The Experts below are selected from a list of 96 Experts worldwide ranked by ideXlab platform
Brian Yin Ting Yue - One of the best experts on this subject based on the ideXlab platform.
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The functional free innervated medial gastrocnemius flap.
Journal of reconstructive microsurgery, 2014Co-Authors: Damien Grinsell, Brian Yin Ting YueAbstract:The functional free innervated medial gastrocnemius flap has been described in four previous articles for the management of foot drop, Volkmann Contracture, and upper limb muscle defects. We expand the indications by describing the use of free innervated medial gastrocnemius musculocutaneous flap in functional reconstruction of the tongue and upper limb musculature. The right medial gastrocnemius muscles were raised as myocutaneous flaps in six patients. These flaps were elevated in the supine position and the flaps included a motor nerve from the sciatic nerve and a sensory nerve from the sural nerve. The average size of flap was 15 × 8 cm. The flaps were transferred successfully with no flap loss and showed consistent reinnervation during follow-up. In particular, all patients who underwent tongue reconstruction exhibited intelligible speech and returned to full oral diet with no aspiration. In patients who underwent upper limb muscle reconstructions, there was moderate to full restoration of power. All donor sites exhibited excellent symmetry in both power and appearance to the contralateral calf. To our knowledge, this study is the first to describe the use of the innervated medial gastrocnemius free flap in the reconstruction of the tongue and deltoid. The advantages of this flap include its thin reliable skin paddle, strong bulky bipennate muscle, and low donor site morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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The functional free innervated medial gastrocnemius flap.
Journal of Reconstructive Microsurgery, 2014Co-Authors: Damien Grinsell, Brian Yin Ting YueAbstract:Background The functional free innervated medial gastrocnemius flap has been described in four previous articles for the management of foot drop, Volkmann Contracture, and upper limb muscle defects. We expand the indications by describing the use of free innervated medial gastrocnemius musculocutaneous flap in functional reconstruction of the tongue and upper limb musculature. Methods The right medial gastrocnemius muscles were raised as myocutaneous flaps in six patients. These flaps were elevated in the supine position and the flaps included a motor nerve from the sciatic nerve and a sensory nerve from the sural nerve. The average size of flap was 15 × 8 cm. Results The flaps were transferred successfully with no flap loss and showed consistent reinnervation during follow-up. In particular, all patients who underwent tongue reconstruction exhibited intelligible speech and returned to full oral diet with no aspiration. In patients who underwent upper limb muscle reconstructions, there was moderate to full restoration of power. All donor sites exhibited excellent symmetry in both power and appearance to the contralateral calf. Conclusions To our knowledge, this study is the first to describe the use of the innervated medial gastrocnemius free flap in the reconstruction of the tongue and deltoid. The advantages of this flap include its thin reliable skin paddle, strong bulky bipennate muscle, and low donor site morbidity.
Damien Grinsell - One of the best experts on this subject based on the ideXlab platform.
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The functional free innervated medial gastrocnemius flap.
Journal of reconstructive microsurgery, 2014Co-Authors: Damien Grinsell, Brian Yin Ting YueAbstract:The functional free innervated medial gastrocnemius flap has been described in four previous articles for the management of foot drop, Volkmann Contracture, and upper limb muscle defects. We expand the indications by describing the use of free innervated medial gastrocnemius musculocutaneous flap in functional reconstruction of the tongue and upper limb musculature. The right medial gastrocnemius muscles were raised as myocutaneous flaps in six patients. These flaps were elevated in the supine position and the flaps included a motor nerve from the sciatic nerve and a sensory nerve from the sural nerve. The average size of flap was 15 × 8 cm. The flaps were transferred successfully with no flap loss and showed consistent reinnervation during follow-up. In particular, all patients who underwent tongue reconstruction exhibited intelligible speech and returned to full oral diet with no aspiration. In patients who underwent upper limb muscle reconstructions, there was moderate to full restoration of power. All donor sites exhibited excellent symmetry in both power and appearance to the contralateral calf. To our knowledge, this study is the first to describe the use of the innervated medial gastrocnemius free flap in the reconstruction of the tongue and deltoid. The advantages of this flap include its thin reliable skin paddle, strong bulky bipennate muscle, and low donor site morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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The functional free innervated medial gastrocnemius flap.
Journal of Reconstructive Microsurgery, 2014Co-Authors: Damien Grinsell, Brian Yin Ting YueAbstract:Background The functional free innervated medial gastrocnemius flap has been described in four previous articles for the management of foot drop, Volkmann Contracture, and upper limb muscle defects. We expand the indications by describing the use of free innervated medial gastrocnemius musculocutaneous flap in functional reconstruction of the tongue and upper limb musculature. Methods The right medial gastrocnemius muscles were raised as myocutaneous flaps in six patients. These flaps were elevated in the supine position and the flaps included a motor nerve from the sciatic nerve and a sensory nerve from the sural nerve. The average size of flap was 15 × 8 cm. Results The flaps were transferred successfully with no flap loss and showed consistent reinnervation during follow-up. In particular, all patients who underwent tongue reconstruction exhibited intelligible speech and returned to full oral diet with no aspiration. In patients who underwent upper limb muscle reconstructions, there was moderate to full restoration of power. All donor sites exhibited excellent symmetry in both power and appearance to the contralateral calf. Conclusions To our knowledge, this study is the first to describe the use of the innervated medial gastrocnemius free flap in the reconstruction of the tongue and deltoid. The advantages of this flap include its thin reliable skin paddle, strong bulky bipennate muscle, and low donor site morbidity.
