Plastic and reconstructive surgery最新文献

{"title":"Risk of Radiation-Induced Capsular Contracture Following Subpectoral or Prepectoral Implant-Based Breast Reconstruction.","authors":"Ronnie L Shammas, Jacob Levy, Lillian A Boe, Benjamin Wagner, Francis D Graziano, Geoffrey E Hespe, Evan Matros, Jonas A Nelson, Babak J Mehrara","doi":"10.1097/PRS.0000000000012262","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012262","url":null,"abstract":"<p><strong>Introduction: </strong>Radiation significantly increases the risk of capsular contracture after implant-based breast reconstruction. However, the relationship between anatomic plane placement (e.g. submuscular or prepectoral) and the development of capsular contracture remains unclear. This study compares the risk of radiation-induced capsular contracture in patients who undergo two-stage prepectoral versus submuscular implant reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent two-stage implant reconstruction with radiation to the tissue expander between 2010-2024 at a single institution. Capsular contracture was evaluated and classified by the Baker scale; patients with documented Baker II, III, or IV capsules were considered to have developed capsular contracture. Cox proportional hazards models identified predictors of contracture, and Kaplan-Meier curves estimated the cumulative incidence in prepectoral versus submuscular reconstruction.</p><p><strong>Results: </strong>585 patients were included; 116 underwent prepectoral and 469 underwent submuscular implant placement. Capsular contracture occurred in 62% of submuscular and 18% of prepectoral patients (p<0.001). The estimated 48-month cumulative incidence of capsular contracture was 61% (95% CI: 56-65%) for submuscular and 35% (95% CI: 19-47%) for prepectoral reconstruction (p<0.001). Submuscular implant placement was associated with a significantly higher risk of developing capsular contracture over time than prepectoral reconstruction (HR: 3.00, 95% CI: 1.88-4.79; p<0.001).</p><p><strong>Conclusion: </strong>In the setting of radiation, submuscular implant placement is associated with a significantly higher risk of capsular contracture compared to prepectoral placement. These findings emphasize the need for thorough patient counseling regarding the risks of capsular contracture and the importance of individualized reconstructive planning to optimize outcomes in patients undergoing radiation.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alveolar Bone Grafting: Outcomes Utilizing Synthetic HA/TCP and rhBMP-2 vs. Autologous Graft Types.","authors":"Riley H Kahan, Skyler K Palmer, Kassra Garoosi, Diego A Gomez, David Y Khechoyan, Brooke French, Kristen Lowe, Phuong D Nguyen","doi":"10.1097/PRS.0000000000012257","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012257","url":null,"abstract":"<p><strong>Intro: </strong>Alveolar ridge defects associated with cleft lip and palate are typically repaired using alveolar bone grafting (ABG), with autologous grafting as the standard despite donor site morbidity. This study investigated outcomes of using hydroxyapatite/beta-tricalcium phosphate (HA/TCP) as a synthetic graft alternative.</p><p><strong>Methods: </strong>A retrospective cohort study identified 118 patients who underwent ABG via CPT codes and were divided into three groups: autologous Iliac Crest Bone Graft (ICBG) (N=37), ICBG + rhBMP-2 (N=65), and 15% hydroxyapatite/85% beta-Tricalcium Phosphate (HA/TCP) + rhBMP-2 (N=16). Primary outcomes included need for regrafting and % graft take, assessed via CBCT imaging. Secondary outcomes included complication rates (swelling, wound dehiscence, SSI) and perioperative data (surgery length, hospital stay).</p><p><strong>Results: </strong>Patients who received HA/TCP + rhBMP-2 experienced similar rates of need for regrafting as the other groups. The median % graft take was higher for HA/TCP + rhBMP-2 (68.0% IQR[45.9-93.1%]) compared to ICBG (25.1% IQR[5.2-43.5%], Z = 3.16, p = 0.002) and ICBG + rhBMP-2 (44.2% IQR[24.5-63.1%], Z = 2.19, p = 0.028). Complication rates were similar across groups (dehiscence, p = 0.319; SSI, p = 0.357), except for a higher rate of post-surgical facial swelling for HA/TCP + rhBMP-2 compared to ICBG (OR = 6.8, 95% CI[1.44-32.00], p = 0.0157).</p><p><strong>Conclusion: </strong>HA/TCP + rhBMP-2 is a viable alternative to ABG, showing comparable success to ICBG and ICBG + rhBMP-2, with superior % graft take and no increased complication risk, aside from increased post-surgical facial swelling compared to ICBG.