Case Reports in Plastic Surgery and Hand Surgery最新文献

{"title":"Diagnostic and management challenges of late chest wall mass following implant-based breast reconstruction: a case report.","authors":"Kathryn Howard, Garrett M Minor, Alisha B Paranzino","doi":"10.1080/23320885.2025.2610546","DOIUrl":"10.1080/23320885.2025.2610546","url":null,"abstract":"<p><p>Peri-prosthetic late hematoma following breast implant procedure is defined as a hematoma presenting longer than 6 months after operation and is a rare complication with sporadic cases reported throughout literature. We present a case of an 85-year-old patient who developed a spontaneous late hematoma nearly 20 years following implant-based breast reconstruction and adjuvant chemotherapy to illustrate the importance of maintaining a wide differential when approaching a chest wall mass that cannot be biopsied in a patient who has previously received breast implants. MRI revealed a peri-implant effusion with a heterogeneous mixed signal partially enhancing mass measuring 3.2 x 4.3 x 1.7 cm, posterior to the left breast implant. The patient had bilateral Mentor smooth, round, silicone, 350 cc implants in the submuscular plane. Ultrasound-guided biopsy was attempted and unsuccessful due to inability to displace the implant and access the mass, indicating the need for an open biopsy. The patient underwent radical left chest wall mass excision of the posterior implant capsule, removal of the left implant, and closure of the anterior capsule. Final pathology confirmed the diagnosis of organized hematoma. Immunophenotyping flow cytometry was utilized to rule out BIA-ALCL or BIA-SCC. Our case is unique in that biopsy was unable to be obtained given retro-implant position of the mass and that the diagnosis and etiology of late hematoma formation following smooth round silicone implants has been infrequently discussed in literature. Providing a comprehensive workup considering patient history, physical exam findings, imaging, and pathology ensures a wide differential optimizing patient outcomes.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2610546"},"PeriodicalIF":0.6,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brachioradialis tendon transfer for a thumb and finger extension disorder owing to distal-type cervical spondylotic amyotrophy: a case report.","authors":"Risa Takenaka, Takashi Oda, Tsutomu Oshigiri, Takuro Wada, Atsushi Teramoto","doi":"10.1080/23320885.2025.2610522","DOIUrl":"10.1080/23320885.2025.2610522","url":null,"abstract":"<p><p>To reconstruct finger extension in distal-type cervical spondylotic amyotrophy, wrist flexor tendons are commonly selected as the donor tendons. However, distal-type cervical spondylotic amyotrophy predominantly affects the C8 myotome, and therefore the wrist flexor muscles may also be impaired. The brachioradialis is mainly innervated by the C6 and is therefore less likely to be affected, it represents a favorable option as a donor tendon. However, there are few reports describing the use of the brachioradialis as a donor tendon. A 72-year-old man presented with limited active extension of his left ring and small fingers and thumb. Posterior cervical decompression was performed for cervical spondylotic amyotrophy (C8 segment involvement); however, at 12 months postoperatively, thumb and finger extension remained impaired. Instead of a wrist flexor transfer, we performed a brachioradialis tendon transfer to the extensor pollicis longus and extensor digitorum communis tendons. At 2 - year postoperative final follow-up, the extension lags of the 4^th and 5^th metacarpophalangeal joints and thumb had improved. His Disabilities of the Arm, Shoulder, and Hand score improved from 30 to 11.6 postoperatively. In finger and thumb extensor paralysis owing to distal cervical spondylotic amyotrophy, the brachioradialis muscle is typically spared and can be considered a donor for tendon transfer. This procedure, combined with extensive release of the fascial attachments, effectively improved dysfunction of finger and thumb extension without resulting in significant functional loss.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2610522"},"PeriodicalIF":0.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dorsal and volar approach to managing a giant bilobed bicompartmental lipoma of the hand: case report.","authors":"Antonioenrico Gentile, Ludovica de Gregorio, Fabrizio Schonauer","doi":"10.1080/23320885.2025.2593035","DOIUrl":"10.1080/23320885.2025.2593035","url":null,"abstract":"<p><strong>Background: </strong>Lipomas are common benign tumors, but giant bicompartmental bilobed lipomas in the hand are rare and pose unique diagnostic and surgical challenges due to the hand's complex anatomy and the proximity of neurovascular structures.