Journal of Plastic Surgery and Hand Surgery最新文献

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Single or double Kirschner wire fixation: which provides better outcomes for pediatric proximal phalanx base fractures? 单根或双根克氏针内固定:小儿近端指骨基部骨折哪种治疗效果更好?
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-09-01 DOI: 10.2340/jphs.v58.13425
Chan Ju Park, Kyung Jin Lee, Jin Soo Kim, Sung Hoon Koh, Dong Chul Lee, Si Young Roh
{"title":"Single or double Kirschner wire fixation: which provides better outcomes for pediatric proximal phalanx base fractures?","authors":"Chan Ju Park,&nbsp;Kyung Jin Lee,&nbsp;Jin Soo Kim,&nbsp;Sung Hoon Koh,&nbsp;Dong Chul Lee,&nbsp;Si Young Roh","doi":"10.2340/jphs.v58.13425","DOIUrl":"https://doi.org/10.2340/jphs.v58.13425","url":null,"abstract":"<p><strong>Purpose: </strong>The most common hand fracture in children is seen at the base of the proximal phalanx. This study aims to compare clinical outcomes of single versus double Kirschner wire pinning for pediatric proximal phalanx base fractures.</p><p><strong>Patients and methods: </strong>The retrospective study enrolled patients who underwent closed K-wire pinning for proximal phalanx base fractures from January 2016 to February 2022. We divided patients into two groups based on the number of K-wire inserted (single versus double). Demographics, removal of implant, complication rate were analyzed. Patients were asked to answer the Michigan Hand Outcomes Questionnaire (MHQ) by telephone. Data including fracture type, diaphyseal axis-metacarpal head angle (DHA) and Total Active Flexion Scale (TAFS) were analyzed.</p><p><strong>Results: </strong>This study included 37 pediatric patients with proximal phalanx base fractures, treated with either single (n = 10) or double K-wire (n = 27) fixation. The mean operation time was significantly shorter for the single K-wire group. No significant differences were observed in complication rates, TAFS, implant removal times, MHQ, or pre- and post-operative DHA between the two groups.</p><p><strong>Conclusion: </strong>The single K-wire technique demonstrates similar effectiveness to the double K-wire technique in treating pediatric proximal phalanx base fractures, with the added benefit of shorter operation time. Therefore, the choice between using one or two K-wires should be determined based on the surgeon's proficiency and preference.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"82-88"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10201037","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
Management of common conditions of the musician: a narrative review for plastic surgeons. 音乐家常见疾病的治疗:整形外科医生的叙述性综述。
IF 1 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-09-01 DOI: 10.2340/jphs.v58.7314
Daniel Chu, Sahand C Eftekari, Peter J Nicksic, Samuel O Poore
{"title":"Management of common conditions of the musician: a narrative review for plastic surgeons.","authors":"Daniel Chu, Sahand C Eftekari, Peter J Nicksic, Samuel O Poore","doi":"10.2340/jphs.v58.7314","DOIUrl":"10.2340/jphs.v58.7314","url":null,"abstract":"<p><p>Career-related injuries and disorders in professional musicians are prevalent across all their respective instruments and fields. They often endure long hours of intensive practice that demand high levels of precision, dexterity, and flexibility of their head, neck, hands, and upper extremities. Unlike the average patient, musicians are sensitive to even mild symptoms and deficits that can interfere with performance, which can potentially be career-threatening. Increasing attention to the care of musicians motivated performing arts medicine to tailor the practice to their individual and unique needs. Plastic surgeons are at the forefront of this practice; however, there are very limited reviews discussing plastic surgery management of the common injuries and disorders in musicians. This article reviews the most relevant literature of the past several decades regarding treatment modalities of the most common conditions endured by professional instrumentalists, with an emphasis on surgical considerations in the field of plastic surgery. A thorough literature search was performed for articles that encompass the interface between plastic surgery and musicians. We examined disorders of the head, ears, eyes, nose, throat, hands, and upper extremities including stress velopharyngeal incompetence, disruption of the embouchure, nerve entrapments, arthritis, traumatic injuries, focal dystonia, Linburg-Comstock syndrome, and overuse disorder. Overall, the goal of this review is to provide a summary of the existing and successful procedures performed to address prevalent musician conditions.