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreign-Trained Physicians in Plastic Surgery: Opportunity or Oversight?","authors":"Forrest Bohler, Madeline N Pham, Kongkrit Chaiyasate, Jesse C Selber","doi":"10.1097/PRS.0000000000012259","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012259","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Predicting Resection Weights of Reduction Mammaplasty: A Multi-Institutional Retrospective Analysis Using Machine Learning\".","authors":"Devin J Clegg, Stefanos Boukovalas, Brett Beaulieu-Jones, Gulsah S Onar, Aaron N Hendizadeh, Kimberley C Brondeel, Michelle Y Seu, Kimberly Khoo, Linda G Phillips, George Kokosis","doi":"10.1097/PRS.0000000000012258","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012258","url":null,"abstract":"<p><strong>Background: </strong>A single-institution study performed by our authors demonstrated that machine learning (ML) utilizing preoperative anthropometric variables was an accurate alternative to the Schnur Scale in predicting resection weights during reduction mammaplasty (RM). We sought to evaluate ML and regression modeling in a heterogenous multi-institutional population for predicting RM resection weights with improved accuracy and generalizability.</p><p><strong>Methods: </strong>A multi-institutional retrospective study was performed including 635 patients from three institutions who underwent RM for macromastia between 2017 and 2022. Preoperative anthropometric variables included body surface area (BSA), body mass index (BMI), sternal notch-to-nipple (SN-N), and nipple-to-inframammary fold (N-IMF) measurements. ML and regression models were evaluated for accuracy in predicting individual and total breast resection weights. The mean absolute errors (MAE) were reported.</p><p><strong>Results: </strong>In our study population, mean age at the time of RM was 38.5 years, mean BMI was 32.8 kg/m2, mean BSA was 2.0 m2, mean SN-N was 33.9 cm, and mean N-IMF was 15.3 cm. Preoperative BMI, SN-N, N-IMF, and race/ethnicity were significant covariates. Six of the seven models evaluated demonstrated lower MAEs than the Schnur Scale across individual and total predicted resection weights. Elastic Net regression had the lowest MAEs across individual right (164.2), left (163.8), and total breast resection weight predictions (310.5).</p><p><strong>Conclusions: </strong>ML and regression modeling demonstrated improved accuracy in predicting resection weights for RM compared to the Schnur Scale in a heterogenous and multi-institutional population. This study provides further evidence of promising alternatives to the Schnur Scale.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroplastic Mechanisms Underlying Facial Symmetry Recovery: Insights from Rich-Club Organization and SC-FC Coupling.","authors":"Hao Ma, Chen-Hao Zhang, Yu-Lu Zhou, Wen-Jin Wang, Gang Chen, Ye-Chen Lu, Wei Wang","doi":"10.1097/PRS.0000000000012260","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012260","url":null,"abstract":"<p><strong>Introduction: </strong>Unilateral facial paralysis is a condition marked by facial asymmetry. Although reconstructive surgeries, such as masseteric-to-facial nerve transfer combined with static suspension, significantly improve facial symmetry, patient outcomes can vary considerably. This study aims to explore cerebral reorganization, focusing on rich-club (RC) organization and SC-FC coupling as potential biomarkers for facial symmetry recovery.</p><p><strong>Methods: </strong>We enrolled 40 patients with severe oral commissure drooping due to unilateral facial nerve lesions who underwent masseteric-to-facial nerve transfer combined with static suspension. Using fMRI and DTI, we analyzed rich-club properties, the macroscale structural connectivity (SC), and functional connectivity (FC). Based on postoperative symmetry levels, patients were categorized into symmetry and asymmetry groups for comparison.</p><p><strong>Results: </strong>Patients with better facial symmetry demonstrated stronger SC-FC coupling and enhanced strength from rich-club nodes. Additionally, greater strength in non- rich-club nodes, along with stronger feeder and local edges, played a compensatory role in improving facial symmetry. In contrast, patients with facial asymmetry exhibited increasing FC in rich- and non-rich-club nodes, possibly as a maladaptive compensatory mechanism.</p><p><strong>Conclusion: </strong>Our study highlights rich-club organization and SC-FC coupling as potential biomarkers for assessing and monitoring facial symmetry recovery in facial paralysis patients post-surgery. These findings offer valuable insights into the brain's adaptive responses, serving as sensitive indicators of disease symptomatology and functional performance.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Flap Debulking After Facial Reanimation Surgery To Enhance Facial Symmetry.","authors":"Jakob B W Weiss, Mark Fricke, Ayla Hohenstein, Branislav Kollar, Steffen U Eisenhardt","doi":"10.1097/PRS.0000000000012247","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012247","url":null,"abstract":"<p><strong>Background: </strong>Free functional gracilis transfer (FFGT) is regarded as the standard treatment for smile reconstruction in long-standing flaccid facial paralysis. Secondary flap debulking is often performed for aesthetic improvement. However, data on the efficacy and safety of these procedures are scarce. This study aims to objectively analyze the results of flap debulking procedures following smile reconstruction.