</p><p><strong>Case presentation: </strong>We report the case of a 67-year-old woman with a slowly enlarging, painless mass in her left hand, located between the second and third metacarpals, with both dorsal and volar extensions. Physical examination revealed a firm, well-defined lesion measuring approximately 5 cm in length, associated with mild paresthesia and decreased range of motion. Magnetic Resonance Imaging (MRI) confirmed a well-encapsulated, hyperintense mass consistent with a benign lipoma, exhibiting bicompartmental extension without signs of malignancy.</p><p><p>A dual approach was employed for complete excision: an S-shaped dorsal incision followed by a volar zigzag incision. Intraoperatively, the lesion demonstrated a bilobed hourglass shape crossing through a constriction ring formed by surrounding anatomical structures. Meticulous dissection enabled safe en bloc removal while preserving the extensor tendons and common digital nerves.</p><p><p>The postoperative course was uneventful. The patient resumed active motion two weeks postoperatively, with full recovery of hand function and no recurrence at 6-month follow-up. Histopathological examination confirmed a spindle cell lipoma with no malignant features.</p><p><strong>Conclusion: </strong>This case highlights the importance of preoperative imaging, surgical planning, and a dual dorsal-volar approach for managing complex lipomas of the hand. Tailoring the surgical strategy to the lesion's anatomy allows complete excision while minimizing the risk to vital structures and optimizing both functional and cosmetic outcomes.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2593035"},"PeriodicalIF":0.6,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12667303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up after en bloc resection of the distal radius with reconstruction using ulnar translocation.","authors":"Yoshiaki Ogawa, Hisaki Aiba, Yohei Kawaguchi, Satoshi Yamada, Hiroaki Kimura, Yusuke Hattori, Makoto Yamaguchi, Hideki Murakami, Hideki Okamoto","doi":"10.1080/23320885.2025.2590296","DOIUrl":"10.1080/23320885.2025.2590296","url":null,"abstract":"<p><p>Reconstruction of the distal radius after en bloc bone tumor resection is challenging. Among various surgical reconstruction methods, ulnar translocation is a simple approach that does not require vascular anastomosis, autograft harvesting, or prosthesis preparation. This report describes the 7-year follow-up of a patient who underwent reconstruction with ulnar translocation following resection of a recurrent giant cell tumor of the bone. A 57-year-old woman was diagnosed with multiple recurrent giant cell tumor of the bone involving the distal radius. The patient underwent en bloc resection of the tumor with osteotomy of the distal radius 5 cm proximal to the wrist joint through a dorsal incision. The distal ulna was osteotomized at the same level and translocated with preservation of the vascularity of the posterior interosseous artery. Then, the translocated ulna was fixed to the carpal bone and distal radius and aligned in the mid-supination and pronation positions; fixation at 10° of wrist dorsiflexion was performed using locking plates. Bone union between the metacarpal bone, grafted bone and proximal radius was achieved at 9 months postoperatively. At the 1-year follow-up examination, the range of motion of the wrist was 90°/65° (supination/pronation), and the grip strength was 9.1 kg. At the final follow-up examination (7 years postoperatively), the range of motion of the wrist was 90°/90° (supination/pronation) and the grip strength was 19 kg (20 kg on the lateral side). The patient's QuickDASH and Hand 20 scores were 25 and 43, respectively, indicating minor difficulties in daily activities. Ulnar translocation is regarded as a practical alternative to more complex reconstructive procedures for the distal radius following en bloc tumor resection. Its benefits include surgical simplicity, long-term durability, and preservation of forearm rotation.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2590296"},"PeriodicalIF":0.