Wang Fa-bin

Medial flap of the shank – Anatomical study and clinical application

SummaryBy anatomical study in 40 cadaver legs it was shown that the blood of the medial leg flap is supplied by the ramus saphenus, which is the cutaneous branch of the descending genicular artery. Venous drainage of the flap is by the great saphenous vein. The medial femoral condyle and the great saphenous vein serve as the markers of the top and the longitudinal ax s of the flap respectively. The vascular pedicle is about 10 cm in length, the flap measures 10×20 cm. This paper presents our experience in the use of the medial leg flap. The largest flap was 16×18 cm as an island flap or a free flap in 6 cases for repairing soft tissue defect of the knee, heel and hand with satisfactory results.

Embryonic limb buds derived neurotrophins on the survival of neurons and the growth of axons in Culturein vitro

SummaryBioactive proteins from SD rat limb buds were extracted and purified. Fractions of 22 ku, 34 ku and 95 ku were proved to have neurotrophic activity to neurons, and the combined activity of these three fractions was the highest. So they were combinedly added into the culture medium of sensor neurons in dorsal root ganglia and motor neurons of anterior spinal cord from 2-week-old embryonic rats, and PBS was added as control. Phase-contrast microscopic and electron microscopic observations, and true cholinesterase measurements were performed to evaluate the survival and changes in growth, function, and ultrastructure of these cultured neurons. In the experimental group, it was found that the AchE activity was higher (P<0. 01), ultrastructural changes in mitochondria, Gorgi’s complex and other cell organs were milder than those in the control group. The results showed limb buds derived neurotrophins played an important role in maitaining the survival of the neurons and promoting the growth of axons. It was concluded that embryonic limb buds derived neurotrophins had high neurotrophic activities on neurons’ survival and axon growth.

Application of forearm island flap to repair of hand injury

In our series there were 15 patients, 7 males and 8 females , aged 11-35 years. In 3 of them the soft tissue in jury was fresh (1 on the dorsum of the hand, 1 on the pa lmar aspect of the thumb, and 1 on the t humb and thenar prominence) , while in the other 12 the t rauma was old (3 had contract ion of the f i rs t web of the hand; 3 had prot ruding f irst carpal bone; 2 had scars on the dorsum of the hand; 2 had scars on the palmar aspect of the index f inger , the r ing finger and the little f inger respectively; 1 had loss of soft t issue on the ulnar side of the thumb wi th exposed interphalangeal joint; 1 had hemangioma of the t hum b) . The largest f lap was 6 × 16 cm, and the smallest was 3 × 5 cm. 5 of them were taken f rom the left fo rearm, and I0 f rom the r ight . The vessel pedicles of the flaps were usua l ly 5 6 cm in length, the shortest being 2 cm, and the longest 8 cm. The dis ta l ly s i tuated vessel pedicles turned 130-180 degrees w i th the f laps rotated distal ly to the hand . In 12 cases the flaps passed th rough a subcutaneous tunnel to reach the recipient site. Only in 3 cases of the scar on the palmar aspect of the f ingers was the passage fo rmed b y an incision made between the f l ap and the recipient region. The donor areas in 9 cases could be closed b y direct a p p r o x i mat ion and 6 b y sp l i t sk in graf t s . The island f laps in all cases su rv ived in their entirety; in 2 cases the f laps became marked ly swollen on the f i r s t day af ter operat ion wi th vesicle f o r m a t i o n on the skin but the swell ing subsided in 3 5 days .