The distal end of the tibia was elevated on the pedicle of the

The distal end of the tibia was elevated on the pedicle of the Y 27632 tibialis anterior vessels. The vascularized tibial flap was shifted distally and inserted into the graft bed in the talus to form a bridge between the tibia and the talus. The talotibial joint was completely fused 2 months after surgery. Three months were required before the patients could walk bearing full weight. Ankle arthrodesis using an anterior sliding inlay vascularized tibia flap is an easy procedure to perform and is indicated for both the treatment of primary and secondary ankle arthritis. © 2010 Wiley-Liss, Inc. Microsurgery, 2011. “
“In the last decade surgical training

is being revolutionized by two novel concepts that have been introduced to almost all branches of surgery including and most recently to microsurgery. These two concepts are: objective assessments of surgical skills and the nurturing of surgical skills in a simulation laboratory setting. Acquiring surgical skills in the laboratory

setting can help move the microsurgical learning curve from the patient to the laboratory and this will in turn improve patient safety. In order to optimize microsurgical training through a competency based training programme, it is imperative for microsurgical educators to understand microsurgical skill acquisition. This requires accurate objective assessment tools that can define and quantify microsurgical competency. This article aims to review the current literature on the various objective assessment tools adapted for microsurgery and attempt to identify the gaps that need to be addressed by research in microsurgical education to establish the ideal objective assessment tool. © 2013 Wiley Periodicals, Inc. Microsurgery 33:406–415, 2013. “
“Introduction: The superficial inferior epigastric artery (SIEA)

PtdIns(3,4)P2 is a useful pedicle in supply to the lower abdominal integument, with its use sparing damage to rectus abdominis muscle or sheath. However, it is limited in usefulness due to its anatomical variability. While previous anatomical studies have been limited in number and study design, the use of preoperative imaging has enabled the analysis of this vasculature in large numbers and greater anatomical detail. Methods: A clinical anatomical study of 500 hemi-abdominal walls in 250 consecutive patients undergoing preoperative computed tomographic angiography (CTA) prior to autologous breast reconstruction was undertaken. The presence, size, location, and branching pattern of the SIEA were assessed in each case. Results: The SIEA was identified in 468 cases, an incidence of 94%. Its mean diameter was 0.6 mm, and in 24% of cases was of a diameter >1.5 mm. SIEA location was highly variable, with mean position 2-cm lateral to the linea semilunaris (range 0–8 cm lateral), and relationship to the superficial inferior epigastric vein (SIEV) was also highly variable, with the distance between them ranging from 0.3 to 8.5 cm apart.

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