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Biomedical subjects

F C Wei

Publications and source records attributed to F C Wei.

At least 181 records · Page 10Linked to original sources
PubMed1994

[Proximal interphalangeal joint dorsal dislocations without fractures--four cases report].

Four patients with proximal interphalangeal joint (PIP) dorsal dislocation without fracture had been treated at Chang Gung Memorial Branch (Kaohsiung and Keelung) Hospital from June 1987 to Jan. 1989. All four cases were open dislocations, only one patient received immediate diagnosis and treatment, while the other 3 cases were delayed diagnosis and treatment. Open reduction, repair of the ruptured ligaments and joint capsule, reinsertion of the disrupted volar plate were given in these 4 patients. The patient with immediate surgical treatment received rehabilitation program, the other three patients with delay surgical management did not receive rehabilitation program. The rehabilitation program included early active exercises of the PIP joint, started from the second week postoperatively. The rehabilitation period was about three to six months. The prompt diagnosis, reduction, institution of appropriate treatment and rehabilitation might result in better function of the PIP joint after dorsal dislocation.

Adolescent↗
PubMed1994

Midfoot replantation: case report.

The replantation of lower extremity amputations is uncommon. Foot replantation is quite rare because of the severity of the primary injury and its rare occurrence compared with lower leg and upper extremity amputations. A successful replantation in a young woman of a foot amputation at the talo-navicular-calcaneal area is reported with a 1-year postoperative follow-up revealing adequate restoration of foot function.

Adult↗
PubMed1994

[Second toe transplantation in loss of a long finger. Indications--planning--technique].

Transplantation of the second toe is a routinely employed method in reconstructive hand surgery. Most often it is used for thumb or midhand amputations. Following partial amputations of digits distal to the MP-joints, toe transplantations are less frequently employed. However, function as well as cosmesis of the hand after partial amputation of digits can considerably be improved by toe transplantation. The length of the reconstructed finger is a most important aspect of operative planning which has influence on operative technique as well as functional and aesthetic results. A smooth junction at the base of the transplanted toe should be maintained. This can be achieved by adequate soft-tissue reduction and exclusion of the metatarsophalangeal joint. Anastomoses of the subcutaneous venous and plantar as well as dorsal arterial vascular systems are recommended.

Amputation, Traumatic↗
PubMed1994

Reconstruction of four damaged or destroyed ipsilateral fingers with free toe-to-hand transplantations.

Three patients with traumatic partial or complete loss of all ipsilateral digits, excluding the thumb, were reconstructed with free microvascular toe transplantations for all involved digits. In two cases, two pairs of combined second and third toe transplantations were utilized; in the third case, four separate toes were employed. Clinical follow-up was 8 1/2 years, 2 years, and 1 2/3 years. Detailed functional analysis was performed. All patients except the first had initially undergone reconstruction of only two digits and had requested a second procedure to transfer two additional toes. While reconstruction of the thumb and two opposing digits is adequate in most cases, selected patients may benefit from the additional two digits, especially with respect to improving hook grip.

Adolescent↗
PubMed1994

Fibula osteoseptocutaneous flap for reconstruction of composite mandibular defects.

The fibula osteoseptocutaneous flap is a versatile method for reconstruction of composite-tissue defects of the mandible. The vascularized fibula can be osteotomized to permit contouring of any mandibular defect. The skin flap is reliable and can be used to resurface intraoral, extraoral, or both intraoral and extraoral defects. Twenty-seven fibula osteoseptocutaneous flaps were used for composite mandibular reconstructions in 25 patients. All the defects were reconstructed primarily following resection of oral cancers (23), excision of radiation-induced osteonecrotic lesions (2), excision of a chronic osteomyelitic lesion (1), or postinfective mandibular hypoplasia (1). The mandibular defects were between 6 and 14 cm in length. The number of fibular osteotomy sites ranged from one to three. All patients had associated soft-tissue losses. Six of the reconstructions had only oral lining defects, and 1 had only an external facial defect, while 18 had both lining and skin defects. Five patients used the skin portion of the fibula osteoseptocutaneous flaps for both oral lining and external facial reconstruction, while 13 patients required a second simultaneous free skin or musculocutaneous flap because of the size of the defects. Four of these flaps used the distal runoff of the peroneal pedicles as the recipient vessels. There was one total flap failure (96.3 percent success). There were no instances of isolated partial or complete skin necrosis. All osteotomy sites healed primarily. The contour of the mandibles was good to excellent.

Adult↗
PubMed1993

Functional and esthetic reconstruction of a mutilated hand using multiple toe transfers and iliac osteocutaneous flap: a case report.

