OBJECTIVETo evaluate the effect of muscular pedicle bone grafts with sartorius or tensor fasciae latae and sartorius in fresh transcervical or subcapital fractures of the femoral neck.

METHODSThirty cases of fresh transcervical and subcapital fractures of the femoral neck were treated by the tail breakable screws and sartorius pedicle bone grafts (single muscular pedicle, SMP group). The other 23 cases were treated by cannulated pressure screws and bone grafts with the muscular pedicles of both sartorius and tensor fasciae latae (double muscular pedicles, DMP group).

RESULTSFifty-two cases were followed up for 3 to 5 years (mean, 4 years). In SMP group, ten cases showed poor therapeutic results. Excellent therapeutic effects were achieved in all cases of DMP group.

CONCLUSIONSThe transcervical or subcapital fractures of the femoral neck can be treated by double muscular pedicles bone graft. The bone graft with double muscular pedicles is more effective than single sartorius muscular pedicles for fresh transcervical and subcapital fractures of the femoral neck during short and medium terms.

Bone Transplantation ; Fascia Lata ; Female ; Femoral Neck Fractures ; surgery ; Humans ; Male ; Prognosis ; Surgical Flaps

Fascia Lata/transplantation* ; Humans ; Rupture, Spontaneous ; Tendons/surgery* ; Wrist ; Wrist Joint/surgery*

The surgeon is, at times, confronted with the problems of covering large defects of the soft tissue of the groin area, which result from trauma, ablative surgical treatment or prosthetic graft infection. Coverage is a challenging problem particularly when the wound is complicated by radiation. Defects of the soft tissue, however extensive, that do not have any vital structures exposed could be easily handled with skin grafting, provided there is a healthy vascular bed after surgical debridement and frequent dressing changes. The complicated wounds should be covered as expeditiously as possible to avoid desiccation and weakening of the vessel wall and, in the presence of vascular prosthesis, to avoid contamination and graft thrombosis. Exposure of the femoral vessels or prosthetic grafts requires urgent coverage with well vascularized muscle and muculocutaneous flaps based on well-defined vascular pedicle. Reonstruction with well-vascularized tensor fascia lata flap has enabled us to maintain the patency of native femoral artery and a viable distal lower extremity in a male patient, who had a sudden ruptured femoral artery after radiation therapy on burned groin.
Bandages ; Blood Vessel Prosthesis ; Burns ; Debridement ; Desiccation ; Fascia Lata ; Fascia ; Femoral Artery ; Groin ; Humans ; Lower Extremity ; Male ; Skin Transplantation ; Thrombosis ; Transplants ; Wounds and Injuries

PURPOSE: To evaluate the clinical outcome of frontalis sling operation using preserved fascia lata with modified direct tarsal fixation in congenital ptosis patients. METHODS: Forty-seven congenital ptosis patients (60 eyes) who underwent a frontalis sling operation using preserved fascia lata with modified direct tarsal fixation method between March 2001 and December 2008 with a mean follow-up time of 52 months (range, 26 to 122 months) were included in this study. The medical records were reviewed retrospectively. RESULTS: A retrospective chart review was conducted in patients who were diagnosed with congenital ptosis and underwent frontalis suspension surgery using preserved fascia lata with modified direct tarsal fixation from 2001 through 2008 at Dong-A University Hospital. The patients were 34 males and 14 females. The age of the patients ranged from 1 to 18 years with an average age of 4.51 years. At a mean follow-up of 60 months, good final results were achieved in 46 eyes (76.6%), fair in 8 eyes (13.3%), and poor in 6 eyes (10%). The poor results consisted of undercorrection of 1 eye and recurrence in 5 eyes. The accumulative survival rate was 87.2%, with all recurrences occurring within 12 months postoperatively. CONCLUSIONS: Frontalis sling operation by preserved fascia lata with modified direct tarsal fixation appears to be an effective treatment for severe congenital ptosis, showing good long term results.
Adolescent ; Blepharoplasty/*methods ; Blepharoptosis/congenital/*surgery ; Child ; Child, Preschool ; Fascia Lata/*transplantation ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Infant ; Male ; Recurrence ; Retrospective Studies ; *Suture Techniques ; Transplantation, Autologous

OBJECTIVE: The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. METHODS: Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at -70degrees C. RESULTS: The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. CONCLUSION: We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.
Anti-Bacterial Agents ; Cadaver ; Fascia Lata ; Follow-Up Studies ; Humans ; Mass Screening ; Meningitis ; Skull Base ; Tissue Banks ; Tissue Donors ; Transplantation, Homologous ; Transplants ; Wound Infection

OBJECTIVETo observe the clinical effects of repair of complicated tissue defects of several body parts with composite anterolateral femoral fascia lata perforator tissue flaps (fascial flap or fascial skin flap) with the aid of micro-surgery.

