Three-Dimensional Visualization for Extended Deep Inferior Epigastric Perforator Flaps.

Purpose: The aim of the study was to provide an applied and digital anatomical basis of acquiring extended deep inferior epigastric perforator (DIEP) flaps for clinical use.

Methods: Five formalin-soaked specimens were received red latex injection and dissected by layers. The arteriography using the modified mixture of lead oxide-gelatin was performed on 10 adult cadavers that were serially scanned by a spiral computed tomography.

Reconstruction of the distal ulnar epiphysis with vascularized proximal fibula including epiphysis in children after osteochondroma resection: report of two cases.

Background: Osteochondromas, especially multiple hereditary osteochondromas, usually cause various deformities of the joints. The authors sometimes find ulnar shortening and acquired wrist varus deformity in distal ulnar osteochondromas and even radial head dislocation resulting in ulnar shortening. In this study, the authors present the clinical outcomes of distal ulnar epiphysis reconstruction in two children using vascularized proximal fibula including the epiphysis after osteochondroma resection.

Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study.

Anatomic study of selective neurectomy of gastrocnemius muscle for calf reduction in Chinese.

Background: Selective neurectomy of the innervating nerves of the gastrocnemius muscle is a popular method employed for calf reduction. However, accidental injury to the untargeted adjacent nerves could happen. This study aims to provide detailed morphometry of the motor branches from the tibial nerve innervating the gastrocnemius muscle, the soleus and the medial sural cutaneous nerve in the popliteal fossa.

A novel in vivo technique for observations of choke vessels in a rat skin flap model.

Background: Choke vessels are reduced-caliber vessels that link adjacent vascular territories throughout the body. The behavior of choke vessels determines flap survival. Therefore, it is important to develop a reliable technique with which to study these vessels.

Vasculature at the medial aspect of the foot and clinical application of flaps based on it for forefoot reconstruction.

Background: Detailed knowledge of the vasculature of the medial aspect of the foot has rarely been reported, but it is of tremendous importance for harvesting the flap in this area to cover defects of the foot and hand. Repair of soft-tissue defects at the dorsal forefoot remains a challenge in reconstructive surgery. The authors describe the use of the distally based saphenous neurovenofasciocutaneous flap at the medial aspect of the foot to cover this region.

[Three-dimensional reconstruction and anatomic variation of the portal vein based on 64-slice spiral CT data].

Objective: To investigate the three-dimensional reconstruction methods of the portal vein using 64-slice spiral CT data and the anatomical variation of the portal vein.

Methods: Three-dimensional reconstruction of the portal vein was performed using Mimics software based on the 64-slice spiral CT data of 64 cases. Each model of the portal vein and its branches was evaluated according to the presentation rate, depiction quality and anatomic variation.

Transoral atlantoaxial reduction plate internal fixation with transoral transpedicular or articular mass screw of c2 for the treatment of irreducible atlantoaxial dislocation: two case reports.

Study Design: Retrospective report of two surgical cases and review of the literature.

Objective: To report the clinical application of transoral atlantoaxial reduction plate (TARP) internal fixation with a novel technique of transoral transpedicular or articular mass screw of C2 in the treatment of irreducible atlantoaxial dislocation and basilar invagination with ventral spinal cord compression.

Summary Of Background Data: Current surgical treatments for IAAD have various disadvantages, such as posterior decompression followed by atlantoaxial or occipitocervical fusion with unsatisfactory decompression, transoral decompression, and one-stage posterior instrumentation needing two approaches although with satisfactory decompression, resection of dens and/or clivus with potential risk of spinal cord injury and CSF leakeage.

Anatomical study of position of the rib head for placing anterior vertebral body screws in a chinese population.

In this study, the variability of rib head position in a Chinese population in terms of the spinal canal and vertebral body was analyzed using computed tomography (CT). Images from transverse CT scan of the T4 to T12 vertebral bodies of 30 normal individuals were 3-dimensionally reconstructed, and analyzed for measurement of parameters that define the relative anatomic position of the rib head. We have found that the distance between the anterior border of the rib head and the posterior margin of the vertebral body, posterior safe angle, and the distance between the most inferior border of the rib head and inferior end plate in the sagittal plane gradually decrease.

