[Diagnostics and correction of vascular disorders in upper extremity muscular transplants].

The features of clinical presentation, diagnosis and treatment of the acute circulatory disorders of muscular transplants in 7 patients after 59 transplantations of revascularized and reinnervated muscle grafts in severe consequences of upper extremities injuries were presented in the article. Tissue complex on pedicle were transplanted to upper extremity in Volkmann contracture (n=47), in consequences of the gunshot wound (n=7) and electric trauma (n=5). Signs of circulatory disorders of the transplanted tissue complex were registered shortly after the operation in 7 patients. Diagnosis was based on the findings of visual and ultrasound investigations. In all cases of circulatory disorders disorders patients were reoperated within 24 hours. Arterial thrombosis occurred in 3 cases and venous - in 2. The cause of impaired venous outflow was a hematoma in 2 cases. Repeated reconstruction of anastomoses with wound drainage in 5 cases led to restoration of blood circulation in transplants. Reoperation was not successful in 2 cases with developing transplant necrosis.

[Present-day possibilities of surgical management of tumour-like forms of arteriovenous angiodysplasias].

Described herein is the treatment policy pursued in a relatively uncommonly encountered variant of congenital vascular pathology, i. e. arteriovenous angiodysplasias. We operated a total of twenty patients presenting with various localization of the pathology concerned. The patients average age amounted to 18 ± 8.6 years. In order to make the diagnosis of the disease and to accomplish the tactical missions we used duplex scanning and angiography. According to the opinion of the authors, in this form of angiodysplasias using any method of treatment independently cannot be efficient. Arteriovenous angiodysplasias were treated by a combined method including endovascular embolisation or sclerotherapy of the afferent vessels and surgical removal of vascular formations. The use of such therapeutic policy makes it possible to attain positive results in 75% of patients.

Reconstruction of the brachial artery in supracondylar humerus fractures and forearm dislocations.

Presented herein is an analysis of the short- and long-term results of the treatment of brachial artery injuries in 25 patients with extension supracondylar humerus fractures and anterior forearm dislocations. The cause of arterial injury was a blunt trauma in 11 patients and contused-crushed wounds in 12 cases. In two patients, iatrogenic injury of the brachial artery occurred after reposition of humerus fractures in other medical institutions. Fourteen patients were admitted to the Department for the first 6 hours from the time of injury, 5 after up to 12 hours, and 6 patients after 12 hours. Decompensation of limb circulation was marked in 2 and subcompensation in 6 patients. In the remaining cases, limb circulation was assessed as compensated. In different medical institutions, the artery was repaired in 4 cases. Operation was complicated by thrombosis in all the cases. Reconstruction of the neurovascular bundle was accomplished under optic magnification in all the patients. The circular suture of the artery was applied in 9, autogenous vein grafting was performed in 7, Y- plasty of the brachial bifurcation in 4, brachioradial bypass grafting in 3, and brachioulnar in 2 cases. Thrombosis of the autogenous vein graft in the short-term postoperative period was identified in 2 patients. Repeated arterial reconstruction appeared successful. The long-term results were followed up in 17 patients over the period as long as 5 years. Anastomosis patency was well preserved in all the cases.