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"89-95"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496518/pdf/nihms-1929720.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term effectiveness of conservative management for lateral epicondylitis: a meta-analysis. 保守治疗外侧上髁炎的长期疗效:荟萃分析。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-08-24 DOI: 10.2340/jphs.v58.12333
Qiaojie Chen, Pingping Shen, Bo Zhang, Yang Chen, Chunli Zheng
{"title":"Long-term effectiveness of conservative management for lateral epicondylitis: a meta-analysis.","authors":"Qiaojie Chen,&nbsp;Pingping Shen,&nbsp;Bo Zhang,&nbsp;Yang Chen,&nbsp;Chunli Zheng","doi":"10.2340/jphs.v58.12333","DOIUrl":"https://doi.org/10.2340/jphs.v58.12333","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the long-term (>12 months) effectiveness of conservative management for lateral epicondylitis.</p><p><strong>Data sources: </strong>PubMed and Embase databases were searched for relevant studies from inception to March 2023.</p><p><strong>Study selection and data extraction: </strong>Only English-written randomized controlled trial (RCT) with data download as well as follow up ≥12 months were acceptable. Raw data were extracted into a predefined worksheet, and quality analysis was conducted based on the Cochrane risk-of-bias tool version 2 (RoB2).</p><p><strong>Data synthesis: </strong>The standardized mean difference (SMD) with 95% confidence interval (CI) were calculated.</p><p><strong>Results: </strong>Extracorporeal shock wave therapy (ESWT) could significantly relive pain for lateral epicondylitis patients in the long term (SMD: -0.19, 95% CI [-0.36, -0.02]); however, there was no significant difference between ESWT and control groups in long-term function outcome (SMD: 0.24, 95% CI [-0.02, -0.49]). No significant difference could be observed between (1) exercise and control groups in pain (SMD: -0.21, 95% CI [-0.60, 0.18]) or function (SMD: 0.06, 95% CI [-0.11, 0.23]), (2) corticosteroids and placebo groups in pain (SMD: 0.70, 95% CI [-0.43, 1.82]) or function (SMD: -0.02, 95% CI [-0.36, 0.31]), and (3) platelet-rich plasma (PRP) in pain (SMD: -0.30, 95% CI [-0.85, 0.25]) and function (SMD: -0.08, 95% CI [-0.78, 0.62]).</p><p><strong>Conclusion: </strong>The present conventional conservative management for lateral epicondylitis, with the exception of ESWT, a lack adequate evidence supporting their long-term effectiveness.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"67-73"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10069837","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
Diagnostical accuracy of hyperspectral imaging after free flap surgery. 游离皮瓣手术后高光谱成像的诊断准确性。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-08-24 DOI: 10.2340/jphs.v58.7140
Torsten Schulz, Rima Nuwayhid, Khosrow Siamak Houschyar, Stefan Langer, Lukas Kohler
{"title":"Diagnostical accuracy of hyperspectral imaging after free flap surgery.","authors":"Torsten Schulz, Rima Nuwayhid, Khosrow Siamak Houschyar, Stefan Langer, Lukas Kohler","doi":"10.2340/jphs.v58.7140","DOIUrl":"10.2340/jphs.v58.7140","url":null,"abstract":"<p><p>Microsurgical free-tissue transfer has been a safe option for tissue reconstruction. This study aimed to analyze the diagnostic accuracy of hyperspectral imaging (HSI) after free-tissue transfer surgery. From January 2017 to October 2019, 42 consecutive free-flap surgeries were performed, and their outcomes were analyzed via HSI. Clinical examination of free-flap perfusion was initially performed. Clinical examination findings were subsequently compared with those of HSI. Potential venous