</p><p><strong>Methods: </strong>We included all patients receiving flap debulking after unilateral smile reconstruction from 2014 to 2023. Facial symmetry before and after debulking was assessed using standardized photographs. Measurements included hemifacial surface area, commissure excursion, commissure height deviation, and commissure excursion ratio.</p><p><strong>Results: </strong>Of 172 FFGT during the study period, 75 received 76 debulking procedures, and 54 patients were included in this study. The hemifacial surface area (affected/healthy) significantly increased following FFGT (median 0.96 (IQR: 0.922 - 0.992) to 1.06 (IQR: 0.989 - 1.115); p < 0.001). After flap debulking, the median ratio adjusted to 1.01 (IQR 0.971 - 1.049; p < 0.001). Commissure height deviation decreased significantly after FFGT and was further reduced after flap debulking (median 9.62 mm (IQR: 6.79 - 13.52 mm) to 3.26 mm (IQR: 1.25 - 4.75 mm); p < 0.001 to 2.8 mm (IQR: 1.6 - 4.06 mm)). The commissure excursion ratio decreased significantly (mean 1.05 ± 0.02 to 0.98 ± 0.02; p < 0.001), further indicating improved symmetry. One patient had a postoperative infection requiring revision. No flap losses occurred.</p><p><strong>Conclusions: </strong>Secondary flap debulking is a safe technique that enhances facial symmetry, following smile reconstruction surgery using FFGT.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective grading of peripheral vascular disease strongly predicts morbidity in microsurgical lower limb salvage.","authors":"John M Felder, Jonah Orr, Hayden Schott, Patrick Geraghty","doi":"10.1097/PRS.0000000000012246","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012246","url":null,"abstract":"<p><strong>Background: </strong>Chronic lower extremity wounds in diabetic and vasculopathic populations frequently lead to amputation. Microvascular free tissue transfer (FTT) is a limb salvage option, but outcomes in patients with peripheral vascular disease (PVD) are variable. This study aimed to assess the severity of PVD using accepted standardized metrics to predict morbidity and negative outcomes in patients undergoing lower extremity FTT.</p><p><strong>Methods: </strong>A retrospective review of 97 FTT procedures performed between January 2018 and April 2023 was conducted. PVD severity was assessed using Wound-Ischemia-Foot Infection (WIfI), Global Limb Anatomic Staging System (GLASS), and Medial Arterial Calcification (MAC) scores. Outcomes of interest included flap failure, amputation, mortality, and major morbidities at various time points.</p><p><strong>Results: </strong>Overall, flap failure occurred within 30 days in 8.2% of cases and amputation within 90 days occurred at a rate of 5.2%. In patients with incomplete pedal arches (i.e. pGLASS scores of P1 or P2), there were increased rates of 90-day mortality (11.1% vs 0; p=0.026) and 30-day flap failure (18.5% vs 3.2%; p=0.026). Severe MAC scores were associated with increased 90-day mortality (p=0.002), 1-year mortality (p=0.003), and major morbidity. WIfI scores were not significantly associated with negative outcomes.</p><p><strong>Conclusion: </strong>PVD severity can be objectively assessed using pedal GLASS and MAC scores to guide patient selection for lower extremity FTT. In patients with an incomplete pedal arch and extensive vascular calcifications, there is a significantly higher risk of major adverse outcomes, emphasizing the need for careful preoperative assessment and shared decision-making in limb salvage procedures.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Driven Blood Loss Prediction in Large-Volume Liposuction: Enhancing Precision and Patient Safety.","authors":"Mauricio E Perez Pachon, Jose T Santaella P, Carlos Oñate, Daniel Oñate, Jonathan De Freitas, Mariana Borras Osorio, Alfredo E Hoyos","doi":"10.1097/PRS.0000000000012240","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012240","url":null,"abstract":"<p><strong>Background: </strong>Over 2.3 million liposuctions are performed annually with a complication rate of about 5%, including a death rate of 1 in 5,000 due to blood loss. Artificial intelligence (AI) models offer potential for improving blood loss prediction and management in these procedures, analyzing extensive data to identify risk factors and accurately estimate blood loss.</p><p><strong>Methods: </strong>Data from 721 large-volume liposuction patients at two centers in Bogotá, Colombia, and Loja, Ecuador, between 2019 and 2023 was evaluated. Both centers followed identical perioperative protocols. The dataset was split into training (621 patients) and testing (100 patients) sets. A supervised machine learning model was trained to predict blood loss. Model's predictions were compared with clinical data using statistical validation metrics.