Practical Microsurgery Cases. Repair, Replantation and Reconstruction

Part 1 Upper limbs and hands 1 Successful replantation of the distal phalanx of the little finger in a newborn: A case report 2 Replantation of amputated finger composite tissue mass 3 Replantation of severed fingers in children 4 Replantation of single hand's multiplane severances with 17 segments 5 Replantation of severed upper arm of a nine-month-old infant 6 Replantation with vessel anastomosis for treatment of hand degloving injuries 7 Transpositional replantation of severed fingers 8 Salvage of the damaged hand by the emergency reconstruction with heterotopic replantation of discarded fingers 9 Salvage of an amputated upper extremity with ectopic implantation followed by replantation at the second stage 10 Emergency repair of a degloving injury in three fingers 11 Reconstruction for forearm deformities with ulnar shortening induced by capitulum ulnae giant chondroma 12 First intention combined plastic reconstruction of the thumb through transplanting separated second toe with full dorsal toenail flaps exchange between the first and second toes 13 Tissues mass replantation of the index and middle finger 14 The Use of a Third Metacarpal Base Vascularized Osteoarticular Graft for Treatment of Metacarpophalangeal Joint Traumatic Defects 15 Two-Staged Surgical Treatment of Composite Tissue Defects of the Dorsum of Hand and Finger Involving Fingerweb 16 Reconstruction of combined thumb amputation at the metacarpal base level and index amputation at the metacarpal level with pollicization and bilateral double toe composite transfer 17 Harvest and separate the second toe for repair of compound tissue defects for multiple fingers 18 Combined biological reconstruction can be used to repair large bone defect after resection of malignant bone tumor 19 Anterolateral thigh flap for the reconstruction of forearm with severe injury 20 The free peroneal artery perforator flap for combined medial ankle injury 21 The ultra-long free peroneal artery perforator flap for lateral foot defect coverage 22 Sural nerve nutritional vessel axial flap for the heel skin defect coverage and calcaneal reconstruction Part 2 Lower limbs and hands 23 Repair and reconstruction of the segmentally destructed lower limb in a child 24 Exploration of the superior retinacular arterial system of the femoral head after femoral neck fractures in young adults 25 Replantation of Segmental destructive disconnect of the child's calf 26 Extension of lower limbs for extreme flexion of knee joint induced by dorsal scar adhesion after burned for 13 years in a child 27 Posterior tibial artery flap in series with medial plantar artery flap for repair of anterior foot degloving injury 28 Adipofascial turnover flap for dorsal foot coverage and dead space filling 29 Repair hot-pressed wound of hand with lobulated chimeric flaps of perforator branch of lateral circumflex femoral artery 30 The waveform design of decending branch of lateral circumflex femoral artery perforator flap for the heel defect reconstruction 31 Chimeric peroneal artery perforator flap for reconstruction post-traumatic osteomyelitis of tibia 32 Dual skin paddles descending branch of the lateral circumflex femoral artery perforator flap for one-staged reconstruction of two adjacent wounds 33 Dual skin paddles descending branch of the lateral circumflex femoral artery perforator flap for reconstruction of extensive foot defects 34 Treatment of tibia GUSTILO IIIC fractures by bone transfer combined with flap technique 35 Large Segmental Free Ectopic Revascularized and Prefabricated Bone Flap for Second Stage Repair of Bone and Soft Tissue Defects 36 Repair of a lateral malleolus defect with a composite pedicled second metatarsal flap Part 3 Head, neck and trunk 37 Replantation repair of total scalp avulsion 38 Replantation of facial tissue mass 39 A case for replantation of amputated ear 40 Salvage of large scalp defect with exposed skull necrosis by a free vascularized greater omentum graft in a 3-year-old child: a case report and 10-year follow-up 41 Maxillary and orbital floor reconstruction with anterolateral thigh flap and individual pre-bended titanium mesh 42 Deep circumflex iliac artery (DCIA) flap for one-staged reconstruction of left mandible defects 43 Case of facial nerve reconstruction 44 Mandibular reconstruction with vascularized fibular flap in double-barrel technique 45 Oromandibular Reconstruction with Intraoral Anastomosis of a Deep Circumflex Iliac Artery Perforator Fascial Flap with Iliac Crest 46 Bilateral submandibular gland transplantations for paediatric several dry eye disease 47 Chimeric thoracoacromial artery perforator flap for one-staged reconstruction of complex pharyngoesophageal defects 48 Maxillary reconstruction with vascularized fibula osteomyocutaneous flap using virtual surgical planning 49 Transoral segmental mandibulectomy and intraoral anastomosis for mandibular reconstruction guided by virtual surgical planning and intraoperative navigation 50 Reconstructed bladder innervation above the level of spinal cord injury to produce urination by abdomen-to-bladder reflex contractions 51 Reconstructed bladder innervation below the level of spinal cord injury to produce urination by Achilles tendon-to-bladder reflex contractions 52 Transfer of normal S1 nerve root to reinnervate atonic bladder due to conus medullaris injury

This book aims to introduce the most recent microsurgical techniques and applications in the pattern of illustrative case presentations, including digit replantation, toe-to-hand transplantation, peripheral nerve injuries especially total brachial plexus avulsion injury, surgical flaps.

Microsurgery appeared to be a great procedure suitable for more applications. Anatomic research of the blood supply of skin, fascia, nerve, muscle, and bone identified flaps could be carried by pedicle vessels. Transfer of these flaps and revascularization by micro-vascular anastomoses of the arteries and veins set the stages for free flaps. In free flap surgery, single-stage and complex reconstructions could be achieved, which then lead to earlier mobilization and better restoration of function with a shorter hospital stay. Today, microsurgical technique is fully matured, and micro-vascular free tissue transfer is an essential part of reconstructive surgery.

Development of microsurgery in China is introduced in the initiation of the current book. Key technical points and experience of replantation, reconstruction, tissue repair, nerve repair and reconstruction, oncological repair and reconstruction cases together with other applications of microsurgery are further demonstrated.

Author Information

Chunlin Hou
Department of Orthopedic Surgery
Changzhen Hospital
Second Military Medical University
Shanghai
China
Chunlin_hou@163.com

Shimin Chang
Department of Orthopedic Surgery
Yangpu Hospital
Tongji University Medical School
Shanghai
China
shiminchang11@aliyun.com

Juyu Tang
Department of Hand and Microsurgery
Xiangya Hospital
Central South University
Changsha
China
tangjuyu7749@163.com