congestion with subsequent necrosis was defined as a tissue hemoglobin index of ≥53%. Student's t-test was used to compare the results of the analysis. The evaluation of sensitivity and specificity for flap failure detection was time dependent using the Fisher's exact test. A p-value of ≤0.05 was considered statistically significant. Microsurgical tissue transfer success rate was 84%. Seven patients presented with venous congestion that caused total flap necrosis. Overall, 124 assessments were made. HSI accurately identified 12 out of 19 pathological images: four as false positive and seven as false negative. The sensitivity and specificity of HSI were 57 and 94%, respectively, compared to those of clinical examination that were 28 and 100%, respectively, within 24 h following tissue transfer. The sensitivity and specificity of HSI were 63 and 96%, respectively, compared to those of clinical examination that were 63 and 100%, respectively, within the first 72 h. A tissue hemoglobin index of ≥53% could predict venous congestion after free-flap surgery. HSI demonstrated higher sensitivity than clinical examination within the first 24 h; however, it was not superior compared to clinical findings within 72 h.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"48-55"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10063086","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 patient-reported achievements of goals and core outcomes with delayed breast reconstruction in irradiated patients: latissimus dorsi with an implant versus DIEP. 患者报告的延迟乳房重建的目标和核心结果的比较:背阔肌植入物与DIEP。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-08-24 DOI: 10.2340/jphs.v58.12417
Jonas Löfstrand, Anna Paganini, Mattias Lidén, Emma Hansson
{"title":"Comparison of patient-reported achievements of goals and core outcomes with delayed breast reconstruction in irradiated patients: latissimus dorsi with an implant versus DIEP.","authors":"Jonas Löfstrand,&nbsp;Anna Paganini,&nbsp;Mattias Lidén,&nbsp;Emma Hansson","doi":"10.2340/jphs.v58.12417","DOIUrl":"https://doi.org/10.2340/jphs.v58.12417","url":null,"abstract":"<p><strong>Background: </strong>Different women's individual goals with a breast reconstruction vary, and few studies compare techniques in light of the different goals. This study aimed to compare patient-reported core outcomes in patients reconstructed with deep inferior epigastric artery perforator (DIEP) flaps and latissimus dorsi (LD) flaps. Second, breast-related factors that the patients were particularly satisfied/dissatisfied with were analyzed.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study, which includes women who had undergone mastectomy and radiation, followed by delayed breast reconstructions with either LD flap and implant or DIEP flap during 2007-2017. The patient-reported core outcomes of overall breast-specific quality of life, normality, women's cosmetic satisfaction, self-esteem, emotional well-being, and physical well-being were analyzed using BREAST-Q.</p><p><strong>Results: </strong>The patients were divided into LD and implant (n = 135 patients) and DIEP (n = 118 patients) groups, and both were demographically similar. The median follow-up was 8 years. The DIEP group scored significantly higher than the LD and implant group in five out of six domains. A high satisfaction was reported in questions regarding the feeling or appearance when having clothes on, whereas the greatest dissatisfaction was reported regarding questions entailing symmetry and the appearance without clothes.</p><p><strong>Conclusion: </strong>After 7 years, patients' breast-specific quality of life, normality, women's cosmetic satisfaction, self-esteem, emotional well-being, and physical well-being seem to be higher in irradiated patients who have been reconstructed with DIEP flap as compared to patients reconstructed with LD flap and implant. In both groups, patient satisfaction is high regarding their appearance when clothed, whereas the lowest satisfaction scores were reported in situations without clothing.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"74-81"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10063629","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
