PDF(Pubmed)
Abstract：
UNASSIGNED: Primary explosion injuries with fireworks can lead to devastating and geometrically complex facial traumas that present a challenge to the reconstructive surgeon. Our patient, a woman in her early thirties, was hit directly in her chin by a large artillery shell firework. This caused complete soft tissue loss of the lower lip and chin beyond the oral commissures, complicated further by a comminuted mandible fracture.
UNASSIGNED: After external fixation, our patient underwent a 2-stage reconstruction with a novel composite flap arrangement. Soft tissue coverage and lip reconstruction were performed with opposing bilateral radial forearm free flaps. The outer flap constituted the soft tissue of the new chin and outer lower lip, whereas the inner flap composed the intraoral lining. In the second stage, portions of the inner upper lip mucosa and superior orbicularis oris muscle were flipped down as a bipedicle, axial pattern \"bucket-handle\" type flap to the lower lip to reconstruct the vermilion. A graft of fascia lata was attached to the modioli of the orbicularis oris and interpositioned beneath the vermilion flap and the radial forearms to restore static and some dynamic sphincter control. One month later, the mandibular fractures underwent open reduction and internal fixation.
UNASSIGNED: Two months after soft tissue reconstruction with no complications, our patient had satisfactory aesthetic outcomes, oral competence, and speech.
UNASSIGNED: This case has shown that use of bilateral, fascia lata-reinforced radial forearm flaps may be an effective choice for soft tissue reconstruction and oral competence restoration in cases of severe facial explosion trauma.
UNASSIGNED: After external fixation, our patient underwent a 2-stage reconstruction with a novel composite flap arrangement. Soft tissue coverage and lip reconstruction were performed with opposing bilateral radial forearm free flaps. The outer flap constituted the soft tissue of the new chin and outer lower lip, whereas the inner flap composed the intraoral lining. In the second stage, portions of the inner upper lip mucosa and superior orbicularis oris muscle were flipped down as a bipedicle, axial pattern \"bucket-handle\" type flap to the lower lip to reconstruct the vermilion. A graft of fascia lata was attached to the modioli of the orbicularis oris and interpositioned beneath the vermilion flap and the radial forearms to restore static and some dynamic sphincter control. One month later, the mandibular fractures underwent open reduction and internal fixation.
UNASSIGNED: Two months after soft tissue reconstruction with no complications, our patient had satisfactory aesthetic outcomes, oral competence, and speech.
UNASSIGNED: This case has shown that use of bilateral, fascia lata-reinforced radial forearm flaps may be an effective choice for soft tissue reconstruction and oral competence restoration in cases of severe facial explosion trauma.
摘要：
未经证实：烟火引起的初次爆炸伤害可能导致破坏性和几何形状复杂的面部创伤，这对重建外科医生构成了挑战。我们的病人,一个三十出头的女人,被一枚大炮弹烟花直接击中她的下巴。这导致下唇和下巴超过口腔连合的软组织完全丧失，再加上下颌骨粉碎性骨折.
UNASSIGNED：外固定后，我们的病人接受了一个新的复合皮瓣排列的两阶段重建.使用相对的双侧radial前臂游离皮瓣进行软组织覆盖和嘴唇重建。外瓣构成了新下巴和外唇的软组织，而内部皮瓣组成口内衬里。在第二阶段,内唇粘膜和口轮匝肌的部分被向下翻转为双蒂，轴向模式“桶柄”型皮瓣到下唇，以重建朱红色。将阔筋膜移植物连接到口轮匝肌的扁桃体上，并置于朱红瓣和radial前臂下方，以恢复静态和动态括约肌控制。一个月后,下颌骨骨折行切开复位内固定。
未经批准：软组织重建后两个月无并发症，我们的病人有令人满意的美学结果，口语能力,和演讲。
UNASSIGNED：此案例表明，使用双边，在严重的面部爆炸创伤的情况下，筋膜筋膜增强的radial前臂皮瓣可能是软组织重建和口腔功能恢复的有效选择。
UNASSIGNED：外固定后，
未经批准：软组织重建后两个月无并发症，
UNASSIGNED：此案例表明，使用双边，
