Plastic and reconstructive surgery最新文献

{"title":"Mandibular Distraction Osteogenesis in Children with Hemifacial Microsomia: A 5-Year Follow-Up of a Prospective Cohort Trial.","authors":"Wenyi Huang, Yingjie Yan, Ziwei Zhang, Xin Li, Zhijie Zhao, Yichi Zhang, Li Lin, Xiaojun Chen, Yan Zhang, Gang Chai","doi":"10.1097/PRS.0000000000012535","DOIUrl":"10.1097/PRS.0000000000012535","url":null,"abstract":"<p><strong>Background: </strong>Mandibular distraction osteogenesis (MDO) is commonly used to treat hemifacial microsomia (HFM); however, its long-term efficacy, particularly on maxillary growth, remains unclear. Preliminary studies have suggested that early MDO in children may result in better outcomes. This 5-year follow-up study evaluated the long-term effects of early MDO on maxillary growth and facial symmetry.</p><p><strong>Methods: </strong>A 5-year follow-up was conducted in patients who participated in a prospective cohort study. Patients were divided into group A (surgical age 1 to 3 years) and group B (surgical age 4 to 6 years). Three-dimensional computed tomography data were analyzed. Symmetry was assessed using occlusal plane canting (∠OP) and the symmetry index (affected/unaffected side), and maxillary growth was evaluated using volume and linear measurements. Correlation analysis was performed to explore the relationship between mandibular distraction and maxillary growth.</p><p><strong>Results: </strong>A total of 24 patients completed the 5-year follow-up, with 11 patients in group A and 13 patients in group B. Patients in group A showed significant and sustained improvements in facial symmetry and maxillary compensatory growth compared with patients in group B. The ∠OP in group A decreased from 4.40 degrees preoperatively to 2.23 degrees postoperatively, with little relapse to 2.51 degrees at 5 years; patients in group B showed less favorable changes. Correlation analysis confirmed a strong relationship between mandibular vertical extension and maxillary growth.</p><p><strong>Conclusions: </strong>Early MDO in children with HFM was demonstrated to be safe and effective, with significant improvements in facial symmetry over a 5-year follow-up period. Further studies are warranted to evaluate the longitudinal outcomes of MDO in 1- to 3-year-old patients with HFM.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"899-908"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293141","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":"Efficacy and Safety of Ultrasound-Guided Carpal Tunnel Release: A Systematic Review and Meta-Analysis.","authors":"Pushti Shah, Suhas Parise, Tiam M Saffari, Seth Noorbakhsh, Ashley Ignatiuk","doi":"10.1097/PRS.0000000000012471","DOIUrl":"10.1097/PRS.0000000000012471","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome is the most common upper extremity compression neuropathy, often requiring surgical intervention. Although open carpal tunnel release is effective, it has been associated with greater scarring and morbidity. Ultrasound-guided carpal tunnel release (USCTR) has emerged as a minimally invasive alternative. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of USCTR compared with open techniques.</p><p><strong>Methods: </strong>PubMed, Embase, ScienceDirect, and the CENTRAL databases were searched for studies describing USCTR with complete transverse carpal ligament release. Risk of bias was performed using the Cochrane risk-of-bias, Newcastle Ottawa, and Joanna Briggs Institute tools. Extracted data included patient demographics, functional outcomes, advanced imaging and nerve conduction metrics, patient-reported outcomes, and complications or reoperations. Meta-analyses were conducted on studies comparing USCTR with open techniques.</p><p><strong>Results: </strong>Forty-three articles were included in this study, with 4097 patients. USCTR demonstrated significant improvements in functional outcomes, nerve conduction metrics, and patient-reported outcomes, exceeding minimal clinically important differences. Meta-analyses revealed no differences in motor latency, sensory conduction velocity, or complication rates between USCTR and open techniques. USCTR patients returned to work 10.15 days earlier ( P = 0.02) and resumed normal activities 21 days earlier ( P < 0.001) compared with open techniques. Complication and reoperation rates for USCTR were 1.57% and 0.34%, respectively.</p><p><strong>Conclusions: </strong>USCTR is a safe and effective alternative to open techniques, offering comparable outcomes with shorter recovery times and earlier return to work. Large-scale prospective studies should further evaluate its role in the treatment of carpal tunnel syndrome.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"875-887"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355582","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":"Reconstructing Segmental Mandibular Defects: A Single-Center, 21-Year Experience with 413 Fibula Free Flaps.","authors":"Robert J Allen, Kevin K Zhang, Zack Cohen, Farooq Shahzad, Jonas A Nelson, Colleen M McCarthy, Snehal G Patel, Jay O Boyle, Jatin P Shah, Joseph J Disa, Peter G Cordeiro, Babak J Mehrara, Evan Matros","doi":"10.1097/PRS.0000000000012516","DOIUrl":"10.1097/PRS.0000000000012516","url":null,"abstract":"<p><strong>Background: </strong>The fibula free flap (FFF) is a common choice for mandibular reconstruction after oncologic resection. Advances in technology and surgical technique have changed the workflow of FFF-based mandible reconstruction. This study characterizes an institutional experience with these changes and their impact on patient outcomes.