Triple nerve transfers for the management of early unilateral facial palsy. 三联神经转移治疗早期单侧面瘫。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-08-09 DOI: 10.2340/jphs.v58.6527
Jose E Telich-Tarriba, David F Navarro-Barquin, Genesis Pineda-Aldana, Alexander Cardenas-Mejia
{"title":"Triple nerve transfers for the management of early unilateral facial palsy.","authors":"Jose E Telich-Tarriba,&nbsp;David F Navarro-Barquin,&nbsp;Genesis Pineda-Aldana,&nbsp;Alexander Cardenas-Mejia","doi":"10.2340/jphs.v58.6527","DOIUrl":"https://doi.org/10.2340/jphs.v58.6527","url":null,"abstract":"<p><strong>Background: </strong>Early onset facial paralysis is usually managed with cross-face nerve grafts, however the low number of axons that reach the target muscle may result in weakness or failure. Multiple-source innervation, or 'supercharging', seeks to combine the advantages of different donor nerves while minimizing their weaknesses. We propose a combination of cross-face nerve grafts with local extra-facial nerve transfers to achieve earlier facial reanimation in our patients.</p><p><strong>Methods: </strong>A retrospective cohort including all patients with early unilateral facial palsy (<12 months evolution) who underwent triple nerve transfer between 2019 and 2021 was conducted. We performed single-stage procedure including zygomatic-to-zygomatic and buccal-to-buccal cross-face grafts, a nerve-to-masseter to bucozygomatic trunk transfer, and a mini-hypoglossal to marginal branch transfer. Results were evaluated using the clinician-graded facial function scale (eFACE).</p><p><strong>Results: </strong>Fifteen patients were included (eight females, seven males), mean age at the time of surgery was 48.9 ± 13.3 years. Palsy was right-sided in eight cases. The mean time from palsy onset to surgery was 5.5 ± 2.8 months. Patients showed improvement in static (70.8 ± 21.9 vs. 84.15 ± 6.68, p = 0.002) and dynamic scores (20 ± 16.32 vs. 74.23 ± 7.46, p < 0.001), as well as periocular (57.33 ± 15.23 vs. 74 ± 7.18, p = 0.007), smile (54.73 ± 11.93 vs. 85.62 ± 3.86, p < 0.001), mid-face (46.33 ± 18.04 vs. 95 ± 7.21, p < 0.001) and lower face scores (67.4 ± 1.55 vs. 90.31 ± 7.54, p < 0.001).</p><p><strong>Conclusion: </strong>The triple nerve transfer technique using cross-face nerve grafts, the nerve-to-masseter, and the hypoglossal nerve, is an effective and reproducible technique to obtain middle and lower face reanimation in cases of early facial palsy.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"62-66"},"PeriodicalIF":1.2,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319238","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
An alternative to opioid-based intravenous patient controlled analgesia in severe burn patients undergoing full thickness split graft in upper limbs. 阿片类药物静脉自控镇痛在重度烧伤患者上肢全层裂骨移植中的替代应用。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-08-01 DOI: 10.2340/jphs.v58.12292
Bo-Fu Shih, Fu-Yu Huang, Shih-Jyun Shen, Chih-Wen Zheng, Chao-Wei Lee, Ming-Wen Yang, An-Hsun Chou, Shiow-Shuh Chuang, Hsin-I Tsai
{"title":"An alternative to opioid-based intravenous patient controlled analgesia in severe burn patients undergoing full thickness split graft in upper limbs.","authors":"Bo-Fu Shih,&nbsp;Fu-Yu Huang,&nbsp;Shih-Jyun Shen,&nbsp;Chih-Wen Zheng,&nbsp;Chao-Wei Lee,&nbsp;Ming-Wen Yang,&nbsp;An-Hsun Chou,&nbsp;Shiow-Shuh Chuang,&nbsp;Hsin-I Tsai","doi":"10.2340/jphs.v58.12292","DOIUrl":"https://doi.org/10.2340/jphs.v58.12292","url":null,"abstract":"<p><strong>Background: </strong>Opioids provide good analgesic effect in burn patients during acute phase, but these patients may develop tolerance after prolonged exposure. Alternative analgesic strategies such as peripheral nerve blocks appear to provide adequate pain control while sparing opioid-related side effects. The purpose of this study was to evaluate intravenous patient-controlled analgesia (IV-PCA) and continuous peripheral nerve block (CPNB-PCA) in severe burn patients with relatively young age undergoing repeated debridement and large-area full thickness skin graft (FTSG).