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Biomedical subjects

F C Wei

Publications and source records attributed to F C Wei.

At least 19 recordsLinked to original sources
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↗
PubMed1992

Compound functioning free muscle flap transplantation (lateral half of soleus, fibula, and skin flap).

The functioning free-muscle transfer is a microneurovascular technique that has proven effective for patients who have a major muscle or muscle group loss for which no other less complicated procedures are available. A new functioning muscle (lateral half of the soleus) transfer was used for forearm reconstruction. This functioning muscle can be transferred alone, or it can be used with overlying skin or nearby fibular bone or both. It was used in a selective complicated case in which not only were major functional muscles lost, but a bone deficiency and skin loss also were seen. The operation was done in one stage with the composite flap (muscle plus bone plus skin). The recovered transferred muscle provided adequate strength and excursion for a functional hand and forearm.

Adolescent↗
PubMed1992

Technique of foot lengthening and shaping with free vascularized iliac osteocutaneous flap.

The iliac osteocutaneous flap has been used widely to replace bony defects of the mandible and the extremities. We report a further application of this flap in foot reconstruction. The iliac osteocutaneous flap proved to be of value to augment both soft tissue and bone in a transmetatarsally amputated foot. This resulted in satisfactory function and an appealing cosmetic result, allowing the patient to wear normal shoes. Flap design and secondary contouring procedures are described for the success of this reconstruction.

Adult↗
PubMed1992

Emergency free-flap transfer for reconstruction of acute complex extremity wounds.

Nine patients with complex extremity injuries were treated with emergency free-flap transfers over a 3 1/2-year period. The transferred emergency free flaps were performed to cover exposed vital structures. All flaps survived without infection. Complete and careful assessment of the systemic condition of the patient and the nature of the injured extremity is mandatory. Emergency free-flap transfers may salvage the limb or finger and may improve the functional and aesthetic results with the shortest possible hospital stay.

Accidents↗
PubMed1991

Eyebrow revascularization.

A 41-year-old man suffered from an incompletely avulsed right eyebrow and forehead after a windshield injury in a traffic accident. Microsurgical techniques were used to revascularize the avulsed tissue of the right eyebrow and forehead with anastomosis of one branch of the frontal branch of the right superficial temporal artery. The revascularized eyebrow and forehead remained viable and provided a good cosmetic result. An aggressive microsurgical approach, either by direct arterial anastomosis or bypass with vein graft, should be encouraged in all incompletely avulsed tissue with inadequate blood supply in the face, hand, and foot.

Adult↗
PubMed1991

Finger reconstruction with triple toe transfer from the same foot for a patient with a special job and previous foot trauma.

After the loss of four fingers at the metacarpal level, triple toe transfer from the same foot was performed in the dominant hand of an art worker who needed three ulnar digits to work with the intact thumb. The toes of the left foot could not be used because of a previous injury. Long-term follow-up at 3 years showed good results in terms of function. He regained dexterity for calligraphy, notably the brush calligraphy and painting that are important in his job. The donor site was treated very carefully to prevent complications. There was minimal donor site morbidity. He still can walk very well and runs fast. Gait analysis of the donor foot is presented. This was a unique situation, and satisfactory results were obtained through the cooperation of the patient as well as detailed analysis before surgery.

Activities of Daily Living↗
PubMed1991

Simultaneous bilateral forearm revascularization.

A successful simultaneous bilateral forearm revascularization was performed on a 17-year-old boy. Functional recovery of both forearms was evaluated 42 months after injury. The patient can use both hands for the activities of daily living. So far, he has been employed and has no significant psychological problems. Temporary intraluminal silicone shunts are extremely helpful for reducing ischemic damage to the injured limb. The sufficient skeletal shortening of the upper limb replantation is crucially important. The wounds must be managed by aggressive and repeated debridement. Accurate primary nerve repair is essential, and the early postoperative rehabilitation is also important to achieve a satisfactory functional return. The functional replanted or revascularized upper extremity is superior to an amputation or prosthesis, especially in the cases of bilateral upper extremity amputation or devascularization.

Adolescent↗
PubMed1991

Successful replantation of an amputated nasal tip by microvascular anastomosis.

Successful microsurgical replantation of a completely avulsed nasal tip is presented. The result is excellent. The technical challenge involved no sizable veins for drainage. This problem was solved by an artery-to-vein shunting. For facial avulsions, there is nothing superior to the original tissue, and replantation should always be attempted first.

Adult↗
PubMed1991

Second toe wrap-around flap.

The microsurgical second toe wrap-around technique is an ideal treatment option for reconstruction of the distal half of the finger with circumferential loss of skin and nail associated with an uninjured proximal interphalangeal joint and an intact insertion of the flexor digitorum superficialis tendon. Follow-up of 13 flaps in 10 patients from 1986 to 1989 demonstrates rapid and adequate functional recovery as well as satisfactory aesthetic appearance in all patients.

