Practical Microsurgery Cases Repair, Replantation and Reconstruction

This book aims to introduce the most recent microsurgical techniques and applications in the pattern of illustrative case presentations, including digit replantation, toe-to-hand transplantation, peripheral nerve injuries especially total brachial plexus avulsion injury, surgical flaps.

Microsurgery appeared to be a great procedure suitable for more applications. Anatomic research of the blood supply of skin, fascia, nerve, muscle, and bone identified flaps could be carried by pedicle vessels. Transfer of these flaps and revascularization by micro-vascular anastomoses of the arteries and veins set the stages for free flaps. In free flap surgery, single-stage and complex reconstructions could be achieved, which then lead to earlier mobilization and better restoration of function with a shorter hospital stay. Today, microsurgical technique is fully matured, and micro-vascular free tissue transfer is an essential part of reconstructive surgery.

Development of microsurgeryin China is introduced in the initiation of the current book. Key technical points and experience of replantation, reconstruction, tissue repair, nerve repair and reconstruction, oncological repair and reconstruction cases together with other applications of microsurgery are further demonstrated.

Part 1 Upper limbs and hands.- 1 Successful replantation of the distal phalanx of the little finger in a newborn: A case report.- 2 Replantation of amputated finger composite tissue mass.- 3 Replantation of severed fingers in children.- 4 Replantation of single hand's multiplane severances with 17 segments.- 5 Replantation of severed upper arm of a nine-month-old infant.- 6 Replantation with vessel anastomosis for treatment of hand degloving injuries.- 7 Transpositional replantation of severed fingers.- 8 Salvage of the damaged hand by the emergency reconstruction with heterotopic replantation of discarded fingers.- 9 Salvage of an amputated upper extremity with ectopic implantation followed by replantation at the second stage.- 10 Emergency repair of a degloving injury in three fingers.- 11 Reconstruction for forearm deformities with ulnar shortening induced by capitulum ulnae giant chondroma.- 12 First intention combined plastic reconstruction of the thumb through transplanting separated second toe with full dorsal toenail flaps exchange between the first and second toes.- 13 Tissues mass replantation of the index and middle finger.- 14 The Use of a Third Metacarpal Base Vascularized Osteoarticular Graft for Treatment of Metacarpophalangeal Joint Traumatic Defects.- 15 Two-Staged Surgical Treatment of Composite Tissue Defects of the Dorsum of Hand and Finger Involving Fingerweb.- 16 Reconstruction of combined thumb amputation at the metacarpal base level and index amputation at the metacarpal level with pollicization and bilateral double toe composite transfer.- 17 Harvest and separate the second toe for repair of compound tissue defects for multiple fingers.- 18 Combined biological reconstruction can be used to repair large bone defect after resection of malignant bone tumor.- 19 Anterolateral thigh flap for the reconstruction of forearm with severe injury.- 20 The free peroneal artery perforator flap for combined medial ankle injury.- 21 The ultra-long free peroneal artery perforator flap for lateral foot defect coverage.- 22 Sural nerve nutritional vessel axial flap for the heel skin defect coverage and calcaneal reconstruction.- Part 2 Lower limbs and hands.- 23 Repair and reconstruction of the segmentally destructed lower limb in a child.- 24 Exploration of the superior retinacular arterial system of the femoral head after femoral neck fractures in young adults.- 25 Replantation of Segmental destructive disconnect of the child's calf.- 26      Extension of lower limbs for extreme flexion of knee joint induced by dorsal scar adhesion after burned for 13 years in a child.- 27 Posterior tibial artery flap in series with medial plantar artery flap for repair of anterior foot degloving injury.- 28 Adipofascial turnover flap for dorsal foot coverage and dead space filling.- 29 Repair hot-pressed wound of hand with lobulated chimeric flaps of perforator branch of lateral circumflex femoral artery.- 30 The waveform designof decending branch of lateral circumflex femoral artery perforator flap for the heel defect reconstruction.- 31 Chimeric peroneal artery perforator flap for reconstruction post-traumatic osteomyelitis of tibia.- 32 Dual skin paddles descending branch of the lateral circumflex femoral artery perforator flap for one-staged reconstruction of two adjacent wounds.- 33 Dual skin paddles descending branch of the lateral circumflex femoral artery perforator flap for reconstruction of extensive foot defects.- 34 Treatment of tibia GUSTILO IIIC fractures by bone transfer combined with flap technique.- 35 Large Segmental Free Ectopic Revascularized and Prefabricated Bone Flap for Second Stage Repair of Bone and Soft Tissue Defects.- 36 Repair of a lateral malleolus defect with a composite pedicled second metatarsal flap.- Part 3 Head, neck and trunk.- 37 Replantation repair of total scalp avulsion.- 38 Replantation of facial tissue mass.- 39 A case for replantation of amputated ear.- 40 Salvage of large scalp defect with exposed skull necrosis by a free vascularized greater omentum graft in a 3-year-old child: a case report and 10-year follow-up.- 41 Maxillary and orbital floor reconstruction with anterolateral thigh flap and individual pre-bended titanium mesh.- 42 Deep circumflex iliac artery (DCIA) flap for one-staged reconstruction of left mandible defects.- 43 Case of facial nerve reconstruction.- 44 Mandibular reconstruction with vascularized fibular flap in double-barrel technique.- 45 Oromandibular Reconstruction with Intraoral Anastomosis of a Deep Circumflex Iliac Artery Perforator Fascial Flap with Iliac Crest.- 46 Bilateral submandibular gland transplantations for paediatric several dry eye disease.- 47 Chimeric thoracoacromial artery perforator flap for one-staged reconstruction of complex haryngoesophageal defects.- 48 Maxillary reconstruction with vascularized fibula osteomyocutaneous flap using virtual surgical planning.- 49 Transoral segmental mandibulectomy and intraoral anastomosis for mandibular reconstruction guided by virtual surgical planning and intraoperative navigation.- 50 Reconstructed bladder innervation above the level of spinal cord injury to produce urination by abdomen-to-bladder reflex contractions.- 51 Reconstructed bladder innervation below the level of spinal cord injury to produce urination by Achilles tendon–to-bladder reflex contractions.- 52 Transfer of normal S1 nerve root to reinnervate atonic bladder due to conus medullaris injury.

Chunlin Hou

Department of Orthopedic Surgery

Changzhen Hospital

Second Military Medical University

Shanghai

China

Chunlin_hou@163.com

 

Shimin Chang

Department of Orthopedic Surgery

Yangpu Hospital

Tongji University Medical School

Shanghai

China

shiminchang11@aliyun.com

 

Juyu Tang

Department of Hand and Microsurgery

Xiangya Hospital

Central South University

Changsha

China

tangjuyu7749@163.com

 

Zhigang Cai

Department of Oral and Maxillofacial Surgery,

Peking University Medical School and Hospital of Stomatology

Beijing

China

czg4209@126.com