Journal of Plastic Surgery and Hand Surgery最新文献

{"title":"Ultrasound improves preoperative Wassel classification of thumb polydactyly in children.","authors":"Xun Liang, Bo He","doi":"10.2340/jphs.v61.46504","DOIUrl":"https://doi.org/10.2340/jphs.v61.46504","url":null,"abstract":"<p><strong>Background: </strong>The Wassel classification for thumb polydactyly relies on radiographs; however, invisible unossified cartilage in young children can lead to misclassification and suboptimal surgical planning. This study evaluated whether ultrasound improves the accuracy of polydactyly classification compared with radiographs.</p><p><strong>Materials and methods: </strong>This prospective study included 31 cases of radial polydactyly initially classified as Wassel type IV or type II based on radiographs. All patients underwent preoperative ultrasound to identify potential cartilaginous connections between the proximal and distal phalanges. The ultrasound findings were compared against intraoperative exploration, which served as the gold standard for final classification.</p><p><strong>Results: </strong>Ultrasound correctly identified cartilaginous connections in the majority of cases, achieving an overall diagnostic accuracy of 93.5%. Thirty eight per cent of radiologic type IV cases were reclassified as type III, and 10% of radiologic type II cases were reclassified as type I after ultrasound detection of hidden connections. The accuracy was 100% for types IV-C and II, whereas type IV-D presented a diagnostic challenge with 75% accuracy. Overall diagnostic accuracy of ultrasound for polydactyly classification was high, with only a small number of misclassifications.</p><p><strong>Conclusions: </strong>Radiograph-based Wassel classification may misclassify thumb polydactyly in children due to unossified cartilage. Ultrasound allows direct visualization of cartilaginous connections and improves preoperative classification accuracy. Combined use of ultrasound and radiographs provides a more reliable anatomical assessment and may help optimize surgical planning and outcomes.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"203-206"},"PeriodicalIF":1.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670005","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":"In vivo virtual investigation of the implant location for scaphoid fractures.","authors":"Ren-Guo Xie, Dong-Shen Ji","doi":"10.2340/jphs.v61.46484","DOIUrl":"https://doi.org/10.2340/jphs.v61.46484","url":null,"abstract":"<p><strong>Introduction: </strong>Scaphoid fractures still have high rate of nonunion, mainly due to the tenuous blood supply and only primary bone healing. Rigid fixation facilitates this kind of bone healing and is considered as vital as protection of the blood supply. The optimal implant (screw) location should meet the requirements for researcher's biomechanical findings on fracture stability.</p><p><strong>Materials and methods: </strong>Raw CT-scanned data of eight volunteers' wrists were imported into Mimics. The 3D scaphoid was segmented out and calculated, then opened in Geomagic Studio. Four fracture planes (proximal, oblique waist, horizontal waist and distal) simulating common broken scaphoid were created. Mimicking scaphoid implants (screws), the longest, the sub-longest, and central and eccentric cylinders perpendicular to each fracture plane were created. Whole and inside-fragmental length, and the relative location of each cylinder were measured and analyzed.</p><p><strong>Results: </strong>The longest (28.5 ± 1.6 mm) cylinder was significantly longer than the sub-longest (25.4 ± 1.4 mm). Several eccentric perpendicular cylinders (so short or cutting out of the scaphoid) couldn't be created. Some proximal inside-fragmental lengths ranged from 3.0 to 5.1 mm. Several central perpendicular cylinders intersected with the longest one. Several central and eccentric perpendicular cylinders were outside of the proximal scaphoid non-contact region.</p><p><strong>Conclusion: </strong>The results of this study showed that scaphoid fracture images from CT scan can be calculated and yield the optimal implant location.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"182-188"},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664153","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":"Venous flaps to repaır the soft tıssue defects of the hand.","authors":"Ali Murat Başak, Çağla Çiçek, Arzu Türkseven Topaçoğlu, Hande Akdeniz, Derya Özçelik","doi":"10.2340/jphs.v61.46466","DOIUrl":"https://doi.org/10.2340/jphs.v61.46466","url":null,"abstract":"<p><strong>Aim: </strong>The venous flaps provide a versatile, easy flap choice to repair the dorsal skin defects of the fingers and web spaces. Its thin and pliable nature provides natural coverage for the important delicate structures of the hand such as bone, tendon, joint or neurovascular bundle.</p><p><strong>Material and methods: </strong>From 2010 to 2025, we used the venous flaps to cover exposed bone, tendon and joint located on the distal phalanx, proximal phalanx, web space and dorsum of the hand in 10 patients. Flaps were unipedicled distally based in nine cases. It was a free venous flap in one case. During the flap elevation, the pedicle of the flap included one superficial vein of the hand and its perivenous areolar tissue.