Journal of Plastic Surgery and Hand Surgery最新文献

{"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":1.4,"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":"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":1.4,"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":"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":1.4,"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":"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":1.4,"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}

{"title":"Clinical outcomes of isolated ulnar shortening osteotomy for ulnar impaction syndrome with concomitant distal radioulnar joint instability.","authors":"Xing Gao, Aozhengzheng Dong, Jingxin Li, Changliang Ma, Wencui Li, Jianquan Liu, Zhiqin Deng, Zhe Zhao","doi":"10.2340/jphs.v61.45517","DOIUrl":"10.2340/jphs.v61.45517","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the clinical outcomes and changes in distal radioulnar joint (DRUJ) stability in patients with ulnar impaction syndrome (UIS) combined with DRUJ instability, treated with ulnar shortening osteotomy (USO) without concomitant triangular fibrocartilage complex (TFCC) repair.</p><p><strong>Materials and methods: </strong>Between November 2017 and December 2024, a total of 16 patients (7 males, 9 females; mean age, 40 ± 12 years) underwent USO combined with wrist arthroscopy, followed by structured rehabilitation and regular follow-up. Clinical outcomes were assessed using ulnar variance, the Ballottement test, visual analog scale (VAS) for pain, Disabilities of the Arm, Shoulder, and Hand (DASH) score, modified Mayo wrist score, Patient-Rated Wrist Evaluation (PRWE), grip strength, and wrist range of motion. Preoperatively, all patients had positive Ballottement tests, and TFCC injuries were confirmed by arthroscopy.</p><p><strong>Results: </strong>At the final follow-up (mean, 31 months), ulnar variance was significantly reduced, and VAS, DASH, modified Mayo wrist score, PRWE, and grip strength all showed marked improvement. DRUJ stability was restored in all patients, with the Ballottement test converting to negative.</p><p><strong>Conclusions: </strong>These findings suggest that isolated USO effectively treats UIS with concurrent DRUJ instability and achieves satisfactory clinical outcomes without the need for simultaneous TFCC repair.</p><p><strong>Type of study/level of evidence: </strong>Therapeutic, Level IV.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"44-50"},"PeriodicalIF":1.4,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512802","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 modified abdominoplasty for excess skin in post-bariatric surgery patients with residual obesity.","authors":"Jonas Ockell, Christina Biörserud, Monika Fagevik Olsén, Anna Elander","doi":"10.2340/jphs.v61.45541","DOIUrl":"10.2340/jphs.v61.45541","url":null,"abstract":"<p><p>Excess skin after massive weight loss is especially discomforting on the abdomen due to physical and psychosocial symptoms, and many patients with excess skin have a lowered Quality of Life (QoL). Abdominoplasty may improve symptoms as well as QoL and is offered to post-bariatric patients in Sweden with a post--operative body mass index (BMI) < 30 kg/m2. However, since > 50% never reach a BMI < 30, they are often left with an abdominal pannus that may hinder further weight loss. The reluctance to operate on patients with BMI > 30 is the increased risk of complications reported in several studies. Contradictorily, many studies have not found BMI > 30 to be an independent risk factor. Thus, the aim of this study was to prospectively evaluate a modified abdominoplasty technique on patients with a residual BMI 30-40, regarding complications and patient satisfaction. To contextualize, this was compared to a group of post-bariatric patients with a BMI < 30 that underwent standard abdominoplasties. A total of 110 patients underwent either a standard abdominoplasty (BMI < 30 group) or a modified abdominoplasty (BMI 30-40 group). Pre-, peri-, and post-operative data were analyzed. The complication rates were similar, apart from that the patients with BMI 30-40 had significantly more bleedings requiring re-interventions. There were no other significant differences in the complication panorama. The results from the questionnaires implied significant improvements in QoL and perception of excess skin, particularly in the BMI 30-40 group. In conclusion, this modified technique for abdominoplasty may be an acceptable compromise to a standard abdominoplasty for post-bariatric patients with residual obesity. Clinical trials registry: https://www.researchweb.org/is/sverige/project/203961.