</p><p><strong>Results: </strong>Most patients were women (79.2%) with median values of age 37 years, weight 65 kg, height 165 cm, BMI 24.34 kg/m², volemia 3924.41 ml, infiltrated volume 5800 ml, and aspirated volume 3900 ml. Previous liposuction was noted in 32%. No significant differences were found between training and testing cohorts. The model achieved a Mean Absolute Error (MAE) of 22.09 ml, Root Mean Square Error (RMSE) of 34.13 ml, and an R² value of 0.974, indicating high predictive accuracy and excellent model fit.</p><p><strong>Conclusions: </strong>Our study has developed and validated an accurate AI-based model to predict blood loss in large-volume liposuction, showing 94.1% accuracy. Our model enhances preoperative planning and intraoperative management, potentially reducing complications and improving outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Natural Progression of Synkinesis.","authors":"Benjamin Rail, Sahejbir S Bhatia, Anthony J Dragun, Chaia S Geltser, Michael Dang, MinJae Lee, Shai M Rozen","doi":"10.1097/PRS.0000000000012243","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012243","url":null,"abstract":"<p><strong>Background: </strong>The severity of post paralysis facial synkinesis typically worsens after onset, but its progression over time is not well characterized. This study examines the time course of synkinesis progression.</p><p><strong>Methods: </strong>Patients with a diagnosis of facial synkinesis presenting between 2010 and 2024 were assessed through photographic and videographic review using the eFACE Facial Nerve Clinician-Graded Scale. Patients included had at least two sets of standardized professional images and videos taken 3 or more months apart after facial palsy onset from any etiology. Patients who underwent surgical intervention for synkinesis or chemodenervation within the previous 3 months were excluded. The eFACE synkinesis score was assessed in 100-day increments after the onset of facial paralysis, with multivariable longitudinal analysis using generalized estimating equations (GEE).</p><p><strong>Results: </strong>Of 409 synkinesis patients, 98 patients met inclusion criteria. Minimal symptoms were observed during the first 100 days following facial palsy onset. Synkinesis severity progressively increased, with the last period of statistically significant worsening occurring between 400 and 500 days. Synkinesis symptoms emerged as early as 1 month and as late as 10 to 11 months after facial palsy onset.</p><p><strong>Conclusions: </strong>Synkinesis symptoms were minimal within 100 days of facial palsy onset and progressively worsened, with the greatest symptomatic worsening occurring between 200 and 300 days, before plateauing around 16 months, with no significant worsening thereafter. This study defines the timeline of post paralysis facial synkinesis, enabling evidence-based discussions of symptom progression.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic Ring Reconstruction with Vascularized Bone Flaps Reduces Compensatory Scoliosis After External Hemipelvectomy.","authors":"Praneet S Paidisetty, Karthik Tappa, Rami Elmorsi, Margaret S Roubaud, Matthew M Hanasono, David M Adelman, Shalin S Patel, Justin E Bird, Valerae O Lewis, Patrick P Lin, Alexander F Mericli","doi":"10.1097/PRS.0000000000012241","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012241","url":null,"abstract":"<p><strong>Background: </strong>External hemipelvectomy (EH) is a complex amputation that removes the hemipelvis and leg, most commonly performed to resect a locally advanced pelvic malignancy. This destabilizes the spinopelvic anatomy and may result in a compensatory scoliosis (CS) to maintain an upright posture. We hypothesized pelvic ring reconstruction with vascularized bone (VB) will reduce CS and improve functional outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients who underwent an EH between 1/2004 and 5/2023. Patients were categorized by use of VB or not (NVB). The primary outcome was CS (Cobb angle >10 degrees on imaging >10 months post-procedure). Secondary outcomes included surgical complications and functional outcomes.</p><p><strong>Results: </strong>We identified 58 reconstructions (29 VB; 29 NVB). Median follow-up (months) for VB was 25.9 (interquartile range=34.6) and NVB was 16.1 (interquartile range=114.9). For VB, fibula (41.4%) and tibia (37.9%) flaps were most common, including 15 pedicled and 14 free filet flaps. Median time to full union in months was 8.8 (range=3.4-11). CS was diagnosed in 22.2% and 78.6% of VB and NVB patients, respectively (p=0.004). Median Cobb angle for VB was 8 degrees (range=2-21) and 15.1 degrees (range=3-30) for NVB (p=0.02). The overall complication rate was not different between the two groups. Similar proportions of VB and NVB patients tolerated prostheses (34.5% vs. 32.1%) and were reliant on a wheelchair (65.5% vs. 60.7%), respectively.</p><p><strong>Conclusion: </strong>Pelvic ring reconstruction with VB after EH appears to reduce the incidence and severity of CS, without increasing complication rates.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}