Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fr...Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fracture who were hospitalized from August 2023 to January 2025 were selected and randomly divided into two groups of 50 cases each.The control group was operated by purely trans-tarsal sinus approach,and the observation group added dalteparin sodium and furosemide on this basis.Postoperative limb swelling,pain,coagulation and inflammation indexes,fracture healing time,foot function and complications were compared between the two groups.Results:In the observation group,postoperative limb swelling subsided faster,pain score was lower,coagulation and inflammation indexes improved more significantly,fracture healing time was shorter,foot function recovery was better,and complication rate was lower,P<0.05.Conclusion:The treatment of heel fracture by trans-tarsal sinus approach combined with sodium heparin and furosemide can significantly accelerate the patient’s recovery and reduce the occurrence of complications,which has high clinical application value.展开更多
AIM: To investigate the detailed microscopic anatomic structures of the lower eyelid in Korean cadavers. METHODS: Eight lower eyelids of 4 formalin-fixed Asian cadavers (4 males; age range, 48-69 years; mean age, 60.2...AIM: To investigate the detailed microscopic anatomic structures of the lower eyelid in Korean cadavers. METHODS: Eight lower eyelids of 4 formalin-fixed Asian cadavers (4 males; age range, 48-69 years; mean age, 60.2 years) were examined. Three perpendicular dissected sections with a 2mm thickness were obtained from each eyelid to investigate anatomic shapes, size and relationship with surrounding structures. One section was obtained from the midline and 2 the other sections were obtained from a 3mm apart from the lateral and medial tarsus margins. RESULTS: The inferior tarsal muscle fibers were not directly attached to the tarsus but were only linked to the tarsus with enclosed fibrous fascia. The inferior tarsal muscles connected loosely with the capsulopalpebral fascia anteriorly and the conjunctiva posteriorly. The inferior tarsal muscle runs horizontally to the tarsus according to the shape of muscle fibers. The capsulopalpebral fascia consisted of an anterior and posterior layer. The anterior layer reached the orbital septum and subcutaneous fat but the posterior layer forwarded into the tarsus. Lockwood’s ligament was separated from the inferior tarsal muscle and capsulopalpebral fascia or fused into the capsulopalpebral fascia.CONCLUSION: This study suggests that the inferior tarsal muscle which runs horizontally and doesn’t insert directly into the tarsus, plays an important role in the movement and localization of the lower eyelid.展开更多
Tarsal Tunnel Syndrome [TTS] is the most common lower limb focal neuropathy but it has a poor pick up rate in most Electrodiagnostic (EXD) Laboratories. There is no gold standard for assessing TTS. The tibial nerve ha...Tarsal Tunnel Syndrome [TTS] is the most common lower limb focal neuropathy but it has a poor pick up rate in most Electrodiagnostic (EXD) Laboratories. There is no gold standard for assessing TTS. The tibial nerve has a complex branching system with 4 main branches and 9 different patterns of division. This study evaluated potential TTS with a similar and extensive assessment of the tibial nerve. The protocol involved 2 tibial motor studies to the Adductor Hallucis Longus (AH) and Adductor Digiti Quinti (ADQ) muscles, assessing amplitudes and distal latencies;medial plantar, lateral plantar and calcaneal sensory studies assessing amplitudes and distal latencies. A needle EMG to the tibial innervated AH and ADQ muscles was also performed. This protocol evaluated 12 different parameters which significantly increased the diagnostic yield. TTS has a low pick up rate using current standard assessment methods accounting for between 0.5% and 0.6% of positive cases referred to electrodiagnostic laboratories. This study had a pick up rate of 3.3% with 40 positive cases identified out of a population of 1210 patients referred to an electrodiagnostic laboratory in a calendar year. A combination of positive findings was observed. There were on average 4.3 positive parameters. The calcaneal sensory study and the needle EMG to the distal AH and ADQ muscles were the most sensitive tests. These 3 tests are not routinely performed in most labs. Of the 40 cases of TTS over 80% had a history of either prior injury or surgery to affected lower limb. This study suggests that this 12 parameter assessment will increase diagnostic sensitivity.展开更多