An anatomic and clinical study of the adductor magnus tendon-descending genicular artery bone flap.

The composite tissue flap of the descending genicular vessels with the adductor magnus tendon is a newly developed, reliable method to repair the Achilles tendon and relevant skin defects. The aim of this study was to evaluate the anatomy of the adductor magnus tendon-descending genicular artery bone flap, and the feasibility and value for the repair of the Achilles tendon and relevant skin defects. There were 34 adult specimens used for the anatomy of this flap.

Anatomy of the transversus nuchae muscle and its relationship with the superficial musculoaponeurotic system.

Background: Previous studies have proved the existence of muscle fibers in the superficial musculoaponeurotic system (SMAS) of the parotid and masseter region; however, no studies have investigated the origination of the muscle fibers in the SMAS. Theoretically speaking, the muscle fibers within the SMAS in the parotid and masseter region might originate from a certain muscle with a definite origin and insertion. Based on this hypothesis, the authors' study investigated the origination of the muscle fibers in the SMAS of the parotid and masseter region to provide anatomical evidence that can improve our understanding of the SMAS.

Anatomical study to the vessels of the lower limb by using CT scan and 3D reconstructions of the injected material.

Purpose: To find out the advantages and insufficiency of the 3D reconstruction and traditional anatomy by comparing them with each other.

Methods: 1. Infused with the radio-opaque material from the arteries and veins, respectively, fresh lower extremity specimens were subjected to spiral CT scanning and then 3D reconstruction was conducted to obtain 3D vessels.

[The nasal development after one-staged correction of nose deformity and unilateral complete cleft lip in infancy].

Objective: To introduce one-staged correction of nasal deformity and unilateral complete cleft lip in infancy and to observe the nasal development after the operation.

Methods: The unilateral complete cleft lip and nasal deformity were corrected in one stage in27 cases. They were followed up for several years.

Measurement and analysis of the perforator arteries in upper extremity for the flap design.

The aim of this study was to provide the anatomical basis for the skin flap pedicled with the nutrient vessels of the cutaneous nerves and cutaneous veins of the upper extremity. Radio-opaque material was injected into the common carotid arteries of five fresh cadavers. The skin and the fascia were meticulously dissected, removed, and radiographed.

An overview of skin flap surgery in the mainland China: 20 years' achievements (1981 to 2000).

Microsurgical anatomy and clinical applications have been widely and extensively practiced throughout the mainland of China since late 1970s. During the 1980s to 1990s, Chinese surgeons and anatomists developed many new flap donor sites and modifications, most of which were published in Chinese literature. These achievements were not fully realized by the Western surgeons.

Demonstration of three injection methods for the analysis of extrinsic and intrinsic blood supply of the peripheral nerve.

Background: The use of free vascularized nerve grafts requires an intimate and accurate knowledge of the blood supply of peripheral nerve. This study was designed to compare the advantages and disadvantages of three methods employed to reveal the blood supply of the peripheral nerve, and to provide morphological basis for vascularized nerve grafts.

Methods: The blood supply of brachial plexus and its main branches (ulnar, median, radial, musculocutaneous and axillary nerve) were observed using three vascular injection techniques: three specimens were injected with red latex through the thoracic aorta; two side specimens were injected with a Chinese ink solution, through the subclavian artery, for diaphanization and histology; one fresh cadaver was injected with the gelatin-lead oxide mixture through the femoral artery for radiography.

Three-dimensional visualization of pelvic vascularity.

The aim of this study was to establish a 3D digitized model of pelvic vasculature for anatomic study, preoperative planning, and virtual reality. Three adult fresh cadavers were perfused with carboxymethyl cellulose/lead oxide mixture to mark blood vessels, and subjected to multilayer spiral computed tomography scanning to obtain a series of thin sections. Then, the 2D images of the pelvis and pelvic blood vessels were transformed into 3D digitized models using Mimics 11.

