BACKGROUNDTo repair late median nerve injury, many methods have been used in the past years. The aim of this study was to review a thirteen-year experience in restoration of thumb opposition by transposing flexor pollicis brevis muscle.

METHODSFrom July 1992 to August 2005, 63 patients without thumb opposition because of late median never injury were treated by transposing the flexor pollicis brevis muscle. All the patients had received primary nerve repair after the jnjury. The interval between the injury and the second operation was (1.87 +/- 2.31) years (6 months to 4.2 years). The patients were followed up for 3 to 48 [months mean (22.93 +/- 2.31) months]. A functional evaluation system designed in 1992 were used to estimate the outcomes of the patients.

RESULTSAll the patients gained excellent functional results without complications and disabilities during follow-up.

CONCLUSIONSRestoration of thumb opposition by transposing flexsor pollicis brevis muscle has the following advantages: 1. Operative trauma is minimal; 2. It is not necessary to transpose other tendons; 3. Except for the thumb in opposition, movements of other fingers and the wrist are not restricted postoperatively.

Adolescent ; Adult ; Biomechanical Phenomena ; Female ; Forearm Injuries ; physiopathology ; surgery ; Humans ; Male ; Median Nerve ; injuries ; Middle Aged ; Muscle, Skeletal ; surgery ; Tendon Transfer ; Thumb ; physiopathology ; surgery ; Wrist Injuries ; physiopathology ; surgery

OBJECTIVETo investigate the clinical application of free forearm flap in the functional hemitongue reconstruction.

METHODSFrom July 2002 to November 2006, 40 patients with tongue cancer underwent hemiglossectomy and primary hemitongue reconstruction with free forearm flaps. In some cases, the lateral antebrachial cutaneous nerves of the flaps were anastomosed with the lingual nerve to restore the flap sensation.

RESULTSAll patients recovered uneventfully after surgery with no morbidity in the donor site. All free flaps survived. The average follow-up period was 2 years and 6 months. The aesthetic and functional results were both satisfactory. The swallowing and speech function were almost normal. The flap sensation was partially restored.

CONCLUSIONSGood functional hemitongue reconstruction can be achieved with free forearm flaps.

Adult ; Aged ; Female ; Forearm ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Oral Surgical Procedures ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Tongue Neoplasms ; physiopathology ; surgery

OBJECTIVETo explore the effect of the patients' articulator function after reconstruction of hemi-tongue defect with forearm flap (FAP) or prime close (PC).

METHODS36 patients who underwent hemiglossectomy were investigated after radical surgery for TSCC. 20 cases were reconstructed with FAP flaps and 16 with primary closure. The patients' articulator functions were evaluated by articulation tests. VS-9700 was used to analyze the speech character when they pronounce /ji/.

RESULTS1) The speech articulation of patients who underwent hemi-tongue reconstruction with FAF was better than that of patients with PC, and there was significant difference between them (P < 0.05). 2) The first formant (F1) of /i/ of the PC group was lower than that of the control group (P < 0.05). But the second formant (F2) of the PC group was higher than that of the control group (P < 0.05). The first formant (F1) of /i/ of the FAF group was lower than that of the control group (P < 0.05), but there were no significant differences between FAF group and control group in F2 of /i/ (P > 0.05).

CONCLUSIONSArticulator function can be well achieved by forearm flaps reconstruction to hemi-tongue defect patients.

Adult ; Aged ; Female ; Forearm ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Suture Techniques ; Tongue Neoplasms ; physiopathology ; surgery ; Voice Quality

BACKGROUND: It is not clear whether the pronator quadratus (PQ) muscle actually heals and provides a meaningful pronation force after volar plating for distal radius fractures (DRFs). We aimed to determine whether the length of the PQ muscle, which is dissected and then repaired during volar plating for a DRF, affects the forearm rotation strength and clinical outcomes. METHODS: We examined 41 patients who requested hardware removal after volar plating. We measured the isokinetic forearm rotation strength and clinical outcomes including grip strength, wrist range of motion, and disabilities of the arm, shoulder and hand (DASH) scores at 6 months after fracture fixation. During the hardware removal surgery, which was performed at an average of 9 months (range, 8.3 to 11.5 months) after fracture fixation, we measured the PQ muscle length. RESULTS: The average PQ muscle length was 68% of the normal muscle length, and no significant relationship was found between the PQ muscle length and the outcomes including isokinetic forearm rotation strength, grip strength, wrist range of motion, and DASH scores. CONCLUSIONS: This study demonstrates that the length of the healed PQ muscle does not affect isokinetic forearm rotation strength and clinical outcomes after volar plating for DRFs. The results of this study support our current practice of loose repair of the PQ that is performed by most of the surgeons to prevent tendon irritation over the plate, and suggest that tight repair of the PQ is not necessary for achieving improved forearm function.
Adult ; Aged ; Bone Plates ; Device Removal ; Female ; Forearm/physiopathology/surgery ; Fracture Fixation, Internal/*methods ; Hand Strength ; Humans ; Male ; Middle Aged ; Muscle Strength ; Muscle, Skeletal/physiopathology/*surgery ; Radius Fractures/radiography/*surgery ; Range of Motion, Articular ; Wound Healing ; Young Adult