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Shi Y, Xu Y, Fan X, Wang T, Su Y, Fang X, Yang X, Fu Q, Luo T, He X. Three-Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities. World J Surg 2023; 47:1821-1827. [PMID: 37027024 DOI: 10.1007/s00268-023-06970-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Traditional research methods have limited the application of anterior tibial artery perforator flap due to incomplete knowledge of the perforator. This study aimed to investigate the feasibility of three-dimensional digitalized virtual planning of free anterior tibial artery perforator flap for repairing soft tissue defects in extremities. METHODS A total of 11 patients with soft tissue defects in extremities were included. The patient underwent computed tomography angiography (CTA) of bilateral lower limbs, and then the three-dimensional models of bones, arteries, and skin were constructed. Septocutaneous perforators with appropriate length and diameter were selected to design anterior tibial artery perforator flaps in software, and the virtual flaps were superimposed onto the patient's donor site in a translucent state. During the operation, the flaps were dissected and anastomosed to the proximal blood vessel of the defects as designed. RESULTS Three-dimensional modeling showed clear anatomical relationships between bones, arteries, and skin. The origin, course, location, diameter, and length of the perforator obtained during the operation were consistent with those observed preoperatively. Eleven anterior tibial artery perforator flaps were successfully dissected and transplanted. Postoperative venous crisis occurred in one flap, partial epidermis necrosis occurred in another flap, while the remaining flaps completely survived. One flap was treated with debulking operation. The remaining flaps maintained aesthetic appearance, which did not affect the function of the affected limbs. CONCLUSIONS Three-dimensional digitalized technology can provide comprehensive information on anterior tibial artery perforators, thus assisting in planning and dissecting patient-specific flaps for repairing soft tissue defects in extremities.
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Affiliation(s)
- Yan Shi
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Yongqing Xu
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Xinyu Fan
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Teng Wang
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Yanting Su
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Xiang Fang
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
- Department of Clinical Medical College, Dali University, Dali, 671000, China
| | - Xi Yang
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Qichen Fu
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Tianxian Luo
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China
| | - Xiaoqing He
- Department of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, 212 Daguan Road, Xishan District, Kunming, 650032, Yunnan, China.
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Hansson S, Östlund E, Bazargani F. The Vectra M3 3-dimensional digital stereophotogrammetry system: A reliable technique for detecting chin asymmetry. Imaging Sci Dent 2022; 52:43-51. [PMID: 35387095 PMCID: PMC8967496 DOI: 10.5624/isd.20210168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The aim of this study was to evaluate the reliability of the Vectra M3 (3D Imaging System; Canfield Scientific, Parsippany, NJ, USA) in detecting chin asymmetry, and to assess whether the automatic markerless tracking function is reliable compared to manually plotting landmarks. Materials and Methods Twenty subjects (18 females and 2 males) with a mean age of 42.5±10.5 years were included. Three-dimensional image acquisition was carried out on all subjects with simulated chin deviation in 4 stages (1-4 mm). The images were analyzed by 2 independent observers through manually plotting landmarks and by Vectra software auto-tracking mode. Repeated-measures analysis of variance and the Tukey post-hoc test were performed to evaluate the differences in mean measurements between the 2 operators and the software for measuring chin deviation in 4 stages. The intraclass correlation coefficient (ICC) was calculated to estimate the intra- and inter-examiner reliability. Results No significant difference was found between the accuracy of manually plotting landmarks between observers 1 and 2 and the auto-tracking mode (P=0.783 and P=0.999, respectively). The mean difference in detecting the degree of deviation according to the stage was <0.5 mm for all landmarks. Conclusion The auto-tracking mode could be considered as reliable as manually plotted landmarks in detecting small chin deviations with the Vectra® M3. The effect on the soft tissue when constructing a known dental movement yielded a small overestimation of the soft tissue movement compared to the dental movement (mean value<0.5 mm), which can be considered clinically non-significant.
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Affiliation(s)
- Stina Hansson
- Department of Orthodontics, Postgraduate Dental Education Center and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Emil Östlund
- Department of Orthodontics, Postgraduate Dental Education Center and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Farhan Bazargani
- Department of Orthodontics, Postgraduate Dental Education Center and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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