</p><p><strong>Methods: </strong>The records of victims in dust explosion in Taiwan in 2016 from Chang Gung Memorial Hospital Pain Service Database between 2016 June and 2017 December were evaluated. The patients' demographic data including age, gender, weight, burn area, degree of burn, type of PCA regimen (IV-PCA versus CPNB-PCA), size of FTSG, and adverse effects were collected.</p><p><strong>Results: </strong>The total in-hospital morphine consumption was significantly lower in CPNB-PCA than IV-PCA group. A trend of decrease in numerical rating scores (NRS) was observed for both groups and CPNB group had comparable NRS than IV-PCA group at rest. On movement, CPNB grouped had significantly lower NRS than IV-PCA on post-operative day 3.</p><p><strong>Conclusion: </strong>Our study demonstrated that in patients requiring high dosage of opioid, CPNB may be a suitable alternative for pain control.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9916652","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
Short term treatment of secondary lymphedema with hyaluronidase injections reduces mouse hindlimb lymphedema. 用透明质酸酶注射短期治疗继发性淋巴水肿可减少小鼠后肢淋巴水肿。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-06-20 DOI: 10.2340/jphs.v58.7791
Farima Dalaei, Amar Bucan, Alexander Wiinholt, Mads Gustaf Jørgensen, Christian Rønn Hansen, Christina Baun, Svend Hvidsten, Eva Kildall Hejbøl, Henrik Daa Schrøder, Jens Ahm Sørensen
{"title":"Short term treatment of secondary lymphedema with hyaluronidase injections reduces mouse hindlimb lymphedema.","authors":"Farima Dalaei,&nbsp;Amar Bucan,&nbsp;Alexander Wiinholt,&nbsp;Mads Gustaf Jørgensen,&nbsp;Christian Rønn Hansen,&nbsp;Christina Baun,&nbsp;Svend Hvidsten,&nbsp;Eva Kildall Hejbøl,&nbsp;Henrik Daa Schrøder,&nbsp;Jens Ahm Sørensen","doi":"10.2340/jphs.v58.7791","DOIUrl":"https://doi.org/10.2340/jphs.v58.7791","url":null,"abstract":"<p><p>Lymphedema is a common complication following breast cancer treatment with axillary lymphadenectomy and radiotherapy. Currently, there is no curative treatment for this disease, hence there is a need for new therapeutic suggestions. The aim of this study was to investigate the effect of hyaluronidase (HYAL) injections after inducing hindlimb lymphedema in 36 female C57BL/6 mice. HYAL injections were administered every second day for 14 days in three groups: (1) HYAL for 1 week followed by saline for 1 week, (2) HYAL for 2 weeks, and (3) saline injections for 2 weeks. Volume of the lymphedema limb was weekly assessed with micro-computed tomography (μ-CT) scans for a total course of 6 weeks. Lymph vessel morphometry was assessed in the end of the study after staining cross-sections of the hindlimb for anti-LYVE-1 blindly. Lymphatic function was assessed by lymphoscintigraphy to assess lymphatic clearance. There was a significant reduction of the volume of lymphedema in mice treated with HYAL-7 compared with mice treated with HYAL-14 (p < 0.05) and saline (p < 0.05). No differences were detected in lymph vessel morphometry and the lymphoscintigraphy between groups. Short-term treatment with HYAL-7 might be a potential therapeutic suggestion for secondary lymphedema induced in mouse hindlimbs. In the future, clinical studies are needed to investigate the potential of HYAL treatment in human beings.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"40-47"},"PeriodicalIF":1.2,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024856","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
Long-term longitudinal follow-up of individuals with UCLP after Gothenburg twostage palate closure: surgical and speech outcomes. 哥德堡两期腭裂术后UCLP患者的长期纵向随访:手术和言语预后。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-06-14 DOI: 10.2340/jphs.v58.7317
Hans Mark, Jan Lilja, Christina Havstam
