Xianfeng Guo

Publications (2)1.33 Total impact

• Article: Donor foot morbidity following modified wraparound flap for thumb reconstruction: a follow-up of 69 cases.

  Yong-wei Pan, Lishan Zhang, Wen Tian, Guanglei Tian, Junhui Zhao, Xianfeng Guo
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  ABSTRACT: To evaluate donor foot morbidity after thumb reconstruction using a modified wraparound flap. We observed patients who accepted thumb reconstruction with the modified wraparound flap between January 2001 and December 2009. We examined and evaluated the reconstructed thumb and donor foot. Donor morbidity was assessed on both a subjective and an objective basis using the Foot Function Index-verbal rating scales (FFI-5pt), the American Orthopaedic Foot and Ankle Society for Hallux Metatarsophalangeal-Interphalangeal (MTP-IP) scale, and gait analysis and dynamic pedodynographic measurements. We reviewed 69 patients; the follow-up period ranged from 6 months to 5 years, with an average of 26 months. The reconstructed thumbs had good aesthetic appearance, and static 2-point discrimination averaged 9.4 ± 2.7 mm. Full length or most of the length of the donor toes was preserved in 67 patients. The retained plantar strip was significantly enlarged from an average of 14.5 ± 1.4 mm measured at surgery to 27.8 ± 4.7 mm measured at last follow-up (p < .05), and its 2-point discrimination was 9.1 ± 2.3 mm. A total of 34 patients were available for FFI-5pt and Hallux MTP-IP scale evaluation. The FFI-5pt total score was 3.1 ± 2.7 and the total Hallux MTP-IP score was 87.9 ± 7.1. Gait analysis and dynamic pedodynographic measurements were available in 20 patients. All 5 biomechanical parameters (timing, trajectory, symmetry, average peak force, and peak pressure between donor foot and the contralateral foot) had no significant difference. The function of the donor foot after a modified wraparound flap for thumb reconstruction was well preserved, the degree of pain and disability in the donor foot was mild, and foot function in gait was not disturbed. Although a certain degree of restriction in interphalangeal joint motion occurred, this was nearly negligible and did not deter return to normal daily living activity, work, and recreation.
  The Journal of hand surgery 01/2011; 36(3):493-501. · 1.33 Impact Factor
• Article: [Thumb reconstruction with modified free wrap-around flap].

  Lishan Zhang, Yongwei Pan, Guanglei Tian, Wen Tian, Xianfeng Guo, Manyi Wang
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  ABSTRACT: To evaluate the function of the reconstructed thumbs and the donor feet after thumb reconstructions with modified wrap-around flap. A total of 65 patients who accepted thumb reconstruction with the modified wrap-around flap between January 2003 and October 2007 were followed up, including 54 males and 11 females with an average age of 33 years (range 15-46 years). There were 12 cases of skin degloving injury and late class I B defect, 44 cases of class II defect and 9 cases of class III A defect. The reconstructed thumbs and donor feet were examined and evaluated. Foot function index-verbal rating scales (FFI-5pt), American Orthopaedic Foot and Ankle Society (AOFAS) for hallux metatarsophalangeal-interphalangeal score, gait analysis and dynamic pedobarography were conducted to 20 patients who were followed up recently. Sixty-five patients were followed up 6-60 months with an average of 22 months. The reconstructed thumbs had aesthetic appearance and satisfactory range of motion. The two-point discrimination was (9.7 +/- 2.8) mm, showing statistically significant difference (P < 0.05) when compared with that of the contralateral normal thumb [(4.2 +/- 1.1) mm]. Full or most length of the donor toes were preserved in 63 patients. The width of remaining plantar strip skin that covered the plantar weight-bearing area was (24.5 +/- 3.7) mm, and its two-point discrimination was (9.0 +/- 2.6) mm; showing no statistically significant difference (P > 0.05) when compared with that of contralateral normal one [(8.1 +/- 1.9) mm]. Of the 20 patients who were followed up recently, the evaluation of the FFI-5pt score showed that the pain scale score was 5.6 +/- 4.5, the disability scale score was 1.2 +/- 2.7, and the FFI-5pt total scale score was 3.2 +/- 2.9. The results of AOFAS clinical rating scale showed that the pain scale score was 34.0 +/- 5.0, the function scale score was 38.7 +/- 4.2, the alignment scale score was 15.0 +/- 0, and the total AOFAS scale score was 87.7 +/- 7.4. There was no statistically significant difference (P > 0.05) in the durations of subphases of the gait cycle between the donor foot and the contralateral normal foot, and in the peak force and force-time integral of the two whole foot. The peak force of the donor toe was significantly smaller than that of the contralateral normal toe (P < 0.05), but there was no significant difference in the peak pressure (P > 0.05); and there were no significant differences in the peak forces and peak pressures of other six anatomical sites of the two feet (P > 0.05). Using the modified wrap-around flap for thumb reconstruction, aesthetic and functional thumbs can be obtained, and most of the function of the donor feet can be preserved.
  Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 03/2010; 24(3):309-14.