Objective To report our experience in the reconstruction of soft tissue defects in the hand with a free anterolateral thigh deep fascia flap and describe the clinical outcomes. Methods This study was a retrospective trial. From November 2016 to January 2020, six patients (four men and two women) with soft tissue defects in the hand were included in this study. The average age of the patients was 33.7 ± 12.7 years (range, 20 to 50 years). All patients underwent reconstructions with free anterolateral thigh deep fascia flaps. Relevant clinical characteristics were recorded prior to surgery. The size and thickness of the deep fascia flap and the thickness of the skin were measured intraoperatively. The survival of the flaps and skin grafts and the occurrence of infection were recorded after the operation. At follow‐up, donor site complications and postoperative effects were evaluated according to the outcome satisfaction scale. The pain in the injured hand was assessed using the visual analog scale. Results The average body mass index (BMI) was 26.6 ± 1.7 kg/m2 (range, 23.9 to 28.7 kg/m2). The defect sizes ranged from 5 cm × 5 cm to 13 cm × 8 cm (average, 53.1 ± 27.9 cm2). The six anterolateral thigh deep fascia flaps ranged from 7 cm × 6 cm to 14 cm × 9 cm in size (average, 71.8 ± 29.1 cm2). The thicknesses of skin ranged from 25 mm to 40 mm (average, 32.5 ± 4.8 mm), and the thicknesses of the deep fascia flaps ranged from 2 mm to 3 mm (average, 2.5 ± 0.5 mm). After the operation, the blood supply of the deep fascia flap was normal in all cases. The second‐stage skin grafts of most patients survived completely. The skin graft in one case was partially necrotic and healed after a dressing change. No infection occurred. At follow‐up (average, 16.3 ± 6.9 months), there was only a linear scar and no loss of sensation at the donor site of each patient. According to the outcome satisfaction scale, the outcome satisfaction score ranged from 6 to 8 (average, 7.2 ± 0.9), all of which were satisfactory. Apart from one patient who reported mild pain, all the other patients reported no pain. Three typical cases are presented in this article. Conclusions The free anterolateral thigh deep fascia flap, which is suitable for reconstruction of soft tissue defects in the hand, can provide very good outcomes both functionally and aesthetically.
Qihong Que and colleagues found that liraglutide exhibited anti-inflammatory activity through the activation of the PKA/CREB pathway in an OA rat model. We believe there was a flaw in this research. In their first experiment, the sacrifice time of the 10 rats in the control group has not been stated. And when the rats in the OA-1, OA-5, OA-10, OA-20 and OA-28 groups were sacrificed, they were in different weeks of age. If the rats in the control group were compared to the rats in the OA-1, OA-5, OA-10, OA-20 and OA-28 groups respectively, the results may be biased due to differences in the week age of the rats. We believe that addressing this issue could further increase the value of their study.
Purpose: To evaluate the effect of the modified retrograde tendon flap technique for reconstructing the extensor tendon defect in zone Ⅱ of a finger.Methods: 12 patients with the extensor tendon defect in zone Ⅱ were investigated retrospectively. They were all treated surgically by the modified retrograde tendon flap technique, featuring the creation of a new terminal slip to bridge the extensor tendon defect using extensor tendon inner lateral bands. At the final follow-up, the range of motion at each joint of the injured finger was recorded.Results: Average follow-up was 18 months (ranging from 11 to 26 mos). Eight patients achieved full active DIPJ extension, whereas one patient had an extensor lag of 10° and three had a lag of 5°. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. All the involved finger joints were clinically stable, with no tenderness, pain, nail deformity, or limitation using their hands for daily life.Conclusions: The modified retrograde tendon flap technique, which is easy to operate and popularize, may be the procedure of choice in patients with a gap deficiency in Zone Ⅱ of the extensor tendon of a finger.
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