Journal of Plastic Surgery and Hand Surgery最新文献

{"title":"Towards consensus on the treatment of congenital craniofacial conditions: the discussion section of a doctoral thesis.","authors":"Victor Van Roey, Irene M J Mathijssen, Aebele B Mink van der Molen, Sarah L Versnel","doi":"10.2340/jphs.v61.45985","DOIUrl":"https://doi.org/10.2340/jphs.v61.45985","url":null,"abstract":"<p><strong>Background: </strong>Congenital craniofacial conditions are a diverse group of rare and complex disorders, leading to significant functional and psychosocial challenges. Their rarity and variability hinder research and clinical standardisation, resulting in substantial practice variation across centres. International collaboration and high-quality evidence are therefore essential to improve and converge care for affected individuals. This article presents the discussion section of a doctoral thesis that addressed these challenges through multiple methodological approaches, the majority of which were conducted within the European Reference Network for Rare and Complex Craniofacial Conditions (ERN CRANIO).</p><p><strong>Methods: </strong>The studies combined systematic reviews, multicentre cohort analyses, expert consensus and registry development to advance understanding and care for three conditions: unilateral cleft lip and palate (UCLP), Treacher Collins syndrome and Miller syndrome.</p><p><strong>Results: </strong>The thesis provides evidence supporting early hard palate closure in UCLP, contributing to improved speech outcomes and fewer oronasal fistulas without increasing surgical burden. For facial dysostosis syndromes, the European clinical consensus statement and the establishment of the first international registry provide a foundation for more standardised multidisciplinary care and collaborative research. The systematic review on Miller syndrome clarifies its phenotypic spectrum and aids differential diagnosis with other syndromes.</p><p><strong>Conclusions: </strong>Through its comprehensive and collaborative approach, this thesis promotes the convergence of care for congenital craniofacial conditions in Europe. It highlights the importance of methodological rigour, standardisation and international collaboration to achieve evidence-based and equitable care for these rare and complex disorders.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"110-114"},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of severe radial translation of distal radius fractures which is a potential cause of distal radioulnar joint instability.","authors":"Jiang Huajun, Liu Sida, Jiang Peilong, Zhang Borui, Yang Jingjing, Qu Wei","doi":"10.2340/jphs.v61.46005","DOIUrl":"https://doi.org/10.2340/jphs.v61.46005","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to (1) introduce a simple and reproducible method to assess severe radial translation of distal radius fractures (DRF) which is a potential cause of distal radioulnar joint (DRUJ) instability, and (2) to construct a treatment-oriented classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;From 2018 to 2023, stress test (ballottement test) was performed to detect DRUJ instability associated with DRF after treatment with locking plate fixation. Potential radiographic predictors of DRUJ instability focus on radial translation were accessed. The severity of radial translation was described by a readily and easily technique as 'point- baseline' method. According to this method, radial translation was categorized into three grades: no translation (the marking points not moved), moderate translation (the marking points moved, but were located on the ulnar side of the baseline), and severe translation (the marking points moved and reached the baseline position, or even completely moved to the radial side of the baseline). All these fractures were divided into two groups, namely Group A (cases with no translation or moderate translation) and Group B (cases with severe translation). Relationships between DRUJ instability and the radiographic parameter of radial translation were analyzed. To investigate the causes of DRUJ instability, all of the cases with DRUJ instability were further divided into two subgroups: subgroup A (cases with DRUJ instability in Group A) and subgroup B (cases with DRUJ instability in Group B). Practices to address DRUJ instability at the time of DRF fixation were explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 226 patients enrolled in this study. According to 'point- baseline' method, there were 174 wrists in Group A and 52 wrists in Group B. There were 34 cases (19.54%) diagnosed as having DRUJ instability intraoperatively via manual stress testing in Group A, while 36 cases (69.23%) in Group B. There was significant difference in the incidence of DRUJ instability between the two groups (p &lt; 0.0001). Of the 70 cases with