Search

Objective Based on 3D printing technology, explore the precision of a perforator vessel location guide plate for fibular musculocutaneous flaps before the transplantation of fibular osteocutaneous flaps and evaluate its application effects. Methods This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. From May 2019 to October 2022, 14 patients with jaw defects who needed to undergo fibular perforator flap transplantation at the First Affiliated Hospital of Xinjiang Medical University were selected. For the seven patients in the guide plate group, CTA was combined with Mimics software to reconstruct both lower limbs, and the perforator vessel positioning guide for locating perforator vessels was designed; the two ends of the guide plate were designed as fixed ends, with the upper end fixed to the knee joint and the lower end fixed to the ankle joint, and the guide plate was fabricated by a 3D printer. For the seven patients in the control group, a conventional handheld Doppler probe was used for perforator vessel location. The average operation time, bleeding volume, recovery time, deviation of perforator vessel location, postoperative flap-related complications, postoperative donor site shape satisfaction, and lower extremity functional scale (LEFS) score were recorded. SPSS 25.0 software was used for statistical analysis. Results The average operation time, bleeding volume, recovery time, deviation of perforator vessel location and postoperative donor site shape satisfaction were significantly better in the guide plate group than in the control group (PP>0.05). Conclusion Based on 3D printing technology, fibular musculocutaneous flap perforator vessels can be more accurately located using a guide plate and the knee and ankle as fixed points, and this method can effectively stabilize the guide position, prevent soft tissue offset, and improve positioning accuracy and thus deserves to be generalized.

Objective To explore the clinical, imaging and pathological characteristics of mandibular peripheral primitive neuroectodermal tumors, and to review relevant literature to improve the understanding and diagnosis of pPNET in mandible. Methods The clinical and imaging features, pathological examination, treatment and prognosis of a case of mandibular pPNET diagnosed and treated at the First Affiliated Hospital of Xinjiang Medical University were observed, and analyzed a literature review. Results The patient′s clinical manifestations were an enlarged mass of the mandible, hard texture, unclear borders, involving loose teeth, and numbness of the lower lip; CT and MRI showed osteolytic and aggressive growth patterns. The mandibular tumor was resected and the mandibular partial truncated resection was performed on the titanium plate. Postoperative pathological sections showed small round cell tumors under HE staining and Vimentin and Fli-1 were positive, and the pathological diagnosis was pPNET. The patient did not undergo chemoradiotherapy after surgery and died of tumor recurrence after 9 months of follow-up. A review of the relevant literature revealed that pPNETs are a group of small round cell tumors, which are more common in children and adolescents. pPNETs have a high degree of malignancy, a short course of disease and fast metastasis. The main route of metastasis is through the blood circulation. Most patients die within 2 years, the 3-year survival rate is only 30%, and the 5-year survival rate is less than 10%. Imaging is generally nonspecific; therefore, pPNETs are easily misdiagnosed. The final tumor type is determined by pathological HE staining and immunohistochemical characteristics. Current treatment methods are mainly complete surgical resection combined with postoperative radiotherapy and chemotherapy, but it is critical to provide individualized treatment to patients when necessary. Conclusion pPNETs have a high degree of malignancy, easy recurrence and poor prognosis, so early diagnosis and treatment are extremely important.

Objective To explore the clinical epidemiological characteristics and treatment methods of maxillofa⁃ cial fracture patients in the Kashgar Prefecture to provide a reference for clinical diagnosis and treatment. Methods The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications. Results Among the 1 115 patients, the ratio of males to females was 4.7∶1, and those aged 21 to 30 years accounted for the majority of patients, with most injuries occurring in the summer (31.38%) and spring (29.69%). The most common cause of trauma was falling (38.57%), followed by traffic accidents (36.95%). Midfacial fractures were the most frequently observed (65.38%), followed by mandibular fractures(30.26%). In all, 42.15% of cases were complicated with systemic injuries, the majority being ocular injuries (35.55%), followed by limb injuries (21.67%). The majority of patients (50.04%) chose treatment by open reduction and internal fixation. Logistic regression analysis showed that males were more prone to midfacial fractures than females. The occurrence of midfacial fracture became more likely with increasing age. Conclusion In the Kashgar Prefecture, the majority of pa⁃ tients with maxillofacial fracture are male and young or middle⁃aged. Most maxillofacial fractures occur in the spring or summer and are mainly caused by falling or traffic accidents. Fractures in the middle part of the face are more common.Ocular injury is the most common complication, and in most cases, the fracture is treated by open reduction and inter⁃ nal fixation. The occurrence of midfacial fracture is closely related to age, sex and cause of trauma.