</p><p><strong>Results: </strong>The size of the flaps ranged from 4 cm2 to 9 cm2. The mean length of the vascular pedicles was 3.1 cm (min: 2 cm, max: 10 cm). In all cases, the flaps survived completely. The donor sites were on the dorsal surface of the hand in nine cases, the volar surface of the wrist in one case. The donor sites were closed primarily in eight cases; skin graft was used in two cases.</p><p><strong>Conclusion: </strong>The aim of this study was to share our experience regarding the venous flap usage in the hand. Another aim is to remind us of this useful flap, which was not popularized enough despite its versatility and being described 40 years ago.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"189-196"},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663300","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":"Impact of intraoperative CT on implant accuracy and reoperation rates in orbital floor reconstruction.","authors":"Anna Persson, Anders Arbrandt, Babak Alinasab, Nikoo Bazsefidpay, Ulf Höckerfelt, Anders Johansson, Eva Larsson, Konstantinos Roussos, Andreas Thor, Daniel Nowinski","doi":"10.2340/jphs.v61.46475","DOIUrl":"https://doi.org/10.2340/jphs.v61.46475","url":null,"abstract":"<p><strong>Background: </strong>Implant malposition is a leading cause of reoperation after orbital floor reconstruction. Intraoperative computed tomography (CT) enables immediate assessment and correction, however its impact on implant positioning accuracy and outcomes remains insufficiently studied.</p><p><strong>Materials and methods: </strong>This retrospective study included 86 patients with isolated orbital floor fractures treated with radiopaque implants between 2011 and 2023 at Uppsala University Hospital. Sixty-five patients underwent postoperative CT and 21 intraoperative CT. Eight senior surgeons from all Swedish university hospitals independently reviewed anonymized scans under hypothetical intraoperative and postoperative conditions, indicating whether they would adjust the implant intraoperatively or recommend reoperation postoperatively. In the intraoperative group, implant position was assessed on final CT obtained after any CT-guided adjustment. Actual re-intervention rates were recorded.</p><p><strong>Results: </strong>Recommendations for implant adjustment were significantly more frequent in the postoperative CT group than in the intraoperative CT group (45% vs. 19%, p = 0.042). Unanimous agreement that no adjustment was required occurred more often in the intraoperative CT group (48% vs. 22%). Consensus among ≥3 experts favoring reoperation was observed in 20% of postoperative cases and in none of the intraoperative cases. The perceived need for reoperation was lower in the intraoperative than in the postoperative CT group (5% vs. 15%, p = 0.45), as were actual reoperation rates (5% vs. 11%, p = 0.68).</p><p><strong>Conclusions: </strong>Intraoperative CT was associated with improved expert-assessed implant positioning. Although reoperation rates were lower in the intraoperative CT group, these differences did not reach statistical significance.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"197-202"},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664175","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 donor-site outcomes of DIEP versus TRAM flaps in post-mastectomy breast reconstruction: a systematic review and meta-analysis.","authors":"Jorge Andrés Urquijo Méndez, Alejandro Rico-Mendoza, Alexandra Porras-Ramírez","doi":"10.2340/jphs.v61.46271","DOIUrl":"https://doi.org/10.2340/jphs.v61.46271","url":null,"abstract":"<p><strong>Background: </strong>Autologous breast reconstruction continues to be a cornerstone of post-mastectomy reconstruction, with abdominally based flaps providing reliable aesthetic and functional outcomes. Of these approaches, the deep inferior epigastric perforator (DIEP) flap and the transverse rectus abdominis myocutaneous (TRAM) flap are the most commonly used. However, controversy exists surrounding their relative effectiveness, complication profile, donor-site morbidity, and reported outcomes.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A search was conducted across PubMed, Scopus, Embase, and Web of Science for comparative studies published between January 2000 and December 2025 that assessed DIEP and TRAM flap breast reconstruction. Outcomes included total flap loss, fat necrosis, donor-site morbidity, abdominal wall complications, and patient-reported outcomes. Random-effects meta-analyses were performed employing pooled odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity was evaluated by Cochran's Q and Higgins' I² statistics. An exploratory network meta-analysis was also performed to compare DIEP with other autologous reconstructive techniques, such as transverse upper gracilis (TUG), transverse myocutaneous gracilis (TMG), profunda artery perforator (PAP), and inferior gluteal artery perforator (IGAP) flaps.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria for the qualitative synthesis, yet five also provided quantitative data that were included in the meta-analysis. Pooled analysis showed no significant difference in fat necrosis between reconstructive techniques (OR: 0.86; 95% CI: 0.54-1.36; I² = 34.6%). Likewise, the total flap loss rates were similar between DIEP and TRAM flaps (OR: 0.79; 95% CI: 0.39-1.61; I² = 7.2%). DIEP reconstruction was consistently associated with fewer donor-site morbidities and significantly better maintenance of abdominal wall health than the TRAM flap. Among exploratory network meta-analysis studies, the TUG flap showed clear superiority in reduced total flap loss, while DIEP flaps ranked favorably in donor-site outcomes and patient satisfaction.