Large tarsal plate defect reconstruction is one of the most challenging tasks for plastic surgeons.Based on our practical work and literature review,the techniques and postoperative results of the preserved sclera,ear...Large tarsal plate defect reconstruction is one of the most challenging tasks for plastic surgeons.Based on our practical work and literature review,the techniques and postoperative results of the preserved sclera,ear cartilage,and acellular dermal matrix(ADM)as tarsal plate substitutes were investigated.Two cases were reviewed.Case 1 was a 22-year-old female who had total loss of the right lower eyelid.Ear cartilage(23 mm25 mm)was implanted under the expanded skin during the forehead skin-expanding procedure to form a skin-cartilageexpander capsule compound structure for lower eyelid reconstruction.Case 2 was a 7-year-old boy with a unilateral divided nevus.The lid and conjunctiva of the lower eyelid were invaded.A piece of ADM(12 mm4 mm)was used to repair the tarsal plate defect(12 mm3 mm).The conjunctiva of ADM was covered by itself.An orbicularis oculi myocutaneous flap was used for anterior lamella reconstruction.In case 1,the compound tissue survived and supported the lower eyelid,the lid margin was clear,and the structure was complete over a 1-year follow-up.The aesthetic appearance of the eyelid improved after depilation.It is the first clinical research on the expander capsule as eyelid conjunctiva.In case 2,the conjunctiva completely covered the superior ADM,and the transplant merged with the surrounding tissues without complications after 5 months.The preserved sclera has the longest application history as a tarsal plate substitute.However,it should be preserved in an eye bank and transplanted with conjunctiva repair.Ear cartilage is an autologous tissue that requires conjunctival reconstruction.Our clinical practice was the first to prove the possibility of the expander capsule as eyelid conjunctiva.It is feasible to prefabricate the skin-tarsal conjunctiva complex during the skin expansion procedure.Allogeneic ADM is a common clinical material with advantages of good biological histocompatibility,supportive strength,conjunctivalization,and not requiring donor site surgery.Plastic surgeons are familiar with autologous ear cartilage and ADM,which are easy to obtain and treat.Both ear cartilage and ADM are expected to be the first-line choices in future studies.展开更多
Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting i...Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting interest in biocompatible alternatives,such as biodegradable diplene membranes.This study introduces a novel modification to the standard protocol: the use of diplene membranes enriched with Solcoseryl,a metabolically active agent that enhances angiogenesis,reduces inflammation,and accelerates epithelialization.Methods: Twenty-seven patients(mean age,68.96 ± 8.09 years) with histologically confirmed malignant lowereyelid tumors underwent reconstruction using diplene membranes combined with Solcoseryl.The outcomes were compared with those of a previously reported cohort treated with Diplene alone.The follow-up period ranged from 3 to 12 months.Results: All patients achieved successful restoration of eyelid support with high aesthetic satisfaction.The Solcoseryl group demonstrated significantly faster epithelialization(mean 9.8 ± 1.2 days),improved microcirculatory parameters,and no serious complications.Minor hematomas occurred in two cases(7.4%).Conclusion: The modified Diplene–Solcoseryl membrane enhanced wound healing and biocompatibility during lower-eyelid reconstruction by transforming the membrane into a bioactive scaffold.This innovation offers superior functional and aesthetic outcomes compared to standard diplene use and represents a significant advancement in oculoplastic and oncological reconstructive surgery.展开更多
Background Thumb web contracture is a common complication after hand injury, and can markedly affect whole hand function. Therefore, surgery involving thumb web reconstruction is often necessary to restore normal func...Background Thumb web contracture is a common complication after hand injury, and can markedly affect whole hand function. Therefore, surgery involving thumb web reconstruction is often necessary to restore normal function of the involved hand. In this study, we present the application of the lateral tarsal artery （LTA） flap in first web reconstruction. Methods From November 1, 2005 to October 31, 2007, seven patients with severe post trauma or burn contractures around the first web space were treated with a LTA flap. All the patients were followed up. Results All flaps survived, with an average size of 6.7 cm×4.8 cm. There were no complications or recurrent contractures during follow-up. All patients were satisfied with the esthetic appearance and functional outcome of the reconstruction. Conclusion The L＇I-A flap could be an excellent option for covering various defects in the thumb web space, serving as an excellent alternative for the thumb web space reconstruction.展开更多
