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Tangshan, China

Wang B.,Second Hospital of Tangshan | Zhang X.,Second Hospital of Qinhuangdao | Jiang W.,Second Hospital of Qinhuangdao | Ma T.,Second Hospital of Qinhuangdao | And 2 more authors.
Journal of Hand Surgery

Purpose: In this article, we report the reconstruction of degloved fingers using a combination of a cross-finger flap and a composite-free flap from the dorsal aspect of the second toe. Methods: From May 2006 until April 2009, we treated 18 degloved fingers in 18 patients (13 male and 5 female patients; mean age, 22 y) using the technique. There were 11 index and 7 ring fingers. The mean volar and dorsal defects were 2.5 × 1.9 cm and 2.7 × 2 cm, respectively. The cross-finger flaps ranged in size from 2.3 × 1.6 cm to 3.5 × 2.6 cm, with a mean of 2.8 × 2.3 cm. The flaps from the dorsal second toe ranged in size from 2.4 × 2.1 cm to 4.5 × 2.3 cm, with a mean of 3.0 × 2.2 cm. At follow-up, we assessed motion and sensation. Results: All cross-finger and free flaps survived. At final follow-up (mean, 17 mo; range, 1425 mo), motion in the injured fingers averaged 102°and 28°at the proximal and distal interphalangeal joints, respectively. The mean static 2-point discrimination of the reconstructed finger pulps was 5 mm (range, 47 mm). Conclusions: The combination of a cross-finger flap and a composite-free flap from the dorsum of the second toe is a useful and reliable technique for reconstruction of a degloved finger. Type of study/level of evidence: Therapeutic IV. © 2012 American Society for Surgery of the Hand. Source

Feng H.-Y.,Tianjin Medical University | Ning G.-Z.,Tianjin Medical University | Feng S.-Q.,Tianjin Medical University | Yu T.-Q.,Second Hospital of Tangshan | Zhou H.-X.,Tianjin Medical University
Journal of Spinal Cord Medicine

Study design: Hospital-based retrospective review. Objective: To describe the epidemiological characteristics and trends of traumatic spinal cord injury in Tianjin, China. Setting: Tianjin Medical University General Hospital. Methods: Medical records of 239 patients with traumatic spinal cord injury admitted to a general hospital from 1998 to 2009 were reviewed. Variables included gender, age, marital status, occupation, etiology, time of injury, level, and severity of injury. Epidemiological characteristics of different countries were compared. Results: Over this period, the mean age of patients with traumatic spinal cord injury was 45.4 ± 14.1 years, and the male/female ratio was 4.6:1. In all, 86.2% were married. The leading cause was fall (52.3%), followed by motor vehicle collision (36.4%). The most common injury site was the cervical spinal cord, accounting for 82.0%. Incomplete tetraplegia made up for 59.4%, followed by complete tetraplegia (22.6%). Eight patients died after operation, six of whom died from respiratory complications. Conclusion: The results of this study are in accordance with that of most other developing countries; falls and motor vehicle collisions were the two leading causes, but the mean age was older. Percentage of the aged with traumatic spinal cord injury was increasing. The low-falls group tended to expand over this period. All these data indicated that the preventive programs should focus on the traffic accidents and falls, and more attention should be paid to the aged for the vulnerability to low fall. © The Academy for Spinal Cord Injury Professionals, Inc. 2011. Source

Chen C.,Second Hospital of Tangshan | Chen C.,Tangshan College | Tang P.,Chinese PLA General Hospital | Zhang X.,Second Hospital of Qinhuangdao | Zhang X.,Chengde Medical College
Annals of Plastic Surgery

Sensate cross-finger flaps and homodigital and heterodigital island flaps can usually be used for sensory reconstruction in the volar aspect of the digit. However, when the donor areas are damaged by concomitant injuries, these flaps are not available. The free dorsal digital flap, including both dorsal branches of the proper digital nerves, can be used as an alternative to resolve this problem. The flap was used in 16 patients with soft tissue defects on the volar aspect of the digits. For comparison, we collected a consecutive series of 31 patients with similar defects treated using a cross-finger flap including one branch. At final follow-up, the static 2PD of 2-branch flap is superior to 1-branch flap. The dorsal digital sensate free flap can be used as an alternative for the reconstruction of volar soft tissue defect of the digits. Sufficient sensory recovery can be achieved using this technique. © 2014 Lippincott Williams and Wilkins. Source