With reconstructive microsurgical techniques, some previously hopelessly mutilated hands have become reconstructable. The functional and esthetic results of such hands can be improved to an acceptable degree with through prereconstruction evaluation and planning. This case report demonstrates the approach to reconstruction of a mutilated hand using the following: a pedicle groin flap for soft tissue reconstruction of the first web space and the amputation stump of the thumb; a combined second and third toe transfer for reconstruction of opposable fingers at the amputated index and middle finger stumps; a single second toe for reconstruction of the thumb, and an iliac osteocutaneous flap for reconstruction of the ulnar border of the palm.

Accidents, Occupational↗
PubMed1993

Microsurgical reconstruction of distal digits following mutilating hand injuries: results in 121 patients.

From 1982-1989, 152 mutilated distal digits were reconstructed with microsurgical foot tissue transfers in 121 patients. These various foot tissues included wrap-around flaps or pulp from the great toe, second toe, or third toe, as well as partial toe, nail, web space skin, and other portions of the foot. The reconstructions were carried out primarily and secondarily in 78 and 74 patients respectively. The immediate success rate was 98%. Most of the patients were satisfied with both the cosmetic appearance and the functional result. This relatively minor microsurgical foot tissue transfer proved to be an ideal reconstructive option for distal digital defects.

Adolescent↗
PubMed1993

Functional restoration of elbow flexion in brachial plexus injuries: results in 167 patients (excluding obstetric brachial plexus injury).

From 1985 to 1990, 167 patients were treated for impaired elbow flexion caused by brachial plexus injury. Surgical procedures were divided into two categories: nerve reconstruction (128 patients) and muscle or tendon transfers (39 patients). Surgery in the nerve reconstruction group included direct suturing, nerve grafting of portions of the brachial plexus responsible for elbow flexion, or nerve transfer (intercostal, phrenic, or spinal accessory nerve) to the musculocutaneous nerve. The second category included tendon or muscle transfer or a functioning free muscle transplantation for biceps replacement. Results were assessed by the Medical Research Council grading system and weight-lifting evaluation. Functional results revealed that nerve reconstruction was superior to muscle tendon transfers, direct suturing was superior to nerve grafting, short nerve grafts (< 10 cm) were superior to long nerve grafts (> 10 cm), infraclavicular plexus injuries did better than supraclavicular injuries, vascularized ulnar nerve grafts (if indicated) were superior to conventional long nerve grafts, ruptured plexus injuries recovered better than root avulsions. Intercostal nerve transfer to the musculocutaneous nerve has satisfactory results. In the muscle tendon transfer group, Steindler flexorplasty resulted in upgrading muscle strength from level one to level two. Functioning free muscle transplantation had results similar to the latissimus dorsi transfer.

Adolescent↗
PubMed1993

Composite finger metacarpophalangeal joint reconstruction in combined second and third free toe-to-hand transfers.

Composite metacarpophalangeal joint reconstruction using the toe proximal phalanx and the metacarpal head, with a capsular repair, is an option during free toe transfer procedures for absent fingers. Eleven composite metacarpophalangeal finger joint reconstructions were performed in four patients concurrent with combined second and third toe-to-hand transfer. The average follow-up period was 5 years. Postoperative assessment included range of motion, stability, radiographic changes, and pain. The average range of motion was 52 degrees, average ulnar stress deviation was 14 degrees. No patients complained of pain. Composite metacarpophalangeal joint reconstruction should be considered in free toe-to-hand procedures when metacarpal head articular cartilage is preserved.

Adolescent↗
PubMed1993

Heel replantation and subsequent analysis of gait.

A case of sharp, complete amputation of the heel with successful replantation is presented. The bones, periosteum, tendons, and neurovascular bundle were repaired. Seventeen months after injury, both motor and sensory recovery were satisfactory. The objective study of gait analysis also revealed an essentially normal gait pattern of the injured foot. These results suggest that in a suitable candidate, the procedure of choice for amputation of the heel is microsurgical replantation.

Adult↗
PubMed1993

Salvage replantation of two fingers from a nonreplantable midpalm.

To achieve better functional results following mutilating multidigital trauma, every effort should be made to maximize the ultimate function of the hand, and the plan of replantation should be guided accordingly. All usable parts should be salvaged from the amputated nonreplantable areas. A patient is reported in whom two fingers taken from the nonreplantable midpalm were used to reconstruct the thumb and ring fingers, ultimately improving the overall quality of the patient's life.

Adolescent↗
PubMed1993

Squamous cell carcinoma complicating tibial osteomyelitis treated with local wide excision and staged microvascular reconstruction.