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12667343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary umbilical malignant melanoma requiring full-thickness abdominal wall resection and reconstruction with autologous fascia lata: a case report.","authors":"Yasue Kurokawa, Yoshihiro Sowa, Soichiro Kado, Yuki Kimura, Takeo Maekawa, Mayumi Komine, Kotaro Yoshimura","doi":"10.1080/23320885.2025.2594830","DOIUrl":"https://doi.org/10.1080/23320885.2025.2594830","url":null,"abstract":"<p><p>Primary malignant melanoma of the umbilicus is extremely rare; evidence guiding optimal resection and reconstruction is limited. A 47-year-old man with primary umbilical melanoma underwent full-thickness abdominal wall resection including the peritoneum. The abdominal wall defect was reconstructed using an autologous fascia lata graft. Histopathology confirmed malignant melanoma with a tumor thickness of 18 mm (pT4bN1aM0, Stage IIIC). At 6-month follow-up, no local recurrence or incisional hernia was observed, and at one year after surgery, no evidence of herniation or recurrence was noted. Autologous fascia lata offers a practical option for abdominal wall reconstruction after extensive oncologic resection of the umbilical region, achieving early freedom from recurrence and hernia in this case.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2594830"},"PeriodicalIF":0.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde intramedullary K-wire fixation of trapezoid dislocation: a case report.","authors":"Chih-Hsun Chang, Chin-Hsien Wu, Hui-Kuang Huang","doi":"10.1080/23320885.2025.2594249","DOIUrl":"https://doi.org/10.1080/23320885.2025.2594249","url":null,"abstract":"<p><p>Trapezoid dislocations are extremely uncommon injuries because of the strong intercarpal and carpometacarpal ligaments that provide greater stability to the trapezoid-metacarpal joint compared with the more ulnar carpometacarpal joints. We report a case of trapezoid dislocation, emphasizing the radiographic features essential for diagnosis and the fixation strategy used for management. A 50-year-old woman sustained a sliding fall while riding a scooter, resulting in a trapezoid dislocation from the carpometacarpal joint accompanied by a fracture at the base of the right third metacarpal. The injury was managed with retrograde intramedullary K-wire transfixation of the second metacarpal-trapezoid joint combined with a spanning plate across the thrid metacarpal-capitate joint. The spanning plate maintained the length of the third metacarpal relative to the capitate, thereby indirectly restoring the anatomical alignment of the second metacarpal and stabilizing the reduced trapezoid. The retrograde intramedullary K-wire was easily positioned so that its tip did not extend beyond the trapezoid, thus preventing potential irritation of surrounding vital structures that might result from an obliquely placed K-wire. The 'missing carpal sign' serves as an important radiographic clue suggestive of trapezoid dislocation. Given the strong surrounding interosseous ligaments, it is important to recognize the possible occurrence of trapezoid dislocation in association with fractures or dislocations involving structures adjacent to the trapezoid. We present a retrograde intramedullary K-wire fixation technique for stabilizing the trapezoid-metacarpal joint, which can be easily and effectively applied after anatomical reduction of the trapezoid.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2594249"},"PeriodicalIF":0.6,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond excision: modern plastic surgery techniques for hidradenitis suppurativa reconstruction.","authors":"Ruben Sanchez Eligio, Christopher J Salgado","doi":"10.1080/23320885.2025.2583879","DOIUrl":"10.1080/23320885.2025.2583879","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent abscesses, sinus tract formation and extensive scarring. In severe cases, surgical excision and complex reconstruction are often required. This case report aims to highlight the role of modern plastic surgical techniques, including regenerative technologies, in managing severe HS. A 37-year-old Hispanic male with a 17-year history of HS presented with extensive lesions involving the buttocks, groin, genitalia, thighs and perianal region. He underwent staged wide excisions totaling over 2,400 cm². Reconstruction included split-thickness skin grafts (STSG), NovoSorb^® BTM (Biodegradable Temporizing Matrix) and RECELL^® autologous skin cell suspension. Postoperative recovery was marked by successful graft take, wound healing and return to normal function, including physical activity and sexual function, by postoperative day 69. This case underscores both the complexity of managing stage III HS and the evolving role of regenerative technologies in improving outcomes. While wide local excision remains the cornerstone of treatment for extensive disease, adjunctive use of BTM and RECELL enhances dermal regeneration, reduces donor-site morbidity and optimizes aesthetic and functional results. These innovations reflect a shift in reconstructive strategy, emphasizing a more tailored, patient-centered approach. The integration of regenerative modalities such as Biodegradable Temporizing Matrix (BTM) and RECELL autologous cell suspension technology into contemporary plastic surgical reconstruction offers significant benefits in treating severe hidradenitis suppurativa. By complementing traditional excisional techniques, these technologies contribute to improved healing, minimized morbidity and restored function, aligning with the goals of modern, multidisciplinary HS management.