DRUJ instability, 18 cases regained stability by ulnar styloid fracture fixation, 12 cases by dorsal ulnar corner fragment (sigmoid notch fracture) fixation, and 40 cases by arthroscopy-assisted triangular fibrocartilage complex (TFCC) repair. To investigate the causes of DRUJ instability, there were 34 wrists in subgroup A, while 36 wrists in subgroup B. There were no significant differences between the two subgroups regarding the causes of DRUJ instability including ulnar styloid process fracture, dorsal ulnar corner fragment (sigmoid notch fracture), and traumatic TFCC injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study helped establish a 'point- baseline' method which can be readily and easily used to identify the severity of radial translation, which was a significant predictor of DRUJ instability. On the other hand, whether or not severe radial tr","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"104-109"},"PeriodicalIF":0.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infiltration level of macrophages and its impact on fat graft retention in mouse free fat grafting model.","authors":"Chengzhi Dong, Jian Zhang, Lijuan Peng","doi":"10.2340/jphs.v61.45744","DOIUrl":"https://doi.org/10.2340/jphs.v61.45744","url":null,"abstract":"<p><strong>Background: </strong>Autologous fat grafting faces the clinical challenge of unstable absorption rates, and the regulatory mechanisms of macrophages need to be elucidated.</p><p><strong>Objectives: </strong>It aimed to investigate the infiltration levels and phenotypic dynamics of macrophages and explore their impact on graft retention rate (RR).</p><p><strong>Methods: </strong>A total of 180 C57BL/6J mice were randomly divided into experimental (AG, fat grafting), sham (BG, no grafting), and intervention (CG, macrophage depletion followed by grafting) groups. Graft RR was assessed, and macrophage status was analyzed by flow cytometry and immunofluorescence postoperatively. Levels of inflammatory, pro-fibrotic, and angiogenic factors were also detected.</p><p><strong>Results: </strong>Macrophage infiltration in the AG peaked at week 2 (21.3 ± 1.5%) and then shifted from M1 to M2 phenotype. The graft RR in the AG was visibly higher as against the CG (p < 0.05). M2 macrophages were strongly positively correlated with RR (based on the aggregated data of all time points, r = 0.821, p < 0.0001), while pro-inflammatory factors suggested negative correlation. The AG had visibly elevated levels of angiogenic factors, which were strongly positively correlated with RR (p < 0.05).</p><p><strong>Conclusion: </strong>Macrophages (especially the M2 subtype) play a key role in fat graft survival by modulating inflammatory responses and promoting angiogenesis. Targeting macrophage polarization may be a novel strategy to improve fat grafting outcomes.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"95-103"},"PeriodicalIF":0.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial femoral condyle flap for ulnar reconstruction and structural bone allograft for radial reconstruction in post-traumatic forearm diaphyseal non-union: a two-case report.","authors":"Matthias Holzbauer, Maximilian Zaussinger, Klaus Strassmair, Stefan M Froschauer, Tobias Gotterbarm, Manfred Schmidt","doi":"10.2340/jphs.v61.45795","DOIUrl":"https://doi.org/10.2340/jphs.v61.45795","url":null,"abstract":"<p><p>The successful treatment of forearm non-unions, which occur as a complication in 2-10% of all forearm fractures, poses a significant challenge in reconstructive surgery. Current treatment often involves revision fixation with non-vascularized bone grafts for atrophic non-unions. Large bony defects in both forearm bones, however, necessitate advanced reconstructive techniques. In isolated reconstructions of the radius or ulna, the vascularized medial femoral condyle (MFC) flap has gained popularity, achieving 98-100% union rate. Allogenic bone grafts have also been described for reconstruction of large bone defects, potentially reducing donor site morbidity and operation time. This two-case report investigates the performance of vascularized MFC cortico-cancellous flap for ulna reconstruction and tricortical allogenic bone graft of the iliac crest for radius reconstruction in excessive, post-traumatic, atrophic non-union of the forearm diaphysis. In May and June 2021, a 62-year-old and a 56-year-old male received reconstruction surgery 9 and 13 months after initial plate osteosynthesis after a motorcycle accident. The MFC flap showed successful bony union of the ulna after 3 months as well as consecutive remodeling. However, the reconstruction of the radius showed a recurrent non-union, which even led to plate breakage in one case. In both cases, ulnar reconstruction with a vascularized MFC flap achieved successful union. However, radial reconstruction using structural allograft did not achieve union, causing recurrent non-union, likely reflecting limited biological incorporation. Level of Evidence: V (Therapeutic).</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"91-94"},"PeriodicalIF":0.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and prognosis of skin cancer arising from burn scars: a systematic review.","authors":"Abdulmajeed Alhadlaq, Ibraheem M Kereet, Basma Kamel, Kainat Jahangir, Nada G Hamam, Mohamed Ashraf Shehab, Mohamed Hisham Alamin, Ahmed S A Osman, Salma Rechid, Mohamed Ahmed Ali, Mohamed Elsaid","doi":"10.2340/jphs.v61.45793","DOIUrl":"https://doi.org/10.2340/jphs.v61.45793","url":null,"abstract":"<p><strong>Background: </strong>Burn scars are recognized risk factors for malignant skin transformation, most notably Marjolin's ulcer (MU). Despite extensive documentation in case reports and series, the epidemiological characteristics and prognosis of burn scar-related skin cancers have lacked large-scale systematic synthesis.</p><p><strong>Methods: </strong>We conducted a systematic review in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, registered with PROSPERO (CRD42024545404), covering literature from PubMed, Scopus, and Web of Science up to 18 January 2024. Eligible studies included case reports, case series, and observational studies reporting any type of skin cancer in burn scars. Data were extracted on demographics, burn and tumor characteristics, treatment, latency, outcomes, and risk of bias using Joanna Briggs Institute tools.</p><p><strong>Results: </strong>A total of 211 studies reporting 830 cases were included. The mean latency period from burn injury to cancer diagnosis was 21.7 years (SD = 19.6). Males constituted 53% of patients, with third-degree burns predominating (89.37%) and lower limbs being the most affected site (33.59%). Squamous cell carcinoma (SCC) was the most frequent malignancy (67.19%), followed by basal cell carcinoma (BCC, 3.83%) and other cancers (15.33%). Recurrence occurred in 13.2% of cases; mortality was 6.96%. SCC accounted for most deaths (63.8%), while melanoma and sarcoma exhibited high rates of recurrence and mortality. Lymph node metastasis and distant metastasis were found in 7.56 and 4.74% of cases, respectively.</p><p><strong>Conclusion: </strong>Skin cancers arising from burn scars, especially SCC, demonstrate aggressive clinical behavior with significant morbidity and mortality. Reduced latency periods and high metastatic potential highlight the importance of vigilant, long-term surveillance and radical initial treatment. This review provides a contemporary benchmark for epidemiological understanding and supports calls for international registries, molecular diagnostics, and standardized management protocols for burn scar malignancies.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"86-90"},"PeriodicalIF":0.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current materials and techniques in cosmetic hand injections.","authors":"Yutong Liang, Jun Zhuang, Xueshang Su, Ziming Zhang, Qingqian Wei, Jintian Hu","doi":"10.2340/jphs.v61.45435","DOIUrl":"https://doi.org/10.2340/jphs.v61.45435","url":null,"abstract":"<p><strong>Background: </strong>With the widespread popularity and development of aesthetic treatments, the focus has extended from facial aging to include the aging of hands. The primary aim of this study is to review the current materials, methods of injection, and testing procedures employed in cosmetic hand injections.</p><p><strong>Methods: </strong>PubMed database (from 1971 to April 2024) was searched to identify relevant studies on materials, injection techniques, and evaluation methods associated with aesthetic hand injections, excluding systematic reviews and medical record reports.</p><p><strong>Results: </strong>A total of 1815 articles were identified, of which 41 articles were included. This study summarizes the current materials, injection techniques, and outcome evaluation methods used for cosmetic hand injections, while discussing observations and making recommendations.</p><p><strong>Conclusion: </strong>Hand skin conditions tend to receive less attention than cosmetic facial injections. In existing studies of injected substances, hydroxyapatite remains the main material used for cosmetic hand injections. Poly-L-lactic acid (PLLA), platelet-rich plasma (PRP), and polycaprolactone injections were significantly more effective than other substances in the hand. In commonly used injection techniques, catheter-based injection methods are more accurate than needle positioning and dose. The most commonly used assessment methods remain ultrasound and the Merz hand partial scale. At present, there is still a relative lack of research on aesthetic hand injections, and extensive and in-depth research, such as randomized studies comparing hyaluronic acid and calcium hydroxylapatite and longitudinal data on the results of PLLA or PRP, is recommended to further develop hand injection techniques with lasting aesthetic results. Increased public awareness of hand injections derives from more reliable and valid studies. And we need standardized outcome measures and long-term follow-up data in future studies.