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"24-34"},"PeriodicalIF":1.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463528","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":"Ulnar nerve innervation patterns and muscle fiber type composition of intrinsic hand muscles in mice.","authors":"Chuxiang Chen, Mingjie Zhou, Chenpei Xu, Tingzheng Jiang, Qianru He, Guillaume Prunieres, Philippe Liverneaux, Su Jiang","doi":"10.2340/jphs.v61.45556","DOIUrl":"10.2340/jphs.v61.45556","url":null,"abstract":"<p><p>The motor function of the hand is crucial in daily life, with fine motor abilities relying on intrinsic hand muscles. Ulnar nerve injury causes atrophy of the intrinsic hand muscles it innervates, severely impacting patients' daily activities. However, current understanding of the innervation patterns and muscle fiber composition of these muscles is limited, hindering the development of effective therapies for restoring hand function after such injuries. In this study, we investigated the anatomical basis of ulnar nerve innervation of the lumbrical and interosseous muscles in mice, a common neuromuscular research model. Our findings revealed that the ulnar nerve innervates the third and fourth lumbrical muscles and all interosseous muscles in mice. Six months after median nerve transection, motor endplate (MEP) areas in the ulnar-innervated fourth lumbrical muscle (152.200 ± 10.63 μm², n = 6) and dorsal interosseous muscles (e.g. third dorsal interosseous muscles: 171.100 ± 10.380 μm², n = 6) were preserved, whereas MEPs in the median-innervated first and second lumbricals were nearly abolished (e.g. LM1: 16.600 ± 1.126 μm², p < 0.001, n = 6).​ The third dorsal interosseous muscles predominantly consist of myosin heavy chain (MHC) -I (11.45% ± 1.92%, n = 6) and MHC-IIa (88.55% ± 1.92%, n = 6) fibers, whereas the lumbrical muscles mainly comprise MHC-IIa (31.67% ± 7.31%, n = 6) and MHC-IIb (64.44% ± 7.17%, n = 6) fibers. These results provide an essential anatomical and histological foundation for using mice to study the functional recovery of intrinsic hand muscles following ulnar nerve injury.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"35-43"},"PeriodicalIF":1.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467906","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 outcomes in cutaneous squamous cell carcinoma of the head and neck: a retrospective analysis of risk factors, recurrence and metastasis.","authors":"Veera Korhonen, Esko Veräjänkorva, Mari Koivisto, Susanna Pajula","doi":"10.2340/jphs.v61.45372","DOIUrl":"10.2340/jphs.v61.45372","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous squamous cell carcinoma (cSCC) is a common non-melanoma skin cancer primarily affecting the head and neck area, with possibility of local recurrence and metastasis. Surgical excision is the standard treatment. The objective of this study was to investigate the treatment outcomes of cSCC including local recurrence, late-onset metastasis and mortality as well as to identify the associated risk factors.</p><p><strong>Material and methods: </strong>A retrospective single-center analysis was conducted involving patients with cSCC of the head and neck treated by surgical excision at Turku University Hospital between 2000 and 2021 with a minimum 2-year follow-up from primary surgery.</p><p><strong>Results: </strong>A total of 195 patients, with a mean age of 79.1 years, were included. During follow-up, 17 (8.7%) recurrences were diagnosed, nine (4.6%) patients developed late-onset metastasis, and 100 (51.3%) patients died. The significant risk factors for recurrences included age ≥ 80 years (p = 0.006), poor tumor differentiation (p = 0.02) and tumor invasion depth (p = 0.02). Tumor depth also increased metastasis risk (p < 0.0001). Poor tumor differentiation (p = 0.004) and metastasis (p = 0.04) were associated with higher mortality. Greater histological deep margins decreased the risk of recurrence (p = 0.01) and metastasis (p = 0.02) and improved survival (p = 0.006). All-cause 3-year and 5-year mortality rates were 27.7 and 36.4%, respectively.</p><p><strong>Conclusion: </strong>Deeper growing, poorly differentiated cSCC tumors of the head and neck carry a higher risk of recurrence and metastasis. Pursuing greater deep excision margins could reduce these risks. Given the high age and all-cause mortality rates of cSCC patients, close surveillance should be individualized.