</p><p><strong>Conclusions: </strong>DIEP and TRAM flaps have comparable flap survival and overall reconstructive efficacy in post-mastectomy breast reconstruction. DIEP reconstruction appears to offer the best performance in reducing donor-site morbidity while preserving abdominal wall integrity. There was no single reconstruction technique that consistently outperformed all other reconstructive approaches across all outcomes, reinforcing an individualized surgical approach based on patient anatomy, comorbidities, reconstruction goals, and surgeon expertise.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"174-181"},"PeriodicalIF":1.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376098","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":"Wedging osteotomy to correct metacarpal adduction for the treatment of Wassel types V and VI duplicated thumb: surgical strategy, outcomes, and anatomical findings.","authors":"Zhixin Wang, Guoqing Chen, Xiaofei Tian","doi":"10.2340/jphs.v61.46296","DOIUrl":"https://doi.org/10.2340/jphs.v61.46296","url":null,"abstract":"<p><p>This study presents a wedge osteotomy technique for correcting metacarpal adduction in the treatment of Wassel types V and VI thumb polydactyly, evaluating its clinical efficacy and reporting intraoperative anatomical abnormalities. A retrospective analysis of 37 thumbs treated between January 2016 and June 2023 was performed. Preoperatively, the median inter-metacarpal angle (IMA) was 0°, and the median radial deviation angle of the metacarpophalangeal (MCP) joint of the ulnar thumb was 30°. All cases underwent excision of the hypoplastic radial thumb, thenar muscle relocation, and a radial closing wedge osteotomy at the base of the ulnar thumb metacarpal to achieve a corrected IMA exceeding 40°. The ulnar capsule and collateral ligament were reinforced, and one or two Z-plasties were performed to enlarge the first web space in most cases. Mean follow-up was 51.4 months (range, 12-120). Postoperative IMA and MCP joint angle improved significantly to a median of 40° (IQR: 35-42°) and 0° (IQR: 0-10°),respectively. Mean range of motion at the MCP and interphalangeal joints was 40° (IQR: 30-45°) and 60° (IQR: 45-75°). According to the modified Tada score, 31 thumbs were rated good, 5 fair, and 1 poor. In conclusion, wedge osteotomy to correct metacarpal adduction deformity in type V/VI thumb duplication yields encouraging results, with good functional outcomes and a low reoperation rate.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"169-173"},"PeriodicalIF":1.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352285","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":"Facial nerve recovery trajectories and predictors after vestibular schwannoma surgery: a single-centre cohort study of 213 patients.","authors":"Lina Nord, Tobias Hallén, Linus Köster, Anna-Lena Roos, Lena Kollén, Madiha Bhatti-Søfteland","doi":"10.2340/jphs.v61.45989","DOIUrl":"10.2340/jphs.v61.45989","url":null,"abstract":"<p><strong>Background: </strong>After tumour control, facial nerve preservation is a primary objective in vestibular schwannoma surgery. Predicting long-term recovery remains challenging, and the prognostic value of the Koos grade is unclear.</p><p><strong>Objective: </strong>The primary outcome was facial palsy at 12 months (partial or severe). Secondary outcomes included Day 1 function, recovery trajectory, intraoperative signal status, Koos grade, complications and difference in surgical approaches.</p><p><strong>Methods: </strong>Retrospective cohort study at Sahlgrenska University Hospital (2006-2024). Two reviewers independently extracted clinical data and assigned blinded Koos grades. Predictors were assessed using multivariable logistic regression.</p><p><strong>Results: </strong>Of 293 surgically treated patients, 213 with complete follow-up formed the study cohort (retrosigmoid 121, translabyrinthine 92). Sixty-four (30.0%) had any palsy at 12 months: 50 (23.5%) partial and 14 (6.6%) severe. Day 1 facial function dominated all models: severe palsy at Day 1 carried an adjusted odds ratio (OR) of 222.08 (95% CI 26.45-1864.44; Firth-corrected OR 128, 21-762), while partial function had an OR of 8.83 (3.93-19.83). Female sex was independently associated with palsy (OR 2.87, p = 0.013); surgical approach was not (OR 0.77, p = 0.550). Koos grade showed no association (OR 1.19, p = 0.730). Among patients with normal Day 1 function, 90% remained palsy free at 1 year; among those with severe palsy, only 4.5% recovered.</p><p><strong>Conclusions: </strong>A single bedside examination on post-operative Day 1 predicts long-term facial nerve outcome more powerfully than any variable tested, including Koos grade; comparison of surgical approaches remained inconclusive owing to era confounding. Three recovery trajectories provide a framework for tailored post-operative management.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"153-160"},"PeriodicalIF":0.