Reconstruction of small skin defect on children heel with V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus for small skin defect on children heel.</p><p><b>METHODS</b>From Mar. 2012 to Jan. 2014, 9 children with small skin defects on heel were treated with adjacent V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus. The flaps were 8.0 cm x 4.0 cm to 9.0 cm x 4.5 cm in size and the wounds at donor sits were directly closed.</p><p><b>RESULTS</b>All flaps survived completely with primary healing. 9 cases were followed up for 6-12 months( average, 9 months). The flaps had good match with surrounding tissue in texture and color. The function of ankle was normal. All the parents were satisfied with functional and cosmetic results.</p><p><b>CONCLUSIONS</b>It is a safe and practical method for treatment of small skin defect on children heel with adjacent V-Y advanced flap pedicled with perforator of peroneal artery at posterior lateral malleolus.</p>

Clinical application of free perforator hypothenar flap for thumb pulp defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the therapeutic effect of free perforator hypothenar flap for thumb pulp defect.</p><p><b>METHODS</b>From Jun. 2012 to Mar. 2013,8 cases with thumb pulp defect accompanied with exposure of phalanges ans tendons were treated by free ipsilateral perforator hypothenar flap. The flaps were 1.4 cm x 2.0 cm-1.8 cm x 2.2 cm in size. Ulnar finger artery in the flap was anastomosed with thumb artery. The accompanied veins and superficial veins were respectively anastomosed with thumb dorsal veins. Nerve branches in flaps were sutured with unilateral finger nerve to reconstruct flap feeling with 9-0 thread. Wounds in the hypothenar donor site were sutured directly.</p><p><b>RESULTS</b>All the flaps survived completely with primary healing both in donor and recipient area. 8 cases (8 fingers) were followed up for 6-13 months (average 9 months). The flaps appearance, texture were good. The two-point discrimination distance on flap was 7-10 mm. The active and passive movement of thumb joints was normal. There was no complain about the feeling at the donor site. Linear scar was left on the donor site. Patients hand grip strength was not decreased.</p><p><b>CONCLUSIONS</b>The free perforator hypothenar flap which has constant vascular anatomy is a new method for thumb soft tissue defect with less morbidity to donor site. The operative procedures are relatively simple.</p>

Clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot.</p><p><b>METHODS</b>Based on the anastomoses between the medial plantar artery of the hallux and the nutritional vein, the flap was designed with the perforator of medial plantar artery adjacent to the first metatarsal bone as the rotation point. The flap axis was along the vein at the medial aspect of the foot between rotation point and medial malleolus.</p><p><b>RESULTS</b>5 cases were treated with primary healing and complete survival flaps. The patients were followed up for 1-12 months with good match of texture and color.</p><p><b>CONCLUSIONS</b>The venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot can be transpositioned to repair the defect at forefoot.</p>

Anatomical basis of the flap based on the perforator of the first plantar metatarsal artery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the morphological features of the perforator from the first plantar metatarsal artery, so as to provide anatomic basis for the reconstruction of soft-tissue defects of the forefoot.</p><p><b>METHODS</b>The first metatarsophalangeal joint was chosen as the landmark on 30 human cadaveric feet prefused with red latex. The following contents were observed under surgical magnifier: (1)The origin, courses,branches,distribution of the perforator of the first plantar metatarsal artery; (2)The anastomoses among the perforator of the first plantar metatarsal artery and other arteries on the medial aspect of the foot. Simulated operation was performed on one fresh specimen.</p><p><b>RESULTS</b>The perforator of the first plantar metatarsal artery passed through the space between the tendon, the abductor hallucis and the first metatarsal bone, and its entry point into the deep fascia was located (2. 3 ± 0.7 ) cm proximal to the first metatarsophalangeal joint. The perforator anastomosed with either the medial tarsal artery, the medial anterior malleolus artery or the branch of the medial plantar artery on the superior margin of the abductor hallucis, forming a longitudinal arterial chain,through which small branches were given off to the skin of the medial aspect of the foot. The perforator was( 1. 1 ± 0.2) mm in diameter and(3.2 ± 0.2) cm in length.</p><p><b>CONCLUSION</b>The flap based on the perforator of the first plantar metatarsal artery can be harvested as an axial flap to repair the defects of soft tissue on the forefoot.</p>