METHODSFrom February 2008 to August 2012, complicated tissue defects in 12 patients were repaired with composite anterolateral femoral fascia lata perforator tissue flaps. Two of the 12 patients suffered from a defect of scalp, skull, and dura mater as a result of resection of a malignant tumor of the scalp; 3 patients showed a defect of skin and tendo calcaneus in the heel and lower leg; 2 patients showed a defect of skin and extensor tendon in the dorsum of hands; the other 5 patients suffered from defects of skin and extensor tendon in the foot and ankle combined with exposure of bone or internal buttress plate. The size of tissue flaps ranged from 12 cm ×6 cm to 19 cm ×18 cm. The donor sites were closed by immediate suturing or skin grafting.

RESULTSAll 12 tissue flaps survived. Patients were followed up for 2 to 36 months. The flaps were shown to have good appearance, texture and function. Two patients with the defect of the scalp, skull and dura mater after a resection of the malignant tumor of the scalp did not have recurrence or herniation of brain tissue. The foot-raising function in 3 patients with the defect of skin and tendo calcaneus in the heel and lower leg was recovered, and according to Arner-Lindholm criteria the result was excellent in 2 cases and good in 1 case. The extension function of fingers of 2 patients with defects of skin and extensor tendon in the dorsum of hands was good according to the evaluation criteria of Chinese Medical Association Society of Hand Surgery for tendon repair of hand. The extension function of toes of 5 patients with defects of skin and extensor tendon in the foot and ankle combined with exposure of bone or internal buttress plate was recovered and improved.

CONCLUSIONSTransplantation of composite anterolateral femoral fascia lata perforator tissue flaps with the aid of micro-surgery is an effective method in repairing the tissue defects of skull, dura mater, and the extensor tendon of hands or feet, with restoration of the extension function.

Adult ; Fascia Lata ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

OBJECTIVETo observe clinical efficacy of using free anterolateral thigh flaps with iliotibial tracts in repairing skin and soft tissue defects around the knee joints with patellar ligament defects.

METHODSTwelve patients with skin and soft tissue defects around the knee joints and patellar ligament defects were hospitalized from June 2010 to June 2014. The defects of skin and soft tissue ranged from 7 cm × 6 cm to 16 cm × 12 cm in area, and patellar ligament ranged from 5 to 12 cm in length and 2.5 to 4.0 cm in width. Free anterolateral thigh flaps with iliotibial tracts were used to repair these defects. During reconstruction of patellar ligament, both ends of iliotibial tract were successively folded to form tendon-like three-layer structure at first, and then the newly formed structure was wrapped around the broken ends of patellar ligament and fixed with suture. The flap size ranged from 9 cm × 8 cm to 18 cm × 14 cm. The iliotibial tract ranged from 7 to 14 cm in length and 8 to 12 cm in width. The donor sites were closed by grafting with autologous split-thickness skin harvested from thigh or trunk, and parked with gauze. Immediately after operation, the knee joints were fixed in extension with orthosis for 6 weeks. Weight bearing training of affected limbs being kept in extension position was started from 2 weeks after operation, and flexion and extension exercise of affected knee joints was begun from 6 weeks after operation. Before operation and 12 months after operation, the degree of pain around the knee joints and knee joint function were evaluated with the international knee documentation committee knee uation form, and the ranges of flexion and extension of knee joints were also evaluated. The integrity of reconstructed patellar ligament was assessed by color Doppler ultrasound from 6 to 12 months after operation. The occurrence of surgery-related complications was observed in all patients within 12 months after operation.

RESULTS(1) After operation, all flaps survived well, and all wounds healed well. (2) The average score of pain around the knee joint was increased from 31 points before operation to 77 points in 12 months after operation. The average score of knee joint function was increased from 14 points before operation to 65 points in 12 months after operation. Before operation, the average ranges of flexion and extension of knee joint were respectively 89° and 65°, and they were respectively increased to 130° and decreased to 15° in 12 months after operation. From 6 to 12 months after operation, color Doppler ultrasound showed that the condition of reconstructive patellar ligaments in all patients was good without the need for further surgical intervention; the superficial sensation of the flaps was recovered in different degrees. No surgery-related complication was observed in all patients within 12 months after operation.