{"title":"Long-term longitudinal follow-up of individuals with UCLP after Gothenburg twostage palate closure: surgical and speech outcomes.","authors":"Hans Mark,&nbsp;Jan Lilja,&nbsp;Christina Havstam","doi":"10.2340/jphs.v58.7317","DOIUrl":"https://doi.org/10.2340/jphs.v58.7317","url":null,"abstract":"<p><strong>Background: </strong>Delayed hard palate closure in unilateral cleft lip and palate (UCLP) patients show on a safe surgical method and good speech outcome, however, occurrence of orally retracted articulation before hard palate closure at 8 years. The aim of this study was to describe surgical and speech outcome in UCLP patients closing the hard palate at 3 years.</p><p><strong>Methods: </strong>A consecutive of 28 participants were operated with Gothenburg two-stage method including soft palate closure at 6 months and hard palate at 3 years. Surgical and speech outcome were evaluated. Recordings of sentences and spontaneous speech at 5, 10, 16, and 19 years were analyzed blindly and independently by three speech-language pathologists. Compensatory articulation, hypernasality, hyponasality, weak pressure consonants, and nasal air leakage were evaluated on ordinal four-point and intelligibility and perceived velopharyngeal function on three-point scales.</p><p><strong>Results: </strong>Long-term follow-up revealed a safe surgical method. Articulation disorders were present in 25-30% at 5-year but largely not later. About 20% had incompetent velopharyngeal function at 5 years but none at 19 years. Most participants were well intelligible after 5 years. Hard palate closure at 3 years indicated less occurrence of orally retracted articulation compared with a cohort who had hard palate closure at 8.2 years.</p><p><strong>Conclusions: </strong>Long-term, follow-up of individuals with UCLP after Gothenburg two-stage palate closure including closure of the soft palate closure at 6 months and hard palate at 3 years of age shows a safe surgical method and indicates less retracted oral articulation compared with hard palate closure at 8 years.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"19-25"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632265","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
Clinical effects of homodigital dorsal branch of the proper digital artery flap on repairing soft tissue defects of fingers. 指真动脉背侧支皮瓣修复手指软组织缺损的临床效果。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-06-14 DOI: 10.2340/jphs.v58.11967
Yong Zhang, Jupu Zhou, Jianzhong Qin
{"title":"Clinical effects of homodigital dorsal branch of the proper digital artery flap on repairing soft tissue defects of fingers.","authors":"Yong Zhang,&nbsp;Jupu Zhou,&nbsp;Jianzhong Qin","doi":"10.2340/jphs.v58.11967","DOIUrl":"https://doi.org/10.2340/jphs.v58.11967","url":null,"abstract":"<p><p>Homodigital dorsal branch of proper digital artery flaps (HDBPDAF) have been proved to be an excellent alternative for repairing distal soft tissue defects of fingertip. This study was to evaluate the clinical effects of HDBPDAF on repairing various soft tissue defects of fingers, including thumb and multi-fingers defects. A retrospective study was conducted in 40 patients with 44 finger defects treated with HDBPDAF from August of 2014 to December of 2021. The defects were located on fingertip and finger pulp (n = 28), finger pulp (n = 10), and dorsum of fingers (n = 6) with bone, tendon or nerve exposed. The average size of the flaps was 1.9 × 3.9 cm. Semmes Weinstein monofilament (SWM) test, Static two-point discrimination (2-PD), Total active motion (TAM) scores, the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score were evaluated through long-term follow-up. Forty-two flaps survived completely and uneventfully. Partial flap necrosis was observed in two flaps because of the absence of dorsal branch of proper digital artery. No visible scar contracture and joint limitation were noticed. The mean SWM score of flaps was 4.11 ± 0.4 g. The average 2-PD of the flaps was 8.9 ± 0.9 mm. The mean TAM of injured fingers was 268.7 ± 5.2° (contralateral side: 283.2 ± 6.4°, p < 0.05). The mean DASH score value was 29.7 ± 7.9. The HDBPDAF was an optimal and reliable alternative to repair various distal soft tissue defects of fingers, despite a lower absent rate of dorsal branch.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"18-23"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632272","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}
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