Chen C.,Second Hospital of Tangshan | Chen C.,Hebei United University | Tang P.,General Hospital of the Peoples Liberation Army | Zhang L.,General Hospital of the Peoples Liberation Army | And 2 more authors.

Background: Providing soft-tissue coverage for multiple finger defects remains a challenge for the hand surgeons. This article reports reconstruction of multiple digital defects using the dorsal homodigital island flaps based on the dorsal branch of the digital artery. Methods: Over 3 years, a retrospective study was conducted with 12 patients who had multiple finger defects treated with the dorsal homodigital island flaps. Our series included nine male and three female patients. There were 30 soft-tissue defects in 30 fingers. The injured fingers included seven index, nine long, nine ring and five little fingers. The average size of soft-tissue defects and flaps was 2.4 ± 0.4 cm × 1.7 ± 0.2 cm and 2.6 ± 0.4 cm × 1.9 ± 0.2 cm, and the mean pedicle length was 1.1 ± 0.2 cm. Results: Full flap survival was achieved in 26 fingers. Partial distal flap necrosis was noted in four fingers, which healed without surgical intervention. At a median of 20 (range, 19-23) months' follow-up, the static two-point discrimination on the flap averaged 9.1 ± 1.6 mm, and the median (range) Semmes-Weinstein monofilament score was 3.84 (3.84-4.17). The donor-site morbidity was accepted. According to the Michigan Hand Outcomes Questionnaire, seven patients were strongly satisfied and five were satisfied with functional recovery of the reconstructed fingers. Conclusions: The dorsal homodigital island flap, based on the dorsal branch of the digital artery, is less invasive, versatile and technically easy for simultaneous coverage of small-to-moderate defects in multiple fingers. Crown Copyright © 2013 Published by Elsevier Ltd. All rights reserved. Source

Sun L.-Q.,Hebei Medical University | Shen Y.,Hebei Medical University | Li Y.-M.,Second Hospital of Tangshan
Spinal Cord

Study design:Prospective study.Objectives:To investigate whether pre- and post-operative changes of signal intensity (SI) and transverse area (TA) of the spinal cord on T2-weighted magnetic resonance imaging (MRI) reflect the surgical outcome in patients with spinal cord injury (SCI) without radiologic evidence of trauma (SCIWORET).Setting:The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.Methods:In 36 consecutive prospective patients, MRI was performed pre-operatively and 3 months post-operatively. The Japanese Orthopaedic Association (JOA) scale and the American Spinal Cord Injury Association (ASIA) motor score (AMS) were used to quantify neurologic status at admission and at least 12-month follow-up. Pre- and post-operative TA, range of signal intensity (RSI), grayscale of signal intensity (GSI) and prevertebral hyperintensities (PVHs) were measured using the image analysis software. Pre-operative status and post-operative recovery were assessed in relation to MRI parameters pre- and post-operatively using univariate and multivariate analysis.Results:Pre-operative JOA and AMS score negatively correlates RSI, GSI and PVH. There was no significant correlation between pre-operative TA and pre-operative JOA and AMS. Recovery rate with JOA negatively correlates pre-operative RSI, post-operative RSI, pre-operative GSI, post-operative GSI and PVH. There was a significant negative correlation between recovery rate with AMS and pre-operative RSI, post-operative GSI and PVH. From these results of multivariate stepwise regression analysis, the predictors of surgical outcomes are pre-operative GSI and pre-operative RSI.Conclusion:Quantitative MRI analysis may provide reliable information for the prediction of the initial neurological status and surgical outcome of patients with SCIWORET. © 2014 International Spinal Cord Society All rights reserved 1362-4393/14. Source

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