Squamous cell carcinoma is a complication of chronic tibial osteomyelitis treated with limb-preserving surgery. A 61-year-old man with 42-year history of chronic osteomyelitis of the left tibia was found to have malignant change. A curettage procedure was performed by a general surgeon. He then was referred to the osteomyelitis service; local wide excision was followed by staged microvascular latissimus dorsi muscle flap and fibular osteoseptocutaneous flap transfer. The patient remains well 36 months later with no clinical or radiologic evidence of local recurrence or distant metastasis. This kind of limb-sparing treatment is an excellent alternative treatment for malignancy.

Carcinoma, Squamous Cell↗
PubMed1993

Cross-chest C7 nerve grafting followed by free muscle transplantations for the treatment of total avulsed brachial plexus injuries: a preliminary report.

The number of donor nerves available for nerve transfer in the reconstruction of total root avulsion injuries of the brachial plexus is always insufficient. Use of the contralateral normal C7 cervical nerve as a donor nerve is a new approach to obtain more nerve fibers but also is a controversial procedure. Fifteen patients with total root avulsion of the brachial plexus received cross-chest C7 nerve grafting as the first stage of reconstruction. Eight of these patients, after an interval of 11 to 20 months, had free muscle transplantations (one to three muscles transferred per individual) to the affected limb. A long period of rehabilitation (at least 2 years) is required. The donor limbs of the 15 patients showed negligible deficits of motor and sensory function. Although independent movement of the transferred muscles from the contralateral limb has not been achieved, useful function of the reconstructed limb is possible. The preliminary results are encouraging.

Adolescent↗
PubMed1993

[Reconstructive microsurgery in the elderly].

Between 1989 and 1990, 20 patients older than 60 years underwent reconstructive microsurgery in our hospital. The procedures consisted of 6 digital replantations in 5 patients and 17 free tissue transfers in 15 patients. The success were 5 out of 6 digital replantations and 16 out of 17 free tissue transfers. This success rate had no significant difference compared with other age groups of our reconstructive microsurgery series. There was no additional complications which might always be considered to encounter with elder patients after prolonged anesthesia. We conclude that with good preoperative work up, careful intraoperative or postoperative care as well as meticulous operative technique, the operative risk remains low and the success rate is comparable to other age groups.

Age Factors↗
PubMed1992

Intercostal nerve transfer of the musculocutaneous nerve in avulsed brachial plexus injuries: evaluation of 66 patients.

Intercostal nerve transfer is a well-established and effective technique for irreparable avulsed brachial plexus injuries. Between 1987 and 1989, 66 patients with brachial plexus injuries were treated by means of intercostal nerve transfer to the musculocutaneous nerve, with or without nerve grafts to obtain elbow flexion. The results were evaluated. Five clinical signs--(1) induction of chest pain by squeezing of biceps, (2) proximal biceps contraction, (3) distal biceps contraction, (4) active elbow flexion against gravity, and (5) active elbow flexion against weight--were identified and used as a guide for functional recovery. The overall success rate with motor function of grade 4 or more was 67%. The motor results were better in 1989 (81%) because of greater familiarity with the anatomy and improved surgical technique. The important factors in obtaining a good result are (1) early exploration (less than 5 months after trauma), (2) use of three intercostal nerves, (3) mixed nerve-to-mixed nerve coaptation, (4) nerve repair without grafts and under no tension, and (5) shoulder stability.

Adolescent↗
PubMed1992

Multiple microsurgical toe-to-hand transfer in the reconstruction of the severely mutilated hand. A series of fifty-nine cases.

The severely mutilated hand is defined as the hand which has lost opposable digit function either through: a) The amputation of all four fingers proximal to the PIP joint or b) The loss of the thumb proximal to the IP joint combined with the loss of at least three fingers proximal to the PIP joint. We have outlined guidelines for the restoration of useful function and appearance to such hands utilising a variety of microsurgical toe-to-hand transfers. Specific points regarding postoperative management have been made.

Adolescent↗
PubMed1992

Free vascularized joint transfers in acute complex hand injuries: case reports.

The loss of function of the metacarpophalangeal joint is a significant disability. Simultaneous reconstruction of the soft tissue, extensor mechanism, joint, and flexor tendon in a complex hand injury is difficult and challenging. Free vascularized autogenous toe joint transplantation is a useful technique that provides not only joint replacement but also the soft tissue, extensor mechanism, and flexor tendon in more severe complex hand injuries. Two patients underwent immediate, free vascularized metatarsophalangeal joint transfer of the second toe to replace the long and ring finger metacarpophalangeal joint in acute complex hand injuries. The follow-up results at 16 months and 8 months postoperatively are presented.

Acute Disease↗