Purpose:To evaluate the postoperative effect of the lateral tarsal strip(LTS)procedure in treating lower eyelid involutional ectropion.Methods:A retrospective study was performed on 85 eyelids in 67 patients with invo...Purpose:To evaluate the postoperative effect of the lateral tarsal strip(LTS)procedure in treating lower eyelid involutional ectropion.Methods:A retrospective study was performed on 85 eyelids in 67 patients with involutional ectropion who underwent LTS procedure.Pre-and postoperative lower eyelid laxity and ocular symptoms as well as perioperative complications were evaluated.Snap back test was performed to evaluate the elasticity of lateral canthal tendon loosening and,a lower lid distraction test was performed to evaluate the degree of severity before surgery.Ocular surface diseases were evaluated by the Ocular Surface Disease Index(OSDI),and symptoms including conjunctivitis,corneal ulcer,dry eye syndrome,and ocular pain were recorded.All patients were evaluated within one week and during the follow-up period of 4.28.3 months.Furthermore,we reviewed the studies that also investigated the surgical effect of the LTS procedure in the literature from 1979 to 2019.Results:The success rate was 95%.Only four eyelids required a second surgical intervention.Seventy-three(86%)eyelids had an excellent position after surgery,9(11%)only little improvement,and three had no improvement.No significant difference was found in the postoperative effects between different degrees of ectropion(p>0.05).No statistical correlation was found between surgical improvements and the ectropion severity(P>0.05).Fiftytwo out of 85 eyes had no discomfort after the surgery.Mild complications included epiphora in 13 eyes(three cases caused by lacrimal punctum eversion),ocular pain in 12 eyes,wound hemorrhage in 12 eyes,and edema in 9 eyelids immediately after surgery,in which 91.2%(n=21)disappeared within one week and did not need any further treatment.Conclusions:The lateral tarsal strip procedure can provide an aesthetically pleasing result for correcting the mild to moderate lower eyelid ectropion while maintaining decent eyelid function.展开更多
文摘Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fracture who were hospitalized from August 2023 to January 2025 were selected and randomly divided into two groups of 50 cases each.The control group was operated by purely trans-tarsal sinus approach,and the observation group added dalteparin sodium and furosemide on this basis.Postoperative limb swelling,pain,coagulation and inflammation indexes,fracture healing time,foot function and complications were compared between the two groups.Results:In the observation group,postoperative limb swelling subsided faster,pain score was lower,coagulation and inflammation indexes improved more significantly,fracture healing time was shorter,foot function recovery was better,and complication rate was lower,P<0.05.Conclusion:The treatment of heel fracture by trans-tarsal sinus approach combined with sodium heparin and furosemide can significantly accelerate the patient’s recovery and reduce the occurrence of complications,which has high clinical application value.
基金supported by the Dong-A University Research Fund
文摘AIM: To investigate the detailed microscopic anatomic structures of the lower eyelid in Korean cadavers. METHODS: Eight lower eyelids of 4 formalin-fixed Asian cadavers (4 males; age range, 48-69 years; mean age, 60.2 years) were examined. Three perpendicular dissected sections with a 2mm thickness were obtained from each eyelid to investigate anatomic shapes, size and relationship with surrounding structures. One section was obtained from the midline and 2 the other sections were obtained from a 3mm apart from the lateral and medial tarsus margins. RESULTS: The inferior tarsal muscle fibers were not directly attached to the tarsus but were only linked to the tarsus with enclosed fibrous fascia. The inferior tarsal muscles connected loosely with the capsulopalpebral fascia anteriorly and the conjunctiva posteriorly. The inferior tarsal muscle runs horizontally to the tarsus according to the shape of muscle fibers. The capsulopalpebral fascia consisted of an anterior and posterior layer. The anterior layer reached the orbital septum and subcutaneous fat but the posterior layer forwarded into the tarsus. Lockwood’s ligament was separated from the inferior tarsal muscle and capsulopalpebral fascia or fused into the capsulopalpebral fascia.CONCLUSION: This study suggests that the inferior tarsal muscle which runs horizontally and doesn’t insert directly into the tarsus, plays an important role in the movement and localization of the lower eyelid.