CONCLUSIONSFree grafting of anterolateral thigh flap with iliotibial tract is an effective and reliable method for repairing skin and soft tissue defects around the knee joints combined with patellar ligament defects, and the surgical procedure can recover function and appearance of knee joint satisfactorily.

Extremities ; Fascia Lata ; Humans ; Knee ; Knee Joint ; Patellar Ligament ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; Surgical Flaps ; Thigh ; Wound Healing

OBJECTIVE: To explore the effect of reparation and restitution of head tissue deletion with autologous fascia lata and local flap. METHOD: The clinical data of 8 cases with scalp squamous celled carcinoma from 2003 to 2010 were summarized retrospectively. All patients carcinoma were removed almost, cerebral dura mater deletion and skin deletion from 5 cm to 15 cm, repaired cerebral dura mater with autologou fascia lata; and restitution scalp with local flap, the area of local flap were planted with free skin graft. RESULT: The outcomes of the treatment with fascia lata were very well, and the local flap of all cases were survival the free skin graft were survival from 85% to 100%. There was no leakage of cerebrospinal fluid or intracranial infection during follow-up. CONCLUSION The method of repairation and reconstruction of head tissue deletion with fascia lata and local flap is effective, the out comes are satisfying.
Carcinoma, Squamous Cell ; surgery ; Dura Mater ; surgery ; Fascia Lata ; transplantation ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Retrospective Studies ; Scalp ; surgery ; Skin Neoplasms ; surgery ; Skin Transplantation ; Surgical Flaps ; transplantation ; Treatment Outcome

OBJECTIVETo evaluate the clinical application of microsurgical fascia latae flaps combined with rib and skin graft for reconstruction of the distal phalanx defect.

METHODSThe phalanx wounds were sutured together like syndactyly. The autologous rib was revised to repair the bone defect of distal phalanx. The fascia latae flap was used to cover the bone exposure with microvascular anastomoses and resurfaced by a meshed split-thickness skin graft.

RESULTS5 cases were treated successfully. The fascia latae flaps were all survived with only skin graft necrosis at the distal end in one case. It was healed spontaneously.

CONCLUSIONSThe fascia latae flap is nourished by the descending branch of the lateral circumflex femoral artery. The flaps has a good blood supply and can be easily obtained with a long vascular pedicle. The flap is ideal for the reconstruction of distal phalanx defect when combined with autologous rib implant and skin graft.

Adolescent ; Adult ; Fascia Lata ; transplantation ; Female ; Finger Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; transplantation ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

transplantation can be considered by reviewing the risk associated with other transplanted hard tissues. Viral, bacterial, and fungal infections have been transmitted via transplantation of soft tissue allografts such as skin, cornea, dura, pericardium. fascia lata, and heart valves. Corneas have transmitted rabies, Creutzfeldt-Jakob disease (CJD), hepatitis B (HBV), cytomegalovirus (CMV), herpes simplex virus (HSV), bacteria, and fungi. Heart valves have been implicated in transmitting tuberculosis, hepatitis B. HIV-1 and CMV. CJD has been transmitted by dura and pericardium transplants. Skin has transmitted CMV, bacteria, and fungi. Cadaveric skin, pericardium, dura, and fascia lata have been used in dental patients with intra-oral soft tissue injuries and GBR. This study is review of the considering transmission of infectious disease in allogenic soft tissues and guidelines of reducing the risk. Prior to use, many tissues are exposed to antibiotics, disinfectants, and sterilants, which further reduce or remove the risk of transmitted disease. Because some soft tissue grafts cannot be subjected to sterilization steps, the risk of infectious disease transmission remains and thorough donor screening and testing is especially important.]]>
Allografts ; Anti-Bacterial Agents ; Bacteria ; Cadaver ; Communicable Diseases ; Cornea ; Creutzfeldt-Jakob Syndrome ; Cytomegalovirus ; Disease Transmission, Infectious ; Disinfectants ; Donor Selection ; Fascia Lata ; Fungi ; Heart Valves ; Hepatitis B ; HIV-1 ; Humans ; Incidence ; Pericardium ; Rabies ; Simplexvirus ; Skin ; Soft Tissue Injuries ; Sterilization ; Tissue Banks ; Tissue Transplantation ; Transplants ; Tuberculosis