{"title":"Case report: Hybrid reconstruction of quadriceps function after sarcoma resection using a reinnervated free flap and tendon transfer.","authors":"B Hoteit, A Delgove, D Adam, M Fau, A Michot","doi":"10.1016/j.anplas.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.08.006","url":null,"abstract":"<p><p>We describe a case of a leiomyosarcoma of the thigh, the resection of all the anterior muscular compartment, and the reanimation of knee extension, using a latissimus dorsi (LD) free flap and tendon transfer. Surgical technique and postoperative care management are described. Functional results, neuropathic pain, and range of motion (ROM) were assessed at 3 months and 12 months after discharge. A complete excision (R0) was carried out and rapid wound healing was obtained despite developing a seroma infection. The patient was able to walk without technical support nor limping at 3 months post-surgery. The patient was still in remission at 12 months follow-up, with Medical Research Council (MRC) scale assessed at 4/5 and ROM rated at 5-105°. In case of total quadriceps resection, knee extension reconstruction can be obtained with tendon transfers and reinnervated free muscular flaps. Combining these techniques could be a good strategy for rapid recovery, with optimal scarring and tissue coverage.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cartographie anatomique du nerf radial dans la région du coude pour son application aux transferts nerveux intraradiaux dans la chirurgie de la spasticité","authors":"","doi":"10.1016/j.anplas.2024.07.005","DOIUrl":"10.1016/j.anplas.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>La spasticité du membre supérieur est un défi chirurgical, tant dans la diminution de la spasticité des muscles agonistes que dans la réanimation des muscles antagonistes. Le muscle brachioradial (BR) est un muscle fréquemment impliqué dans la spasticité des fléchisseurs du coude. L’extension des doigts et du pouce est souvent déficitaire chez les patients présentant une spasticité du membre supérieur. Ce travail a pour but de démontrer la faisabilité du transfert d’une branche du BR sur le nerf interosseux postérieur (NIOP) dans le cadre des neurectomies du BR, et de cartographier les fascicules au sein du nerf radial au niveau du pli du coude pour faciliter le repérage du NIOP.</p></div><div><h3>Matériel et méthodes</h3><p>Dix avant-bras issus de 10 corps frais congelés ont été disséqués. Les branches motrices du BR, des extenseurs du poignet, du supinateur, le NIOP et la branche sensitive du nerf radial ont été identifiés. Le transfert de la branche du BR sur le NIOP a été réalisé et sa faisabilité étudiée (longueur du donneur, tension de la suture).</p></div><div><h3>Résultats</h3><p>Le transfert de la branche motrice du BR sur le NIOP était faisable dans 9 cas sur 10. La position de la branche sensitive du nerf radial était inférieure ou médiale dans tous les cas. La position du NIOP était latérale dans 90 % des cas.</p></div><div><h3>Conclusion</h3><p>Le transfert de la branche motrice du BR sur le NIOP semble faisable dans la plupart des cas. La prédominance d’une topographie d’émergence latérale du NIOP et inféromédiale de la branche sensitive au sein de notre échantillon nécessite d’être vérifiée sur un échantillon plus important, ce qui permettrait un meilleur repérage peropératoire lorsque la neurostimulation n’est pas possible.</p></div><div><h3>Niveau de preuve</h3><p>IV, étude anatomique de faisabilité.</p></div><div><h3>Introduction</h3><p>Upper limb spasticity is a surgical challenge, both in diminishing agonists spasticity and reconstructing antagonist function. Brachioradialis (BR) is often involved in elbow flexors spasticity. