Journal of Plastic Surgery and Hand Surgery最新文献

Variations in orbital morphology, globe:orbit volume relation, and ophthalmological outcome in unicoronal synostosis.

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-12-12 DOI: 10.2340/jphs.v59.42322

Hanna M Lif, Evangelia Ntoula, Eva Larsson, Daniel J Nowinski

{"title":"Variations in orbital morphology, globe:orbit volume relation, and ophthalmological outcome in unicoronal synostosis.","authors":"Hanna M Lif, Evangelia Ntoula, Eva Larsson, Daniel J Nowinski","doi":"10.2340/jphs.v59.42322","DOIUrl":"https://doi.org/10.2340/jphs.v59.42322","url":null,"abstract":"Nonsyndromic unicoronal synostosis is associated with variability of severity in orbital morphology and ophthalmological manifestations. The relation between the two is not fully understood, nor how surgical treatment with fronto-orbital advancement and remodelling (FOAR) changes the relation. The aim of this study was to elucidate associations between ophthalmological manifestations and variations in orbital morphology and globe:orbit volume ratios preoperatively and at long-term follow-up after surgery. Twelve children referred to Uppsala Craniofacial Center who underwent computed tomography and standardized ophthalmological examinations regarding strabismus, spherical equivalent, astigmatism, anisometropia, and subnormal vision preoperatively and at 3 years of age were included. Orbits and globes were segmented. Principal component analysis elucidated morphological variation, and symmetry between orbital pairs was measured as the Dice similarity coefficient and globe:orbit volume ratios were calculated. The defined orbital shape variations were correlated with strabismus, refractive error, and subnormal vision. Different shape variations were associated with strabismus pre- and postoperatively and ipsi- and contralateral astigmatism. Greater improvement in orbital symmetry after surgery was associated with improvement in astigmatic anisometropia and new onset strabismus at follow-up. A small globe:orbit volume ratio was associated with preoperative strabismus, while the opposite was seen at follow-up. Different mechanisms seem to cause strabismus pre- and postoperatively, and FOAR might not sufficiently correct orbital morphology.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"162-170"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813533","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}

引用次数: 0

Translation and validation of the Swedish version of the Appearance Schemas Inventory-Revised and investigation of the modified three subscale structure in patients undergoing breast reconstruction. 翻译和验证瑞典语版的 "外貌模式清单-修订版"，并对接受乳房再造的患者进行经修改的三分量表结构调查。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-27 DOI: 10.2340/jphs.v59.42324

Linn Weick, Carolina Lunde, Emma Hansson

{"title":"Translation and validation of the Swedish version of the Appearance Schemas Inventory-Revised and investigation of the modified three subscale structure in patients undergoing breast reconstruction.","authors":"Linn Weick, Carolina Lunde, Emma Hansson","doi":"10.2340/jphs.v59.42324","DOIUrl":"https://doi.org/10.2340/jphs.v59.42324","url":null,"abstract":"Breast cancer can lead to changes in appearance and subsequent concerns about body image. This study aimed to translate the body investment instrument, Appearance Schemas Inventory-Revised (ASI-R), to Swedish, and perform a validation in women who underwent mastectomy and were awaiting breast reconstruction. The instrument was translated, and its psychometric properties were investigated according to current guidelines. Three hundred and ninety-seven women were eligible for the study, and 215 (54%) participants responded. An exploratory factor analysis (EFA) revealed that a three-factor structure was the most adequate solution. Three new subscales were suggested: body image investment cognition; breast and body image investment emotions; breast reflecting dysfunctional cognitive and emotional patterns of appearance investment and body image investment behaviors; breast reflecting positive ways of investing in body image. Consistent with previous findings, control over appearance is a central theme in women with breast cancer undergoing mastectomy and reconstruction. The obtained factor structure was considered similar to the original structure and three-factor solutions obtained from an American cohort of patients with breast cancer. The ASI-R has shown good psychometric properties in Swedish women undergoing mastectomy and reconstruction. Further studies on convergent validity and confirmatory factor analysis are required.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"153-161"},"PeriodicalIF":1.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729415","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}

引用次数: 0

Staged dissection reduces blood loss in surgery for metopic synostosis. 分阶段剥离可减少偏头合骨术的失血量。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-12 DOI: 10.2340/jphs.v59.42160

Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby

{"title":"Staged dissection reduces blood loss in surgery for metopic synostosis.","authors":"Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby","doi":"10.2340/jphs.v59.42160","DOIUrl":"https://doi.org/10.2340/jphs.v59.42160","url":null,"abstract":"Introduction: Fronto-orbital remodelling for metopic synostosis is an extensive operation with substantial blood loss, particularly from emissary veins in the glabellar region. One possibility to reduce blood loss may be to stage dissection and cauterise anomalous emissary veins before dissecting in the subperiostal plane. OBJECTIVE: The aim of the present study was to compare perioperative bleeding using a staged dissection in the glabellar region with the traditional subperiostal dissection technique during surgery for metopic synostosis.Methods: All consecutive patients operated for metopic synostosis with the new staged dissection technique (T2) were included. For comparison, the most recent equal number of cases operated with the traditional dissection technique (T1) were included. Age, sex, weight, surgical technique (spring or bone graft), perioperative blood loss, perioperative blood pressure, per- and postoperative blood transfusion, operation time and length of hospital stay were registered. RESULTS: A total of 80 patients were included; 40 T1 and 40 T2, respectively. Perioperative blood loss was significantly reduced with the new staged dissection technique. Blood loss in absolute numbers was reduced from 160.0 (120-240) (median and (interquartile range)) ml to 150 (102.5-170.0) ml, p=0.028. Blood loss in relation to patient weight was reduced from 24.2 ml/kg (15.3-33.3) to 18.7 (16.6-23.1) ml/kg, p=0.024. As percentage of total blood volume, blood loss was reduced from 32.3 (20.3-32.3) % to 29.9 (18.4-30.8) %, p=0.024. No other variables differed significantly between the techniques. CONCLUSION: In summary, staged dissection technique in the glabellar region, allowing control of the emissary veins, reduces perioperative blood loss during surgery for metopic synostosis.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"146-152"},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622675","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}

引用次数: 0

Finnish translation and linguistic validation of the FACE-Q Head and Neck Cancer Module. FACE-Q 头颈癌模块的芬兰语翻译和语言验证。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-06 DOI: 10.2340/jphs.v59.40518

Lotta Varakas, Ian Barner-Rasmussen, Aaro Haapaniemi, Andrew Lindford, Patrik Lassus, Pauliina Homsy

{"title":"Finnish translation and linguistic validation of the FACE-Q Head and Neck Cancer Module.","authors":"Lotta Varakas, Ian Barner-Rasmussen, Aaro Haapaniemi, Andrew Lindford, Patrik Lassus, Pauliina Homsy","doi":"10.2340/jphs.v59.40518","DOIUrl":"https://doi.org/10.2340/jphs.v59.40518","url":null,"abstract":"Head and neck cancer (HNC) and its treatment can result in permanent changes to a patient's appearance, speaking, eating, and psychosocial well-being. To better assess the impact of the disease on HNC patients, the FACE-Q Head and Neck Cancer Module, a health-related quality-of-life instrument, was developed. The aim of this study was to produce and linguistically validate a Finnish version of the module. The module was translated into Finnish following the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. A total of 51 patients who had undergone tumour resection and reconstruction of the oral cavity, tonsil, or tongue area between 2019 and 2021 were approached for a pilot study. They completed the translated module and provided feedback on any linguistic issues. Adjustments were made based on the pilot study comments. The FACE-Q Head and Neck Cancer Module translated well into Finnish. Twenty-one (41%) patients participated in the survey, 12 men (57%) and nine women (43%) with a median age of 66 years (range 48-89 years). The median time since surgery was 3 years (range 1-4 years). Based on the feedback from the pilot study participants, one word was changed, and one question was rewritten. Otherwise, no deficiencies were identified in the language of the module. In summary, this study produced a linguistically valid Finnish version of the FACE-Q Head and Neck Cancer Module, enabling its application in evaluating the health-related quality-of-life among Finnish HNC patients who have undergone reconstructive surgery.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"141-145"},"PeriodicalIF":1.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581687","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}

引用次数: 0

Anatomical research and clinical application of multistage advancement in dorsal finger V-Y flap. 手指背侧 V-Y 皮瓣多级推进的解剖学研究和临床应用。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-10-24 DOI: 10.2340/jphs.v59.41373

Qiu Shenqiang, Wang Zengtao, Chen Jingguo, Zhang Di, Sun Jun, Kou Wei, Hao Liwen, Xu Lanwei

{"title":"Anatomical research and clinical application of multistage advancement in dorsal finger V-Y flap.","authors":"Qiu Shenqiang, Wang Zengtao, Chen Jingguo, Zhang Di, Sun Jun, Kou Wei, Hao Liwen, Xu Lanwei","doi":"10.2340/jphs.v59.41373","DOIUrl":"https://doi.org/10.2340/jphs.v59.41373","url":null,"abstract":"Objective: To investigate the anatomical basis and clinical efficiency of the advancement distance in dorsal digital V-Y advancement flap.Materials and methods: Thirty-four fingers in 11 fresh adult hand specimen were selected, V-Y flap was performed with the digital artery as vascular pedicle, and the advancement distance was measured. The relationship between the distance and extensibility of skin, sliding degree of subcutaneous superficial fascia, angular displacement of digital arterial dorsal branch, elasticity of digital artery was discussed. Two cases were provided to demonstrate the feasibility and importance of this flap.Results: In the dorsal digital V-Y advancement flap simulated on fresh adult hand specimens, the mean advance distance of the middle segment flap and proximal segment flap is 18 ± 0.8 mm and 34 ± 1.7 mm, respectively, and the maximum can reach 24 and 45 mm, respectively. Two cases of dorsal digital V-Y advancement flaps were designed and performed in the dorsal side of the ring finger middle segment and the thumb proximal segment, respectively. The advancement distances were 25 and 26 mm, respectively. All flaps survived completely and the incisions healed by first intention. The flap texture was good, the affected finger was symmetrical, and the activity and sensation restored well.Conclusion: The dorsal digital V-Y advancement flap with the digital artery as the main vascular pedicle can exert four factors for advancement effect, and significantly increase the advancement distance. The operation is simple, the blood supply is reliable, and the postoperative sensation is normal. It is an ideal flap for repairing the digital dorsal defect.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"132-140"},"PeriodicalIF":1.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502637","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}

引用次数: 0

Animation of latissimus dorsi flap in breast reconstruction: a retrospective analysis based on 203 cases. 背阔肌皮瓣在乳房再造中的动画效果：基于 203 例病例的回顾性分析。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-10-15 DOI: 10.2340/jphs.v59.39952

Yoshihiko Fujita, Noriko Matsunaga, Maiko De Kerckhove, Shoichi Tomita, Miwako Fujii, Yasunobu Terao

{"title":"Animation of latissimus dorsi flap in breast reconstruction: a retrospective analysis based on 203 cases.","authors":"Yoshihiko Fujita, Noriko Matsunaga, Maiko De Kerckhove, Shoichi Tomita, Miwako Fujii, Yasunobu Terao","doi":"10.2340/jphs.v59.39952","DOIUrl":"https://doi.org/10.2340/jphs.v59.39952","url":null,"abstract":"Background: Breast animation is a common postoperative complication of breast reconstruction surgery. This study investigates the factors affecting the onset and degree of animation to suggest an ideal treatment strategy for this complication.Methods: This study included patients who underwent latissimus dorsi reconstruction at Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, between 2009 and 2020 and had an outpatient visit after July 2020. Statistical analysis was performed and the patients' background and surgical factors were examined to determine whether they affected the animation incidence rate.Results: The animation incidence rate was 69.6%. There was no significant relationship between animation incidence and any patient background or surgical factors, except for the complete dissection of insertion into the humerus of the latissimus dorsi muscle (p = 0.0039). The rate of uncomfortable animation was 4% and recurrence of animation was observed in one of the two patients who underwent denervation.Conclusion: Prophylactic denervation is not considered necessary and should be offered only for persistent discomfort with animation. Instead, the muscle insertion must be dissected during flap elevation to prevent animation, and the thoracodorsal nerve must be preserved to avoid muscle atrophy.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"128-131"},"PeriodicalIF":1.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485740","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}

引用次数: 0

Comparison of nerve block and spinal anesthesia in second toe pulp free flap surgery for fingertip reconstruction. 比较神经阻滞和脊髓麻醉在第二趾髓内游离皮瓣手术中用于指尖重建的效果。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-09-30 DOI: 10.2340/jphs.v59.34020

Deok Hyeon Yu, Yunki Kim, Jiho Park

{"title":"Comparison of nerve block and spinal anesthesia in second toe pulp free flap surgery for fingertip reconstruction.","authors":"Deok Hyeon Yu, Yunki Kim, Jiho Park","doi":"10.2340/jphs.v59.34020","DOIUrl":"https://doi.org/10.2340/jphs.v59.34020","url":null,"abstract":"Toe pulp flap surgery is a viable option for soft tissue defects of the fingertips, effectively addressing patient needs and fingertip characteristics. The preferred anesthesia for lower-extremity surgery includes spinal and regional anesthesia. However, the choice between these methods depends on patient safety and surgical efficacy. In this retrospective study, we aimed to ascertain the optimal anesthetic technique by examining the efficacy, safety, pain control, and potential side effects of spinal and peripheral nerve block anesthetics. We included 40 patients aged 18-60 years who underwent partial second toe pulp free flap surgery for fingertip reconstruction. Twenty patients received spinal anesthesia (SA), while the remaining 20 received peripheral nerve block anesthesia. We conducted a comparative analysis of postoperative pain scores, adverse effects, analgesic usage, and patient satisfaction scores associated with each anesthesia method. Independent t-test, Mann-Whitney U test, and chi-squared test were performed. The SA group exhibited hypotension, bradycardia, urinary retention, and postdural puncture headache rates of 10%, 10%, 5%, and 5%, respectively. A significant difference in the timing of first analgesic use was observed (spinal, 3.7 ± 0.8 vs. peripheral nerve block, 13.2 ± 6.6; P = 0.006). Visual analog scale (VAS) scores of the patients at the 2nd, 4th, and 6th h were significantly lower in the peripheral nerve block group (P < 0.001, P < 0.001, P < 0.001, respectively). VAS scores at 12 and 24 h were similar between the groups (P = 0.07, P = 0.135, respectively). Peripheral nerve block anesthesia is superior to SA for partial second toe pulp free flap surgery, offering lower complication rates, reduced postoperative pain, and improved patient comfort.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"123-127"},"PeriodicalIF":1.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348910","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}

引用次数: 0

Spring-assisted posterior vault expansion in children over 2 years of age with craniosynostosis. 弹簧辅助后穹隆扩张术用于两岁以上的颅骨发育不良儿童。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-09-25 DOI: 10.2340/jphs.v59.41906

Karin Säljö, Madiha Bhatti-Søfteland, Peter Tarnow, Robert Olsson, Tobias Hallén, Wen-Chih Chao, Lars Kölby, Giovanni Maltese

{"title":"Spring-assisted posterior vault expansion in children over 2 years of age with craniosynostosis.","authors":"Karin Säljö, Madiha Bhatti-Søfteland, Peter Tarnow, Robert Olsson, Tobias Hallén, Wen-Chih Chao, Lars Kölby, Giovanni Maltese","doi":"10.2340/jphs.v59.41906","DOIUrl":"https://doi.org/10.2340/jphs.v59.41906","url":null,"abstract":"Background: This study evaluated spring-assisted posterior vault expansion (SA-PVE) in children aged > 2 years with craniosynostosis and signs of high intracranial pressure (ICP).Methods: We retrospectively analysed all consecutive patients aged > 2 years and operated with SA-PVE between 2018 and 2020 at the Craniofacial Center at Sahlgrenska University Hospital, Sweden. During the procedure, a circumferent occipital bone flap extending below the torcula was created and remained attached to the dura. Intracranial volumes (ICVs) were calculated from computed tomography (CT) images, and demographic data and information regarding symptoms and signs of high ICP were collected.Results: The study included eight patients [Crouzon/Pfeiffer (n = 4), multiple craniosynostosis (n = 3), and secondary synostosis (n = 1)]. Median age at SA-PVE was 3.8 years (range: 2.5-12.8 years), and springs were removed after a median of 5.5 months (range: 2.3-8.3 months). The median operating time was 164 min (range: 102-221 min), and estimated blood loss was 4.5 mL/kg body weight (range: 1.4-59.1 mL/kg body weight), with 50% of patients receiving a blood transfusion. The median increase in ICV was 206 cm3 (range: 122-344 cm3) representing an 18.7% increase (range: 7.9-24.1%; p = 0.01). We observed no major perioperative complications, and symptoms related to high ICP were improved or absent at clinical follow-up.Conclusion: These results demonstrated that SA-PVE involving creation of a large occipital bone flap including the torcula as a safe and effective surgical treatment in children aged >2 years with craniosynostosis and elevated ICP.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"117-122"},"PeriodicalIF":1.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348911","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}

引用次数: 0

Efficacy and safety of volar locking plate versus cast immobilization for distal radius fractures: a systematic review and meta-analysis of randomized controlled trials. 桡骨远端骨折的外侧锁定钢板与石膏固定的有效性和安全性：随机对照试验的系统回顾和荟萃分析。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-09-23 DOI: 10.2340/jphs.v59.41372

Faxiang Li, Yuzhong Tan, Liuchao Cui, Lin Tian

{"title":"Efficacy and safety of volar locking plate versus cast immobilization for distal radius fractures: a systematic review and meta-analysis of randomized controlled trials.","authors":"Faxiang Li, Yuzhong Tan, Liuchao Cui, Lin Tian","doi":"10.2340/jphs.v59.41372","DOIUrl":"https://doi.org/10.2340/jphs.v59.41372","url":null,"abstract":"Volar locking plates (VLPs) are increasingly used for distal radius fractures (DRFs), yet their efficacy compared to cast immobilization remains debated. This meta-analysis aimed to compare VLPs versus cast immobilization for DRFs across various follow-up durations. Randomized controlled trials reporting patient-reported functional scores, wrist range of motion (ROM), radiological assessments, and complications were included. Meta-analysis was performed for 6-week, 3-month, 6-month, 12-month, and >12-month follow-ups. Subgroup analysis stratified studies by age group, ≥ 60 years and < 60 years. VLPs showed significantly lower Disabilities of the Arm, Shoulder, and Hand (DASH) scores at 6 weeks (p < 0.001), 3 months (p < 0.001), 12 months (p = 0.012), and > 12 months (p < 0.001), and lower PRWE scores at 6 weeks (p < 0.001), 3 months (p = 0.048), and >12 months (p = 0.032). Wrist ROM favored VLPs at 6 weeks (p < 0.05), with higher flexion and supination at 3 months (p = 0.027) and 12 months (p = 0.003). Radiologically, VLPs showed improved parameters at 3- and 12-month follow-up. Overall complications did not significantly differ. Subgroup analysis in patients < 60 years generally supported these findings, while in patients ≥ 60 years, radiological outcomes aligned, yet only lower DASH scores were observed with VLPs at 3 months (p < 0.001). VLPs may offer superior clinical, functional, and radiological outcomes compared to cast immobilization at 3- and 12-month follow-up for patients < 60 years, with comparable safety profiles. For patients ≥ 60 years, VLPs may yield better radiological outcomes at 3- and 12-month follow-up, though clinical benefits remain uncertain.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289756","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}

引用次数: 0

Experimental study of contrast-enhanced ultrasound in the evaluation of random-pattern flap blood supply in the early postoperative stage in rats. 对比增强超声波在大鼠术后早期评估随机模式皮瓣供血的实验研究。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-09-09 DOI: 10.2340/jphs.v59.39975

Jian-Xun Ma, You-Chen Xia, Zhi-Yong Bai, Hua-Bin Zhang, Xia Xie

{"title":"Experimental study of contrast-enhanced ultrasound in the evaluation of random-pattern flap blood supply in the early postoperative stage in rats.","authors":"Jian-Xun Ma, You-Chen Xia, Zhi-Yong Bai, Hua-Bin Zhang, Xia Xie","doi":"10.2340/jphs.v59.39975","DOIUrl":"https://doi.org/10.2340/jphs.v59.39975","url":null,"abstract":"Purpose: This study aims to investigate whether contrast-enhanced ultrasound (CEUS) could be used to reveal the status of blood supply of the superficial flap of rat model in the early postoperative stage.Methods: One viable and one ischemic random-pattern flap were prepared on the left and right back of the same rat respectively with a number of 40. CEUS examinations were applied within 12 h and 7 days postoperatively, and the quantitative measurements of microvascular blood volume (BV) of the base and the end of both flaps were expressed using acoustic intensity as a ratio to that of the healthy skin.Results: Within 12 h post operation, there was a smaller BV value of the ischemic ends than that of both the ischemic bases and viable ends (p < 0.001), while no difference was indicated between ischemic bases and viable bases or between viable bases and viable ends. The same result was provided 7 days post operation.Conclusion: Microcirculation of superficial tissues such as random-pattern flaps in this rat model can be assessed quantitatively by CEUS. It could sensitively and accurately reveal the objective status of tissue perfusion in the early postoperative stage.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"102-107"},"PeriodicalIF":1.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154453","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}

引用次数: 0