In 10 adult specimens, we observed the distribution of the temporal branches of the facial nerve and its relation with the superficial temporal artery. The 6.3±0.9 temporal branches (5-8 branches, mean 6.3+0.9) went across the lateral margin of the M. frontalis and 10.3±2.2 branches entered the muscle. Their in-let, points were 2.86±5.35 mm upwardand outward of the outer canthus, and all points were about in one line. In conclusion, it was safe for surgeons, to operate in the "safe area" of the temporal region, medial to thevertical line to the outer canthus, without the risk to damage the branches of the facial nervc .
Various tissue flaps are currently used to repair the defect and injury of bone and joint. In this paper, based upon a series of anatomical studied, the author presents anatomical guidelines and principles for the selection of vaseularized bone flaps. Under these guidelines, the applied anatomical essential for vaseularized transplantation of ilium, scapula, fibula, costa, tibia, radius, ulna, humerus, femur and clavicle are provided.
ObjectiveTo compare the incidence of chondral injury using Rigidfix femoral fixation device via the anteromedial approach and the tibial tunnel approach during anterior cruciate ligament (ACL) reconstruction.
MethodsEighteen adult cadaver knees were divided randomly into 2 groups, 9 knees in each group. Femoral tunnel drilling and cross-pin guide insertions were performed using the Rigidfix femoral fixation device through the anteromedial approach (group A) and the tibial tunnel approach (group B). ACL reconstruction simulation was performed at 0, 10, 20, 30, 45, 60, 70, 80, and 90°in the horizontal position. The correlation between incidence of chondral injury and slope angles was analyzed, and then the incidence was compared between the 2 groups.
ResultsThe correlation analysis indicated that the chondral injury incidence increased with the increasing of the slope angle (r=0.611, P=0.000; r=0.852, P=0.000). The incidence of chondral injury was 69.1% (56/81) and 48.1% (39/81) in groups A and B respectively, showing significant difference (χ2=7.356, P=0.007). The sublevel analysis showed that the chondral injury incidence of group A (36.1%, 13/36) was significantly higher than that of group B (0) at 0-30°(χ2=15.864, P=0.000), but no significant difference was found between group A (95.6%, 43/45) and group B (86.7%, 39/45) at 45-90°(P=0.267).
ConclusionIt has more risk of chondral injury to use Rigidfix femoral fixation device via the anteromedial approach than the tibial tunnel approach to reconstruct ACL.
【Abstract】 Objective To explore the feasibility and safety of the femoral vein as a vascular graft material. Methods A total of 114 specimens of lower limbs were harvested from 60 adult cadavers; the lower extremity femoral veins, popliteal vein, deep femoral vein, and the communicating branch were dissected and observed; the length of the available femoral vein, from the point at which deep femoral vein and femoral vein joint to the lower edge of abductor hiatus, and squash vein diameter were measured. Computed tomography venography (CTV) data from 120 patients with lower extremity femoral vein thrombosis were analysed, and the venous reflux pathway of the lower extremity was observed. Results The average height of male was 158.3 cm, and the available length of femoral vein was (18.8 ± 2.3) cm (relative length, 0.118 ± 0.013), and squash vein diameter was (15.8 ± 0.8) mm. The average height of female was 149.2 cm, and the available length of femoral vein was (15.1 ± 1.5) cm (relative length, 0.101 ± 0.010), and squash vein diameter was (14.0 ± 1.1) mm. There were significant differences in the length of the available femoral vein (t=6.354, P=0.000) and squash vein diameter (t=5.555, P=0.000) between male and female. Positive correlation was found between the length of the available femoral vein and height (r=0.964, P=0.000). Low correlation was found between squash vein diameter and height (r=0.382, P=0.003). Double femoral veins were found in 16 limbs (14.0%), a femoral-popliteal vein communicating branch in 48 limbs (42.1%), a deep femoral-popliteal vein communicating branch in 38 limbs (33.3%). CTV showed that great saphenous vein, femoral-popliteal, or deep femoral-popliteal vein communicating branches had compensative capacity in patients with femoral vein thrombosis. Conclusion It is reliable and safe to harvest femoral vein as a vascular graft because of the existence of the great saphenous vein and communicating branches between the popliteal vein and femoral vein or deep femoral vein.
Objective To explore the operative managements of ectopic gallbladder during laparoscopic cholecystectomy (LC).Methods Twenty one cases of ectopic gallbladder undergone LC in this hospital were analyzed regarding the perioperative management, principle, and technique of operation.Results There were 2 cases of situs transversus, 1 case with gallbladder under right posterior lobe of liver, 2 under left lateral lobe of liver and 16 in the liver. All 21 cases of ectopic gallbladder had undergone LC successfully, and no complications were found during and after operation. Conclusion Anatomic ectopia of gallbladder tosses a challenging problem to laparoscopic surgeon. It is safe for surgeons to recognise actual anatomical anomaly and to manage them appropriately.
Objective To investigate the variation of supratrochlear vein and its relationship with supratrochlear artery and to provide anatomical basis for the reduction of congestive necrosis of paramedian forehead flap in the reconstruction of nasal defect. Methods Twenty sides of 10 antiseptic head specimens were anatomized macroscopically and microscopically. Using the horizontal and anterior median l ine of supraorbital rim as X and Y axis to locate supratrochlear vein and artery, the angles between the supratrochlear artery and vein and the supraorbital rim were detected, and the distances from the supratrochlear artery and vein to the anterior median l ine on the horizontal l ine of supraorbital rim were measured. Results The distance from the supratrochlear artery and supratrochlear vein to the anterior median l ine on thehorizontal l ine of the supraorbital rim was (16.2 ± 2.1) mm and (9.7 ± 3.1) mm, respectively, indicating there was a significant difference (P lt; 0.05). The angle between the supratrochlear vein and artery and the supraorbital rim was (83.3 ± 6.4)° and (80.5 ± 4.2)°, respectively, indicating there was no significant difference (P gt; 0.05). Two asymmetric supratrochlear veins were observed around the area of anterior median l ine in every specimen, one was far from the anterior median l ine (group A) and the other was close to or even on the l ine (group B). The distance from the supratrochlear veins to the anterior median l ine on the horizontal l ine of the supraorbital rim was (11.0 ± 1.9) mm in group A and (7.9 ± 3.2) mm in group B, showing there was a significant difference between two groups (P lt; 0.05). For all the specimens, the supratrochlear vein ran laterally along the medial anterior median l ine of the supratrochlear artery (one side was just on the anterior median l ine). The distance from the supratrochlear veins to the supratrochlear arteries on the horizontal l ine of the supraorbital rim was (6.6 ± 3.2) mm, (5.5 ± 2.0) mm in group A and (7.9 ± 3.9) mm in group B, indicating the difference between two groups was significant (P lt; 0.05). Conclusion The pedicle of the paramedian forehead flap should be wide enough (1.5-2.0 cm), the lateral boundary of the pedicle should be the supratrochlear artery while the medial boundary should be the supratrochlear vein.