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"78-85"},"PeriodicalIF":0.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of tear trough deformity in young patients without eyebags using orbital fat reposition and release of tear trough ligament.","authors":"Xianyu Zhou, Mengmeng Hou, Shun Yu, Jun Yang, Yucheng Qiu, Fei Liu","doi":"10.2340/jphs.v61.45298","DOIUrl":"10.2340/jphs.v61.45298","url":null,"abstract":"<p><strong>Background: </strong>Tear trough deformity (TTD) is a periorbital hollow extending from the medial canthus to the midpupillary line, which is mainly caused by the traction of the tear trough ligament (TTL). This study aimed to present a retroseptal transconjunctival lower-eyelid blepharoplasty with orbital fat reposition and release of TTL for correcting TTD in young patients without eyebags.</p><p><strong>Methods: </strong>Seventy-nine young patients with TTD without eyebags receiving the described technique were retrospectively reviewed from September 2020 to April 2023. TTD was preoperatively categorized into different Hirmand types. Cosmetic outcomes were evaluated through tear trough rating scale (TTRS), Barton grading system and patient self-assessment.</p><p><strong>Results: </strong>The average follow-up time was 14.7 months (range, 12-18 months). Average TTRS in Hirmand class I and II were significantly different between pre- and post-operation (p < 0.05), while there was no significant difference in class I (p > 0.05). As to Barton grading system, TTDs in Hirmand class I were all graded as 1 preoperatively and were all shifted to grade 0 postoperatively. In class II, grade 1 (20%), grade 2 (71.4%), and grade 3 (8.6%) TTDs were shifted to grade 0 (85.7%) and grade 1 (14.3%) postoperatively. In class III, grade 2 (54.5%) and grade 3 (45.5%) TTDs were shifted to grade 0 (18.2%), grade 1 (45.5%) and grade 2 (36.3%). The overall patient self-assessed satisfaction was 96.2%.</p><p><strong>Conclusions: </strong>Retroseptal transconjunctival lower-eyelid blepharoplasty with release of TTL and orbital fat reposition can achieve satisfactory outcomes to correct TTDs without eyebags.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"72-77"},"PeriodicalIF":0.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schwannomas of the deep motor branch of the ulnar nerve: a systematic review of the literature with an additional case report and anatomical analysis.","authors":"Filippo Pantaleoni, Mariia Kotova, Marta Montanari, Marco Passiatore, Davide Gravina, Paolo Boccolari, Danilo Donati, Marta Starnoni, Andrea Leti Acciaro","doi":"10.2340/jphs.v61.45668","DOIUrl":"https://doi.org/10.2340/jphs.v61.45668","url":null,"abstract":"<p><strong>Purpose: </strong>Schwannomas originating from the deep motor branch of the ulnar nerve (DMBUN) are exceptionally rare, presenting with variable and often heterogeneous clinical manifestations depending on their precise anatomical location. While these tumors have been described in the literature, reports specifically involving the DMBUN are exceedingly limited, rendering postoperative prognostication challenging. This study aims to systematically review the existing literature and present a novel case, with the objective of delineating anatomical characteristics and clarifying potential postoperative outcomes.</p><p><strong>Methods: </strong>A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the MEDLINE and Scopus databases. Data regarding patient demographics, clinical presentation, anatomical localization, and surgical outcomes were extracted and analyzed.</p><p><strong>Results: </strong>Seven articles met the inclusion criteria. A total of nine tumors were initially identified as schwannomas of the DMBUN over a 73-year period; however, only five cases - including the newly reported one - were confirmed. The median patient age was 59.6 years; complete recovery was achieved in three cases, with time to functional improvement ranging from 4 to 6 months.</p><p><strong>Conclusion: </strong>In this limited series, available data suggest that accurate preoperative imaging and careful intraoperative microsurgical dissection may lead to favorable outcomes, with complete recovery achievable in schwannomas of the DMBUN. No clear association was observed between postoperative nerve function and tumor size, patient age, or time since symptom onset.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"65-71"},"PeriodicalIF":0.