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205117","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":"The Swedish National Cleft Registry as a tool for long-term outcome evaluation: secondary alveolar bone grafting as an example.","authors":"Sofia Larsson, Henry Svensson, Mia Stiernman, Anna-Paulina Wiedel, Magnus Becker","doi":"10.2340/jphs.v61.46192","DOIUrl":"10.2340/jphs.v61.46192","url":null,"abstract":"<p><p>National quality registries provide valuable opportunities for prospective, standardised follow-up of clinical outcomes over long periods. In cleft care, such long-term data remain limited internationally, particularly beyond childhood. The Swedish National Cleft Lip and Palate (CL/P) Registry, established in 1999 with predefined variables and standardised follow-ups, enables longitudinal evaluation of treatment outcomes across centres. The primary aim was to demonstrate the long-term usability of the Swedish National CL/P Registry for outcome assessment. As a clinical example, long-term outcomes after secondary alveolar bone grafting (SABG) from a single centre with complete historical registry coverage were analysed. National analyses of SABG outcomes are currently constrained as the first complete nationwide cohorts became available in 2025. To enable a longer observation period, data from a centre with consistent documentation since the registry's initiation were therefore examined. Since April 2006, 167 patients had documented SABG outcomes at a standardised 16-year follow-up. Outcomes were assessed using a nationally agreed bone height scoring system based on two-dimensional dental radiographs, where a bone height of ≥ 3/4 of the root length was considered successful. Successful grafting was observed in 84% of unilateral and 71% of bilateral clefts. Higher age at first SABG and the need for complementary grafting were associated with poorer outcomes. This study illustrates how a national quality registry with predefined variables and long-term follow-up can identify clinically relevant patterns and challenges. The presented SABG outcomes exemplify registry-based quality evaluation and provide a structured basis for continuous discussion, adjustment and improvement of cleft care.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"161-168"},"PeriodicalIF":0.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205163","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":"Abstract book for the 75th Anniversary Congress of the Scandinavian Association of Plastic Surgeons (SCAPLAS).","authors":"No Authors Listed","doi":"10.2340/jphs.v61.46186","DOIUrl":"10.2340/jphs.v61.46186","url":null,"abstract":"<p><p>75th Anniversary Congress of the Scandinavian Association of Plastic Surgeons (SCAPLAS) June 3-5th, 2026 Oslo, Norway.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143775","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":"Comparative analysis of breast cancer-related lymphedema after autologous and implant-based reconstruction: emphasizing differences between prepectoral and subpectoral placement of implant.","authors":"Geun-Young Park, Ahran Kim, Young Jae Choi, Daiwon Jun, Ji Young Ryu, Pill Sun Paik, Jung Ho Lee","doi":"10.2340/jphs.v61.46066","DOIUrl":"10.2340/jphs.v61.46066","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the incidence and long-term progression of breast cancer-related lymphedema (BCRL) following autologous or implant-based breast reconstruction, with subgroup analysis based on prepectoral versus subpectoral implant placement.</p><p><strong>Methods: </strong>A retrospective review was conducted of 228 patients who underwent mastectomy and immediate breast reconstruction by a single surgeon between 2017 and 2020, using either a deep inferior epigastric perforator (DIEP) flap or a tissue expander. Arm circumference was measured at standardized proximal and distal points. BCRL was diagnosed clinically and confirmed by lymphoscintigraphy demonstrating dermal backflow and/or delayed axillary nodal uptake. Soft-tissue compliance was assessed using ultrasonography to evaluate differences in tissue response with and without compression.</p><p><strong>Results: </strong>The overall incidence of BCRL showed no significant difference among groups (DIEP 8.9%, prepectoral 14.8%, subpectoral 15.6%). However, during 2-year follow-up, the subpectoral group demonstrated faster progression and greater limb volume increase compared with the DIEP and prepectoral groups. Improvements in soft-tissue compliance were greatest in the DIEP group, followed by the prepectoral group, while the subpectoral group showed the least improvement.</p><p><strong>Conclusions: </strong>Autologous reconstruction demonstrated the most favorable lymphatic outcomes, supporting prior literature. Among implant-based approaches, prepectoral placement was associated with a milder course of BCRL than subpectoral placement, possibly due to decreased postoperative pain and shoulder restriction. These findings suggest that reconstruction type and implant placement plane may influence BCRL severity and should be considered when planning surgery to reduce complications and optimize long-term outcomes.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"146-152"},"PeriodicalIF":0.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143820","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}