</p><p><strong>Methods: </strong>A 21-year retrospective review was performed of patients who underwent segmental mandibulectomy with FFF-based reconstruction.</p><p><strong>Results a total of: </strong>401 patients underwent reconstruction with 413 free flaps, with a median follow-up period of 2.9 years. Over the study period, there was an upward trend in case volume, with an average procedure length of 675.6 ± 132.5 minutes. Mini-plates ( n = 340 [82.3%]) were most commonly used for flap fixation initially, but reconstruction bars ( n = 73 [17.7%]) later became the preferred fixation method. A total of 168 (40.7%) patients had surgical planning with computer-aided design and manufacturing. A total of 98 (23.7%) patients underwent immediate dental implant placement. As computer-aided design and manufacturing and immediate dental implant placement became more prevalent during the study period, dental rehabilitation rates increased. A total of 226 (54.7%) patients experienced a complication at the recipient site, 122 (29.5%) of which required operative management; the rate of complications showed no discernable trend during the study period. The overall flap success rate of this cohort was 97.8%, with an all-cause mortality rate of 43.6%.</p><p><strong>Conclusions: </strong>This study presents an institutional series of FFF-based mandible reconstruction in the 21st century. Advances in surgical technique and technology have improved operative workflow and patient outcomes; however, postoncologic mandible reconstruction remains a highly morbid procedure.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"911-920"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145392239","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":"Breast Implant-Associated Malignancies: Current Recommendations for Workup and Management.","authors":"Megan E Fracol, Roberto N Miranda, Anne S Tsao, Megan M Rodriguez, Loretta J Nastoupil, Patricia A Young, Andy E Sherrod, Danielle M LeBlanc, Lisa M Hunsicker, Carlos E Bacchi, Thiago Gabriel, Terence M Myckatyn, Shoichiro Tanaka, Lauren V Kuykendall, Erika Resetkova, Mark G Evans, Puja Jagasia, Colleen M McCarthy, Fabio Santanelli Di Pompeo, Kelly K Hunt, L Jeffrey Medeiros, Cara Haymaker, Mark W Clemens","doi":"10.1097/PRS.0000000000012796","DOIUrl":"10.1097/PRS.0000000000012796","url":null,"abstract":"<p><strong>Learning objectives: </strong>After studying this article, the participant should be able to: 1. Name the 3 major subtypes of breast implant-associated (BIA) malignancies. 2. Recognize the most common presenting symptoms of BIA malignancies. 3. Identify appropriate treatment options for each BIA malignancy, including chemotherapy, radiation, and surgery. 4. Answer patient questions about recurrence and reconstruction after a diagnosis of BIA malignancy.</p><p><strong>Summary: </strong>Although rare, breast implants have been associated with several malignancies, categorized into 3 major subtypes: BIA anaplastic large-cell lymphoma, B-cell lymphoma, and squamous cell carcinoma. BIA anaplastic large-cell lymphoma is the most common subtype, with more than 1700 cases reported to date. BIA squamous cell carcinoma is the most aggressive subtype. The most common presenting symptom is late seroma. Patients typically report pain and swelling. Workup should begin with an ultrasound or mammography, and any fluid collections should be aspirated and evaluated in conjunction with pathology. The authors provide an algorithm for surgical excision and adjuvant treatment based on disease stage and subtype.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"774e-784e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778435","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":"Reply: Remote Incisions as an Alternative to Mastectomy Scars for Breast Tissue Expander-to-Implant Exchange: A Propensity Score-Matched Analysis.","authors":"Rami Elmorsi, Jose E Barrera, Alexander F Mericli, Mark V Schaverien, Donald P Baumann, J Bryce Olenczak","doi":"10.1097/PRS.0000000000012502","DOIUrl":"10.1097/PRS.0000000000012502","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"799e-800e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778543","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":"Evaluating Mechanisms and Surgical Alternatives to Hyperselective Neurectomy for Treatment of Spasticity in a Rat Model of Spinal Cord Injury.","authors":"Zohra V Aslami, Aidan S Weitzner, William Padovano, Emma K Rowley, Alexis Lowe, Cameron Ghergherehchi, Rachana Suresh, Danielle J Sim, Zachary H Zamore, Erica B Lee, Matthew J Elrick, Sami H Tuffaha","doi":"10.1097/PRS.0000000000012487","DOIUrl":"10.1097/PRS.0000000000012487","url":null,"abstract":"<p><strong>Background: </strong>Hyperselective neurectomy (HSN) involves transection of most terminal nerve branches supplying a spastic muscle with subsequent recovery of strength resulting from collateral regeneration of spared motor neurons. However, the underlying mechanisms driving spasticity reduction have not been defined. This study aimed to address this knowledge gap and compare the efficacy of HSN to other forms of nerve injury as a therapy for spasticity in a rodent model of spinal cord injury.</p><p><strong>Methods: </strong>Six weeks after T8 spinal transection, rats ( n = 90) were randomized into 5 groups: sham ( n = 18); HSN of the nerves to gastrocnemius and soleus muscles ( n = 17); transection without repair ( n = 18); transection with repair ( n = 19); and crush ( n = 18) of the tibial nerve. Muscle resistance, modified Ashworth scale, and changes in spindle innervation and VGLUT1 density in the spinal cord were analyzed at 2 and 12 weeks after nerve injury.