Objective To investigate the short-term outcome of vascularized supraclavicular lymph nodes flap transplantation to treat the lower extremity lymphedema.Methods From June,2014 to June,2016,6 cases of stage Ⅱ-Ⅲ lower extremity lymphedema received vascularized supraclavicular lymph nodes flap transplantation in this study.Flap size ranged from 2.5 cm×8.0 cm to 3.5 cm×10.0 cm.The anterior tibial artery and accompanying vein were detached for anastomosis.Results One case suffered flap necrosis and then received lymphatic-venous anastomosis instead;2 cases suffered vascular crisis and partial flap necrosis,but transplanted lymph node survived and the wound were closed with skin graft.The other 3 flaps survived without any complication.Follow-up time ranged from 0.5 to 2.0 years.The affected limb circumference and the incidence of lymphangitis decreased significandy,with no complications observed in donor site.Conclusion Using vascularized supraclavicular lymph nodes flap transplantation to treat lower limb lymphedema,it has satisfactory short-term outcome and no obvious complications.It is a promising treatment choice for patients with lower extremity lymphedema in the early and mid stage.

Objective To investigate the value of the B-mode ultrasound method for muscle recovery after transplantation.Methods From January,2009 to January,2014,35 patients of functioning free gracilis muscle transplantation for brachial plexus injury were involved.Using B-mode ultrasound to determine the cross-sectional area (CSA) of transplanted gracilismuscle at rest and contraction state.The contraction ratio (CR) and the muscle bulk ratio (MBR) was calculated based on the CSA.Then the CR and MBR were analysised statistically with manual muscle strength and joint range of motion (ROM) to investigate the correlation.Results The followed-up time was 8-24 months,averaged of 22.4 months.The CR of the transplated muscle was (1.23±0.15),which was significantly correlated with muscle strength and joint ROM (P＜0.01,r=0.872,r=0.847,respectively).CR of transplanted muscle with or larger than M4 was greater than that of less than M4 [CR were (1.35±0.10),(1.09±0.06),respectively],and the difference was statistically significant (P＜0.05).The MBR was greater than 1 in 17 cases,and less than 1 in 18 cases.There was no significant correlation between MBR and muscle strength and ROM (P＞0.05).There was no statistically significant difference in muscle strength and ROM between patients with MBR greater than 1 and those with MBR less than 1 (P=0.054,P=0.284,respectively).Conclusion The transplanted muscle recovery can be quantitatively reflected by the CR.CR enlargement of the transplanted gracilis muscle indicated a better recovery of muscle contraction function.MBR is not suitable for evaluating function recovery of transplanted muscles.

Objective To explore the method and clinical effect of radial artery pedigreed conjoined perfora-tor flap for repairing cross-joint long-shaped skin and soft tissue defects in fingers. Methods From June, 2015 to June,2017,six patients with cross-joint long-shaped skin and soft tissue defects of the fingers were treated with radial artery pedigreed conjoined flap which axis was the artery superficial line, and carried two radial artery perforators, in order to enlarge flap cut range to repair.The size of flaps ranged from 3.0 cm ×6.0 cm to 3.5 cm ×7.5 cm.The donor site was directly sutured. After operation, all patients were followed up for 3 to 8 months. All the necessary parts are observed, such as the flaps appearances, textures, the donor sites, checked the flap sensation, activity functions of the fingers. Results Six cases of flap all survived.The wounds healed well(phase I),and all patients were followed up for 3 to 8 months, with an average of 5 months. All the flaps do not obviously bloat, the textures were soft,the colors are normal,the appearances of flaps were similar to recipient sites. The donor sites healed well only with linear scars. Conclusion Using radial artery pedigreed conjoined perforator flap to repair cross-joint long-shaped skins and soft tissue defects in fingers that it not only can enlarge the cut range but also cut conveniently, the textures are close to recipient sites.Therefore,it is an ideal repair way.