文摘Tarsal Tunnel Syndrome [TTS] is the most common lower limb focal neuropathy but it has a poor pick up rate in most Electrodiagnostic (EXD) Laboratories. There is no gold standard for assessing TTS. The tibial nerve has a complex branching system with 4 main branches and 9 different patterns of division. This study evaluated potential TTS with a similar and extensive assessment of the tibial nerve. The protocol involved 2 tibial motor studies to the Adductor Hallucis Longus (AH) and Adductor Digiti Quinti (ADQ) muscles, assessing amplitudes and distal latencies;medial plantar, lateral plantar and calcaneal sensory studies assessing amplitudes and distal latencies. A needle EMG to the tibial innervated AH and ADQ muscles was also performed. This protocol evaluated 12 different parameters which significantly increased the diagnostic yield. TTS has a low pick up rate using current standard assessment methods accounting for between 0.5% and 0.6% of positive cases referred to electrodiagnostic laboratories. This study had a pick up rate of 3.3% with 40 positive cases identified out of a population of 1210 patients referred to an electrodiagnostic laboratory in a calendar year. A combination of positive findings was observed. There were on average 4.3 positive parameters. The calcaneal sensory study and the needle EMG to the distal AH and ADQ muscles were the most sensitive tests. These 3 tests are not routinely performed in most labs. Of the 40 cases of TTS over 80% had a history of either prior injury or surgery to affected lower limb. This study suggests that this 12 parameter assessment will increase diagnostic sensitivity.
基金the Shanghai Committee of Science and Technology,China(grant no.19ZR1430100)。
文摘Large tarsal plate defect reconstruction is one of the most challenging tasks for plastic surgeons.Based on our practical work and literature review,the techniques and postoperative results of the preserved sclera,ear cartilage,and acellular dermal matrix(ADM)as tarsal plate substitutes were investigated.Two cases were reviewed.Case 1 was a 22-year-old female who had total loss of the right lower eyelid.Ear cartilage(23 mm25 mm)was implanted under the expanded skin during the forehead skin-expanding procedure to form a skin-cartilageexpander capsule compound structure for lower eyelid reconstruction.Case 2 was a 7-year-old boy with a unilateral divided nevus.The lid and conjunctiva of the lower eyelid were invaded.A piece of ADM(12 mm4 mm)was used to repair the tarsal plate defect(12 mm3 mm).The conjunctiva of ADM was covered by itself.An orbicularis oculi myocutaneous flap was used for anterior lamella reconstruction.In case 1,the compound tissue survived and supported the lower eyelid,the lid margin was clear,and the structure was complete over a 1-year follow-up.The aesthetic appearance of the eyelid improved after depilation.It is the first clinical research on the expander capsule as eyelid conjunctiva.In case 2,the conjunctiva completely covered the superior ADM,and the transplant merged with the surrounding tissues without complications after 5 months.The preserved sclera has the longest application history as a tarsal plate substitute.However,it should be preserved in an eye bank and transplanted with conjunctiva repair.Ear cartilage is an autologous tissue that requires conjunctival reconstruction.Our clinical practice was the first to prove the possibility of the expander capsule as eyelid conjunctiva.It is feasible to prefabricate the skin-tarsal conjunctiva complex during the skin expansion procedure.Allogeneic ADM is a common clinical material with advantages of good biological histocompatibility,supportive strength,conjunctivalization,and not requiring donor site surgery.Plastic surgeons are familiar with autologous ear cartilage and ADM,which are easy to obtain and treat.Both ear cartilage and ADM are expected to be the first-line choices in future studies.