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2583879"},"PeriodicalIF":0.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological allograft failure for humerus reconstruction: the 'strategic' vascularized fibula.","authors":"Alessia Pagnotta, Virginia Maria Formica, Stefano Gumina, Francesca Romana Grippaudo, Carmine Zoccali","doi":"10.1080/23320885.2025.2572833","DOIUrl":"10.1080/23320885.2025.2572833","url":null,"abstract":"<p><p>The allograft for humeral reconstruction is a widely used technique in oncology but complication rates are high and Free Vascularized Fibula Graft (FVFG) represents a \"strategic\" solution to preserve satisfactory upper limb function. We treated 3 cancer patients with allograft failures and FVFG was used to reconstruct complex humeral defects.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2572833"},"PeriodicalIF":0.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing soft tissue infection of the scalp and face.","authors":"Sakar Gupta, Pradeep K Attaluri, Jeffrey Larson, Ahmed M Afifi","doi":"10.1080/23320885.2025.2575330","DOIUrl":"10.1080/23320885.2025.2575330","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing soft tissue infections (NSTIs) are characterized by rapidly spreading, life-threatening infections with widespread soft tissue necrosis that most commonly infect the extremities, torso, and perineum. Although rare, NSTIs of the head and neck are particularly dangerous given the complex anatomy surrounding the region and demand early diagnosis, antibiotic administration, and surgical debridement.</p><p><strong>Case presentation: </strong>We report a case of a 64-year-old male who presented with a NSTI of the scalp and face after sustaining a laceration to the posterior scalp. The patient initially presented at his local emergency department with subtle and nonspecific clinical signs and unrevealing imaging, which represented a diagnostic challenge for early intervention. Upon presentation to our facility's emergency department three days later, the patient had already started to develop severe sepsis and systemic involvement. As a result, despite intensive supportive care and surgical debridement, the patient's clinical course was complicated by multisystem organ failure and death.</p><p><strong>Discussion: </strong>Our case highlights the importance of maintaining a high clinical index of suspicion for NSTIs in patients with soft tissue infections of the head and neck, even when hallmark features are absent. Timeliness to intervention remains the single most important factor in determining survival.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2575330"},"PeriodicalIF":0.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior ulnar recurrent artery perforator flap for elbow reconstruction: a forearm-based propeller flap.","authors":"Jenaleen Law, Isobel Yeap, Bishoy Soliman, Tim Wang","doi":"10.1080/23320885.2025.2572842","DOIUrl":"10.1080/23320885.2025.2572842","url":null,"abstract":"<p><p>Soft tissue reconstruction around the elbow is challenging due to the need for durable yet pliable coverage that preserves joint mobility and function. We present the case of a 56-year-old gentleman with a chronic elbow wound secondary to osteomyelitis. Following debridement, the defect was reconstructed using a posterior ulnar recurrent artery perforator (PURAP) flap designed in a propeller style. Unlike previous reports that have described PURAP flaps based on arm perforators, this case uniquely utilised perforators arising from the forearm. This forearm-based approach offers several advantages, including reduced donor-site morbidity, and avoidance of dissection near the ulnar nerve. This case highlights the versatility and safety of the forearm-based PURAP flap for elbow reconstruction. <i>Level of evidence</i>: Level 5.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"12 1","pages":"2572842"},"PeriodicalIF":0.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}