Qiao Hu-yun - One of the best experts on this subject based on the ideXlab platform.
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Late functional reconstruction of moderate to severe Volkmann Contracture
Chinese Journal of Hand Surgery, 2007Co-Authors: Qiao Hu-yunAbstract:Objective To introduce the surgical procedures of functional reconstruction for moderate to severe Volkmann eontracture and evaluate the treatment outcomes.Methods Forty-two patients with moderate to severe Volkmann Contracture were surgically treated to improve the forearm function.Cross lengthening of flexor digitorum superficialis and profundus was done in 6 cases.In 17 eases,tendon transfer,interosseous membrane release and pronator quadratus release were done.The other 19 eases in addition to tendon transfer and release of the interosseous membrane and pronator quadratus,supination of the forearm was restored with flexor carpi ulnaris transfer.Results The postoperative follow-up ranged from 6 to 34 months.Forearm and hand function was evaluated.Supination was graded as excellent in 9 cases,good in 18 cases,fair in 12 cases and poor in 3 cases.The excellent and good rate was 64.3 %.Hand function was graded as excellent in 11 cases, good in 15 cases,fair in 14 cases and poor in 2 cases.The excellent and good rate was 61.9%.Conclusion To patients with moderate to severe Volkmann Contracture,different surgical procedures should be chosen depending on severity of the Contracture to improve functional recovery.
Liang Bin - One of the best experts on this subject based on the ideXlab platform.
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Clinical outcome of early and late surgical treatment of moderate Volkmann Contracture
Chinese Journal of Hand Surgery, 2005Co-Authors: Liang BinAbstract:ObjectiveTo observe the clinical outcome of early and late surgical treatment for moderate Volkmann's Contracture, and discuss timing of the operative management.Methods50 cases of moderate ischemia Contracture of the forearm treated from 1997 to 2003 were involved in the study. 25 cases were operated within 3 months after the injury, while the other 25 were operated between 6 to 18 months following the injury. For most cases in the early surgery group, only decompression and lysis of the muscles and nerves were done. Self lengthening or cross lengthening of flexor tendons, or distal sliding of the flexors were done in 6 cases. Neurolysis, tendon lengthening, tendon transfer, or distal sliding of the flexors were the procedures carried out in the late surgery group. Assessment of hand function and nerve conduction study were undertaken at follow up.ResultsAccording to assessment of the hand function, there were 11 cases graded as excellent (S3M4), 8 as good (S3M3), and 6 as fair (S2M2) in the early operation group. The overall excellent and good rate was 76%. Nerve conduction velocity of the median nerve and ulnar nerve was faster than that of the pre operative level. In the late operation group, the result was excellent (S3M4) in 6 cases, good (S3M3) in 6, fair (S2M2) in 11, and poor (S1M2) in 2. The overall excellent and good rate was 48%. Nerve conduction study did not show significant change.ConclusionEarly surgical treatment of moderate ischemia Contracture is critical for improving functional recovery and avoiding secondary joint deformity. The best timing is within 3 months following the injury.
Mark W Ashton - One of the best experts on this subject based on the ideXlab platform.
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angiosome based allografts vascularized composite allotransplantation for tailored subunit reconstruction with Volkmann ischemic Contracture as a case in point
Plastic and Reconstructive Surgery, 2017Co-Authors: Ian G Taylor, David S Sparks, Adam C Gascoigne, Russell J Corlett, Mark W AshtonAbstract:Background: As we enter an age with new approaches to tissue reconstruction, the emphasis on the adage "like for like" has become even more relevant. This study illustrates the potential for several tailored vascularized composite allotransplantation reconstructive techniques and, in particular, for the management of Volkmann Contracture. Methods: Twenty fresh cadaver dissections and 30 archival lead oxide radiographic studies were examined to (1) identify potential upper limb vascularized composite allotransplantation donor sites (i.e., elbow, forearm, and flexor tendon complex) and (2) demonstrate a "mock transplant" of the vascularized volar forearm allograft for a severe Volkmann ischemia defect. They were designed without skin to reduce antigenicity. Results: The elbow joint was supplied within the brachial angiosome and the flexor tendon complex of the flexor digitorum superficialis and flexor digitorum profundus by the superficial palmar arch of the ulnar angiosome. The forearm allograft of flexor muscles, median, ulnar, and anterior interosseous nerves, when harvested on the brachial vessels, was supplied within the radial, ulnar, and anterior interosseous angiosomes but could be based on the ulnar artery alone because of intramuscular connections with the other territories. A mock transplant was performed with a distal-to-proximal dissection of the allograft, facilitating the best and fastest technique. Conclusions: This application of the angiosome concept highlights the anatomical feasibility of the volar forearm vascularized composite allotransplantation donor site focusing on a complex subunit problem in the upper limb - severe Volkmann ischemic Contracture. It demonstrates the potential use and immunologic advantage of subdivided and modified nonskin variations of vascularized composite allotransplantation in reconstructive transplantation surgery.