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"17-23"},"PeriodicalIF":1.4,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284297","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 outcome comparison of suture button suspensionplasty versus trapeziectomy with ligament reconstruction and tendon interposition in patients with carpometacarpal joint arthritis: a systematic review of direct comparison studies.","authors":"Wildan Latief, Riky Setyawan, Winona Andrari Mardhitiyani","doi":"10.2340/jphs.v61.44912","DOIUrl":"10.2340/jphs.v61.44912","url":null,"abstract":"<p><strong>Introduction: </strong>Trapeziectomy nowadays is predominantly done with Ligament Reconstruction and Tendon Interposition (LRTI) or Suture Button Suspensionplasty (SBS). This article is intended to highlight comparison between SBS and trapeziectomy with LRTI through direct comparison evidence.</p><p><strong>Material and method: </strong>The LRTI technique involves the removal of the diseased trapezium bone and creating suspension through the use of flexor carpi radialis tendon, while SBS stabilize the metacarpal base by suspending the first metacarpal bone. The record screening process of this systematic and meta-analysis was in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. QuickDASH, post-operative strength, visual analog scale were set as the primary outcomes, while the adverse event reported and miscellaneous findings worth mentioning per study were set as the secondary outcomes.  Results: Of the 102 records screened, 1 Randomized Control Trial (RCTs) and 1 Cohorts, consisting of 188 cases were included in the analysis. Both modalities showed comparable, non-significant difference in efficacy (alleviating pain associated with basal joint arthritis, improving strength and function of the affected thumb, in the long term) at the endpoint of the follow-up. Both procedures also showcased excellent safety and long-term functional profile. However, SBS displayed an advantage in post-operative recovery aspect as well as the biomechanical aspect compared to LRTI.  Conclusions: Both LRTI & SBS demonstrated non-inferiority to each other, hence clinical judgment might be more based on the preference and tolerability of the patient, as well as the experience of the center. Further prospective, comparative study might be needed to truly erect the superiority of one of the procedures to another.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"12-16"},"PeriodicalIF":1.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157484","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":"Minor modification of soft palate surgical technique resulted in a considerable increase of residual cleft dimensions for unilateral cleft lip and palate.","authors":"Midia Najar Chalien, Hans Mark, Josef Rizell, Sara Rizell","doi":"10.2340/jphs.v61.45063","DOIUrl":"10.2340/jphs.v61.45063","url":null,"abstract":"<p><strong>Introduction: </strong>A two-stage surgical approach, starting with the soft palate, has been practiced in the Gothenburg cleft team for unilateral cleft lip and palate (UCLP) since decades. To improve the velopharyngeal function, a modified soft palate closure (SPC) technique was introduced. Clinical observations did however indicate that the novel technique resulted in a deviant residual cleft shape, potentially contributing to future compromised dental arch form.</p><p><strong>Aim: </strong>This study aimed to compare residual cleft dimensions (area, width and length) between different SPC techniques and at various age, in individuals born with UCLP.  Material and methods: The sample consisted of three groups of children with non-syndromic UCLP:  1. 27 individuals who had original SPC and hard palate closure (HPC) at 3 years (GBG3) 2. 37 individuals who had a modified SPC and HPC at 2 years (GBGmod)  3. 29 individuals who had original SPC and HPC at 2 years (GBG2).  Residual cleft area, length and width were measured on digitised cast models using Blender software. Multiple linear regression analysis was used to compare the groups.</p><p><strong>Results: </strong>Larger residual cleft dimensions (area and length) were found for GBGmod compared to both GBG3 (p < 0.001, p = 0.009) and GBG2 (p = 0.009, p = 0.009). In addition, GBGmod had increased cleft width in comparison with GBG3 and GBG2 in quartile 1.</p><p><strong>Conclusion: </strong>The modified SPC technique resulted in larger residual clefts in comparison with the groups operated with the original SPC method. Timing differences between GBG3 and GBG2 are likely one explanation of cleft width variations anteriorly.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"61 ","pages":"6-11"},"PeriodicalIF":1.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118943","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}