.

BACKGROUND: Delayed wound healing is a potention complication after Achilles tendon suture repair and occurs for various reasons. The conventional treatment for delayed wound healing is open surgery, but patients face long recovery times and postoperative care is difficult. CASE PRESENTATION: This report presents three patients who were seen at our institute from April 2008 to October 2017 due to long-term non-healing wounds after surgery. All three patients had undergone surgery at least 2 months previously. We performed endoscopic surgery on these patients. After the operation, patients received less antibiotics and simpler care than would be required for conventional open surgery. There is no need to keep the wound open after the operation or perform wound cleaning for multiple times at the same time, which can reduce healing time. At the last follow up, all postoperative scores among the patients were significantly improved compared to before surgery. The Achilles tendon total rupture scores were excellent and the American Orthopedic Foot and Ankle Society scores were satisfactory, indicating improvements in Achilles tendon function and movement in patients after surgery. CONCLUSION: Our case reports demonstrate that arthroscopic treatment for delayed wound healing after Achilles tendon suture repair is satisfactory and reliable; frequent opening of the wound for cleaning is not required after the operation, thus reducing the healing time.

[Investigation of replantation of thumb rotation avulsion injury].

OBJECTIVE: To investigate replantation methods and clinical outcomes of thumb rotation avulsion injury,and to evaluate the advantages and disadvantages of each procedure. METHODS: From Feburary 2009 to March 2012, 21 thumbs suffered from rotation avulsion injuries and replanted by different methods, including 16 males and 5 females with an average age of 32 years old ranging from 16 to 45 years old. Diffierent methods were chosen according to the traumatic condition. And the survival condition and function of the thumbs after replantation were observed and evaluated. RESULTS: Among them, 19 replanted figers were survival, 2 cases failed. The mean follow-up period was 8 months (ranged from 3 to 14 months). According to the criteria for function assement of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 13 cases, good in 5, and poor in 1. CONCLUSION: According to the traumatic condition to choose various approach in replantation of thumb with rotation avulsion, leading to a higher success rate, and provide the patients with a more aesthetic appearance and satisfied function.

[Abdominal random single pedicled flap of three leaves for the treatment of multiple finger skin defects].

OBJECTIVE: To discuss the effect of abdominal random single pedicled flap of three leaves for skin defects construction of the ends of several fingers. METHODS: From March 2005 to October 2010, 30 patients (90 fingers) with skin defects of the ends of several fingers were treated by abdominal random single pedicled flap of three leaves, including 20 males (60 fingers) and 10 females (30 fingers) with an average age of 36 years old ranging from 15 to 56 years. The degloving injury or transverse defect of distal phalanx were treated with abdominal random single pedicled flap of three leaves. Postoperative survival of skin flap, flap shape, complications were observed, and the static two-point discrimination of flap were determined. RESULTS: All patients were followed up for 12.6 mouths in average. All the flaps survived. The color, texture and shape of the flaps were good. The static two-point discrimination was 5 to 10 mm. The function of the hands recovered satisfactory. CONCLUSION: The method of abdominal random single pedicled flap of three leaves has the advantages of simple, safe and less trauma for the donor site. The effect is satisfatory for skin defects construction of the ends of several fingers.