Adolescent↗
PubMed1991

Free flap transfer in burn reconstruction.

Wound healing in burn patients with exposure of vital tissues has been greatly facilitated by the use of free flap transfers for reconstruction with good functional as well as aesthetic results. Preoperative angiography is not an indispensable way to localize recipient vessels. Knowledge of the changes that occur in vessels at the zone of injury is crucial in the selection and preparation for microsurgical anastomosis. One team approach is advocated because the plan for the procedure may be changed when no appropriate recipient vessel is located during the dissection. We present our study of ten cases followed up in the last six years. Nine cases were successful, and severe wound infection resulted in one flap failure. Proper recipient vessel selection and adequate wound debridement are important factors for successful free flap transfer in burn reconstruction.

Adult↗
PubMed1990

Presenile (early ageing) changes in tissues of Kaschin-Beck disease and its pathogenetic significance.

The selenium level and activity of glutathione peroxidase in blood of children living in Kaschin-Beck disease (KBD) endemic areas were lower than that in nonendemic areas. KBD children were deficient in selenium, their lipid components, structure and function of the red cell membrane and cartilage tissue were abnormal. That is, the phospholipid (PL) content in the tissues of the patient was less than that of the controls in endemic and non-endemic areas. Especially as the phosphatidylcholine (PC) content decreased significantly, but sphingomyelin (SM) increased, the molar ratio of SM/PC and cholesterol (Ch)/PL increased. Increase of acanthocyte content was seen under the electron microscope and the fragility of erythrocytes was also increased. It indicated that there were membrane defects and membrane damage in KBD. At the same time, the sulfation extent of mucopolysaccharides in cartilage of patients was lower, and the collagen content was higher than that of controls. The presenile changes in lipid composition, structure and function of biomembranes and cartilage metabolism of KBD are very significant in studies on the aetiological pathogenesis of KBD and other ageing diseases.

Aging↗
PubMed1990

Emergency free flaps to the type IIIC tibial fracture.

Type IIIC tibial fractures are complex injuries involving extensive bone and soft-tissue devascularization that result in a high percentage of complications and ultimate amputation. An emergency free flap transfer not only may salvage the limb but also may improve the aesthetic and functional results of reconstruction by placing the injured structures in a well-vascularized bed. Two cases of type IIIC tibial fracture were treated in this manner, and we present our experience with a 30-month follow-up of one patient and a 6-month follow-up of another patient.

Adult↗
PubMed1990

Complex osteocutaneous injuries--timing of reconstruction. A report of 3 cases.

Twenty-seven patients with osseous trauma and soft-tissue loss were subjected to a treatment protocol aimed at obtaining definitive wound coverage within 10 days of injury. Reconstructive procedures included 19 successful microvascular tissue transfers as well as 8 pedicle flaps. The rate of serious complications was 8%, and patient morbidity was significantly reduced compared with a previous regimen of late reconstruction. An outline of the protocol is presented and technical points, which might enhance results, are discussed.

Adult↗
PubMed1989

"Smile" reconstruction in facial paralysis.

Reanimation of the face following facial nerve paralysis, especially the socially important smile, presents a complex surgical challenge requiring an individualized approach. Both neural and non-neural operative procedures have been used in an attempt to achieve the goal of a symmetrical synchronous smiling expression. A retrospective review of the results of both neural and nonneural methods was made to determine the relative efficacy of various methods. Of the neural techniques, early direct nerve repair primarily consistently achieved the best functional recovery. Double nerve grafts were found to be superior to a single nerve graft in nerve severance with a nerve gap at the facial nerve trunk bifurcation in delayed cases. In long-standing cases, ipsilateral or cross-face nerve grafting followed by functioning muscle transfer gives the most acceptable synchronous smile. Although cross-face nerve graft only, hypoglossal facial transfer, or non-neural techniques such as temporal muscle transfer achieved restoration of the smile, their inconsistent results and asynchronous action still limited the patient's confidence in social interactions.

Facial Expression↗
PubMed1989

Difficult reconstruction of an extensive injury in the lower extremity with a large cross-leg microvascular composite-tissue flap containing fibula.

In the absence of proper recipient vessels, a large microvascular composite-tissue flap was transferred successfully for reconstruction of a leg with an extensive crush injury. This was accomplished by using vessels of the normal leg. The microvascular flap containing skin, muscle, and 15 cm of fibula survived well after division of the pedicle. To achieve good bone healing, the leg was protected by a brace while gradually increasing weight bearing. The functional result is satisfactory.

Adolescent↗