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147530223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and histopathological effects of topical pentoxifylline on autonomisation processes in rat dorsal randomised skin flaps.","authors":"Melike Zeynep Kuşçu, Selman Hakkı Altuntas, Özlem Özmen, Simge Garlı","doi":"10.2340/jphs.v61.45582","DOIUrl":"https://doi.org/10.2340/jphs.v61.45582","url":null,"abstract":"<p><strong>Background: </strong>Staged pedicled skin flaps that require pedicle division are frequently employed in reconstructive surgery, rely on their pedicle for vascular supply following transfer until neovascularisation occurs at the recipient site, a phenomenon referred to as autonomisation (pedicle-independent flap viability following neovascularisation). This study sought to investigate the application of topical pentoxifylline to expedite the autonomisation process.</p><p><strong>Methods: </strong>Caudal-based skin flaps were surgically created in the dorsal region of 60 Wistar rats. On the fifth day, the bases of the flaps were surgically cut, and the flaps were subsequently monitored for an additional 7 days. The rats were divided into three groups: (1) Control group (Vaseline for 5 + 7 = 12 days), (2) Experimental-1 group (topical pentoxifylline for 5 days + vaseline for 7 days), and (3) Experimental-2 group (topical pentoxifylline for 5 + 7 = 12 days). Flap viability was assessed both macroscopically and microangiographically, and histopathological examinations were conducted.</p><p><strong>Results: </strong>On day 12, the viable flap areas were 40.7% in the control group, 95.5% in experimental-1 group, and 100.0% in experimental-2 group (p < 0.05). Microangiography was conducted on day 5 and 12, and both experimental groups exhibited markedly greater vascularisation compared to the control group. Histopathological and immunohistochemical analyses revealed that pentoxifylline significantly enhanced angiogenesis, new vessel formation, and epithelisation, while mitigating early-stage inflammation, edema, and late-stage fibrosis (p < 0.05).</p><p><strong>Conclusion: </strong>The application of topical pentoxifylline significantly promoted angiogenesis, thereby expediting the autonomisation of rat dorsal randomised skin flaps. Consequently, its use in reconstructive surgery may be considered, as it has the potential to reduce reliance on the pedicle, minimise complications, and enhance patient outcomes.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"56-64"},"PeriodicalIF":0.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duplex ultrasound analysis of hemodynamic changes following microsurgical repair of unilateral digital artery injuries: a retrospective follow-up study.","authors":"Justus Osterloh, Bastian Drollmann, Luca Kümmerl, Andreas Arkudas, Raymund E Horch, Aijia Cai","doi":"10.2340/jphs.v61.45557","DOIUrl":"https://doi.org/10.2340/jphs.v61.45557","url":null,"abstract":"<p><strong>Background: </strong>Whether unilateral digital artery injuries benefit from surgical repair remains controversial, as perfusion is typically preserved by the remaining, contralateral artery. Evidence on the long-term patency and hemodynamic effects of reconstructed unilateral arteries is limited. This study aimed to evaluate the patency and flow characteristics of digital arteries after microsurgical repair using duplex ultrasonography.</p><p><strong>Methods: </strong>A retrospective single-center study was conducted including patients with unilateral digital artery injuries at the level of the digit who underwent primary microsurgical anastomosis between 2017 and 2022. Patients with fractures, proximal injuries, or vein grafts were excluded. Duplex ultrasonography was used to assess arterial patency and blood flow at follow-up.</p><p><strong>Results: </strong>Twenty-seven patients were examined at a mean follow-up of 37 months (range 16-82). Duplex ultrasonography demonstrated anterograde flow in 26 of 27 reconstructed arteries (96.3%). The median flow volume in the repaired artery (1.1 ml/min, interquartile range [IQR]: 0.5-2.8) was significantly lower than in the contralateral artery of the same digit (3.6 ml/min, IQR: 1.4-7.7) and the corresponding artery of the contralateral hand (2.8 ml/min, IQR: 1.3-6.8). No significant compensatory increase was observed in the intact artery of the injured digit compared with its contralateral counterpart.</p><p><strong>Conclusion: </strong>Duplex sonography demonstrates that repaired unilateral digital arteries remain patent in the long term, despite reduced flow compared with contralateral controls. While the functional benefit of arterial repair remains uncertain, long-term patency suggests a potential role for repair in selected cases to support vascular integrity.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"51-55"},"PeriodicalIF":0.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}