文摘Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting interest in biocompatible alternatives,such as biodegradable diplene membranes.This study introduces a novel modification to the standard protocol: the use of diplene membranes enriched with Solcoseryl,a metabolically active agent that enhances angiogenesis,reduces inflammation,and accelerates epithelialization.Methods: Twenty-seven patients(mean age,68.96 ± 8.09 years) with histologically confirmed malignant lowereyelid tumors underwent reconstruction using diplene membranes combined with Solcoseryl.The outcomes were compared with those of a previously reported cohort treated with Diplene alone.The follow-up period ranged from 3 to 12 months.Results: All patients achieved successful restoration of eyelid support with high aesthetic satisfaction.The Solcoseryl group demonstrated significantly faster epithelialization(mean 9.8 ± 1.2 days),improved microcirculatory parameters,and no serious complications.Minor hematomas occurred in two cases(7.4%).Conclusion: The modified Diplene–Solcoseryl membrane enhanced wound healing and biocompatibility during lower-eyelid reconstruction by transforming the membrane into a bioactive scaffold.This innovation offers superior functional and aesthetic outcomes compared to standard diplene use and represents a significant advancement in oculoplastic and oncological reconstructive surgery.
基金This research was supported by a grant from the Natural Science Foundation of Guangdong Province （No. 8151031701000001）.
文摘Background Thumb web contracture is a common complication after hand injury, and can markedly affect whole hand function. Therefore, surgery involving thumb web reconstruction is often necessary to restore normal function of the involved hand. In this study, we present the application of the lateral tarsal artery （LTA） flap in first web reconstruction. Methods From November 1, 2005 to October 31, 2007, seven patients with severe post trauma or burn contractures around the first web space were treated with a LTA flap. All the patients were followed up. Results All flaps survived, with an average size of 6.7 cm×4.8 cm. There were no complications or recurrent contractures during follow-up. All patients were satisfied with the esthetic appearance and functional outcome of the reconstruction. Conclusion The L＇I-A flap could be an excellent option for covering various defects in the thumb web space, serving as an excellent alternative for the thumb web space reconstruction.
基金supported by the Fundamental Research Funds for the Central Universities(grant No.2021FZZX005-15)the Koeln Fortune Program/Faculty of Medicine,University of Cologne,Germany(grant No.2680148101)+2 种基金National Natural Science Foundation of China(grant No.81970834)Science and Technology Commission of Shanghai Municipality(grant No.19441900800)GEROK program of the University of Cologne.
文摘Purpose:To evaluate the postoperative effect of the lateral tarsal strip(LTS)procedure in treating lower eyelid involutional ectropion.Methods:A retrospective study was performed on 85 eyelids in 67 patients with involutional ectropion who underwent LTS procedure.Pre-and postoperative lower eyelid laxity and ocular symptoms as well as perioperative complications were evaluated.Snap back test was performed to evaluate the elasticity of lateral canthal tendon loosening and,a lower lid distraction test was performed to evaluate the degree of severity before surgery.Ocular surface diseases were evaluated by the Ocular Surface Disease Index(OSDI),and symptoms including conjunctivitis,corneal ulcer,dry eye syndrome,and ocular pain were recorded.All patients were evaluated within one week and during the follow-up period of 4.28.3 months.Furthermore,we reviewed the studies that also investigated the surgical effect of the LTS procedure in the literature from 1979 to 2019.Results:The success rate was 95%.Only four eyelids required a second surgical intervention.Seventy-three(86%)eyelids had an excellent position after surgery,9(11%)only little improvement,and three had no improvement.No significant difference was found in the postoperative effects between different degrees of ectropion(p>0.05).No statistical correlation was found between surgical improvements and the ectropion severity(P>0.05).Fiftytwo out of 85 eyes had no discomfort after the surgery.Mild complications included epiphora in 13 eyes(three cases caused by lacrimal punctum eversion),ocular pain in 12 eyes,wound hemorrhage in 12 eyes,and edema in 9 eyelids immediately after surgery,in which 91.2%(n=21)disappeared within one week and did not need any further treatment.Conclusions:The lateral tarsal strip procedure can provide an aesthetically pleasing result for correcting the mild to moderate lower eyelid ectropion while maintaining decent eyelid function.
