From September 2002 to May 2006, five patients ( age range, 24 to 46; mean, 32) with tibial defect underwent transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis. All the osteocutaneous flaps survived without any serious complications, and tibial defects were improved completely. After 1.5 to 4.5 years' follow-up ( mean, 2.6), no remarkable dysfunction was found at donor sites, and local injury was reduced. This study indicates that transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis might be useful in leg reconstructive surgery if only one vessel is remained.

In many cases, extraction and visualization of blood vessels in 3D magnetic resonance angiography (MRA) images are important in clinical diagnosis and surgery planning. Thus, this paper proposes a novel method to reconstruct high-accuracy outer surface of blood vessels from the 3D MRA. With the method, we first detect such local regions that contain blood structures from 3D image by using a boundary tracking technique. Second, in different local regions, different optimal isosurface patches are computed to adaptively represent outer surface of the contained blood vessels. Finally, all computed isosurface patches form a high-accuracy surface model for outer surface of the whole blood vessel structure are obtained. Error analysis and experimental results illustrate the effectiveness of the proposed method.
Algorithms ; Blood Vessels ; anatomy & histology ; Brain ; anatomy & histology ; blood supply ; Cerebrovascular Circulation ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Angiography ; methods ; Models, Theoretical