[Role of the retro-auricular flap in nose reconstruction. Example of septo-columellar reconstruction].
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Posttraumatic soft tissue and bone defects can pose problems for the surgeon. Autogenous bone from the iliac crest may be used to fill bone defects. To achieve bone healing, a well vascularized recipient site for the graft is important. Local muscle flaps or distant microvascular flaps improve vascularity by introducing a fresh blood supply. Cellular and humoral antibodies are more effective and allow quicker revascularisation of the transplanted graft. 49 soft tissue defects were treated by local muscle flaps. In 14 cases the soleus, in 28 the gastrocnemius, in three the tibialis anterior, in two the abductor hallucis, and in two the gracilis muscle was transposed. 38 cases had posttraumatic osteitis, in eight the defect was merely a soft tissue defect and in three due to tumour excision. In 24 patients a combination of soft tissue repair and cancellous bone grafting was performed. Four flaps failed because of total or partial necrosis. In all cases full weight bearing on the leg with good soft tissue cover was achieved.
On the basis of long years' experiences the "no man's land" has been divided by the author into 2 parts: the proximal and the distal part. For the treatment of the flexor tendon lesions occurred in the distal part of the author advocates his method already published: in the "tendon sheath" formed from the vein its "bridging" by free tendon transplant. If the lesion occurred in the proximal part, the formation of a long "tendon sheath" from a vein and then its "bridging" by long tendon transplant are advocated by the author.
The advantages and special features of the THRP-system enabled us to develop new operative techniques. The combination of the advantages of external fixation devices and those of the internal osteosynthesis has proved to be decisive in order to obtain good results. The clinical results in 30 patients confirm the recently published findings from animal studies. Histological examination of human specimens comparing 2 types of screws developed by us are discussed.
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