</p><p><strong>Results: </strong>At 12 weeks, muscle resistance and modified Ashworth scale scores were reduced in transection with repair, but not HSN rats. Reinnervated muscle spindles in both groups presented with atypical morphology. VGLUT1 density representing Ia afferent synapses in the spinal cord was not different between groups.</p><p><strong>Conclusions: </strong>Nerve transection with primary epineural repair demonstrated enhanced long-term spasticity reduction in spinal cord-injured rats. However, differences in functional synapses on spinal cord motor neurons between groups were not found. Loss of the stretch reflex may alternatively be explained by atypical muscle spindle morphology or central processing in a spinal cord injury cohort. Future studies are needed to further elucidate how peripheral nerve injury modulates disruption of the stretch reflex and treatment of spasticity.</p><p><strong>Clinical relevance statement: </strong>This novel animal study contributes to our understanding of the mechanisms underlying an emerging surgical treatment for patients with spasticity. This is the first study to investigate the effect of peripheral nerve injury on the stretch reflex in the context of surgical treatment for spasticity. These results provide initial insights into the mechanisms driving the clinically proven treatment benefits of a popular surgical approach for spasticity, and evaluates related surgical strategies that may offer additional benefits.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"853-865"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225693","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":"Predictors of Facial Synkinesis Severity.","authors":"Yeui-Seok Seo","doi":"10.1097/PRS.0000000000012518","DOIUrl":"10.1097/PRS.0000000000012518","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"809e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275497","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":"PRS Journal Club: From Prepectoral Implants, Direct-to-Implant Reconstruction, and Microsurgery: Balancing Innovation in Breast Reconstruction with Outcomes and Cost-Effectiveness.","authors":"Priyanka Naidu, Lucas M Harrison, Christopher L Kalmar","doi":"10.1097/PRS.0000000000012855","DOIUrl":"10.1097/PRS.0000000000012855","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"953-955"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778454","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":"Discussion: Cost of Care and Surgical Outcomes between Direct-to-Implant and Staged Tissue Expander Breast Reconstruction.","authors":"Kevin Urlaub, Terence M Myckatyn","doi":"10.1097/PRS.0000000000012667","DOIUrl":"10.1097/PRS.0000000000012667","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"811-812"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778499","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":"Anatomical Reconstruction of the Abdominal Wall through Fat Grafting and Modified Plication Technique in the Abdominal Rectus.","authors":"Giovanni Mera-Cruz, Natalia Murillo-Romero, Carlo Julio Barragán Guadalupe, Sergio Arbeláez, Laura Camacho-Domínguez, Yulia Daniela Guio Gomez, Juan Jose Mera Herrera","doi":"10.1097/PRS.0000000000012396","DOIUrl":"10.1097/PRS.0000000000012396","url":null,"abstract":"<p><strong>Background: </strong>Abdominal lipectomy is considered today one of the most important and common aesthetic procedures in plastic surgery. It presents very satisfactory results; however, it is not free of complications, which is why modifications are constantly being made to the conventional technique in search of more natural and safe results. The objective of this study is to report the authors' experience modifying the conventional lipectomy technique by combining it with muscle fat grafting and to evaluate the effects of intramuscular pressures and body mass index (BMI) on fat graft retention.</p><p><strong>Methods: </strong>The study was conducted between 2022 and 2024, involving patients undergoing abdominoplasty with fat grafting into the rectus abdominis muscles. Fat graft resorption was assessed postoperatively by analyzing variables such as intramuscular pressure, BMI, and patient age. Data were collected through clinical follow-ups and imaging techniques.</p><p><strong>Results: </strong>The study found that intramuscular pressures greater than 8 mmHg significantly increased fat graft reabsorption rates. Higher BMI and age also showed an association with greater reabsorption, although the impact was more pronounced under high-pressure conditions. Treatment with lower pressures (<8 mmHg) resulted in lower reabsorption.</p><p><strong>Conclusions: </strong>Through this new technique, an anatomical reconstruction of the abdominal wall was achieved, with an increase around 80% in muscle volume, which was evidenced in the appearance of the muscle that is evaluated during the inspection of the patient and is evident in the photographic record, giving rise to a natural appearance and better body posture in the long term with an almost decrease in possible complications described in the literature and persistence of long-term aesthetic results.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"836-848"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964558","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}