The topographical relationships and anastomosis of the nerves in the human internal auditory canal.

Introduction: The anatomy of the nerves in the human internal auditory canal (IAC) has been reported by a number of authors, and there are some differences among the viewpoints of the literatures. With the development of the microsurgery and endoscopic surgery in the IAC, the study of the topographical relationship of the nerves in the human IAC becomes more and more important. The purpose of this study was to investigate the anastomosis and topographical relationship of the nerves in the human IAC.

Lateral retromalleolar perforator-based flap: anatomical study and preliminary clinical report for heel coverage.

Background: Repair of heel soft-tissue defects remains a challenging problem in reconstructive surgery. The distally based sural neurofasciocutaneous flap is among the flaps of choice for coverage of this difficult region. The authors describe a modified lateral retromalleolar perforator-based neurocutaneous flap with a lower pivot point.

[Evaluation of perioperative blood loss following total knee arthroplasty].

Objective: To evaluate perioperative occult blood loss following total knee arthroplasty (TKA).

Methods: A retrospective analysis of 40 patients undergoing TKA was conducted to calculate the mean blood loss and occult blood loss according to Gross formula.

Results: The mean total blood loss was 1538 ml in these cases with occult blood loss of 791 ml.

[Anatomic evaluation the entry point of C2 pedicle screw].

Objective: To study the relevant position of C(2) pedicle to C(2) inferior articular process, set up a technique of C(2) pedicle screw placement with the inferior articular process of axis as an anatomic landmark.

Methods: Fifty C(2) bone specimens were used to measure the distance from the sagittal midline to the medial border, the midpoint and the lateral border of C(2) inferior articular process or C(2) pedicle; the width and the height of the C(2) pedicle were also evaluated. The anatomic relation between the measurements data of C(2) pedicle and that of C(2) inferior articular process were analyzed, and the technique of C(2) pedicle screw fixation was established.

[Pelvic artery representation on three-dimensional reconstructed multislice spiral CT images: variability between the young and the elderly].

Objective: To analyze the variability in pelvic artery representation on three-dimensional reconstructed multislice spiral CT images between young adults and the elderly.

Methods: Eight young adult volunteers from the medical staff and 8 elderly people undergoing regular coronary artery examination, who were all free of coronary artery disease and diabetes mellitus, were enrolled in this study. After administration of the contrast agent through the median cubital vein at 3.

[Anatomic study of the hypoglossal nerve in hypoglossal-facial nerve anastomosis].

Objective: To determine the optimal position of hypoglossal nerve in hypoglossal-facial nerve anastomosis and the eligibility of hypoglossal-facial nerve anastomosis with the cervical loop.

Methods: The cervical course and adjacent structures of the hypoglossal nerve were observed on 21 adult cadavers. The hypoglossal nerve and facial nerve were taken from 3 fresh specimens, and the number of the fasciculus and the cross-sectional area of the nerve were measured.

[Rotational malalignment causing patellofemoral complications after total knee replacement].

Objective: To study the rotation of femoral component and tibial component with CT and evaluate the relationship between patellofemoral complications and rotational alignment of the components.

Methods: Thirty patients with isolated patellofemoral complications after total knee arthroplasty were compared with 20 patients with well functioning total knee replacements free of patellofemoral complications. The epicondylar axis and tibial tubercle were used as references on CT scans to quantify the rotational alignment of the femoral and tibial components.

The frontal-temporal nerve triangle: a new concept of locating the motor and sensory nerves in upper third of the face rhytidectomy.

Background: How to avoid damage to the temporal branch of the facial nerve has long been a central topic of discussion. Recently, damage to the supraorbital nerve, the auriculotemporal nerve, and other branches of the trigeminal nerve divisions has attracted much attention. Focusing on frontal and temporal rhytidectomy, the authors have investigated the course and distribution of the facial nerve branches, the supraorbital nerve, the auriculotemporal nerve, and other branches of trigeminal division.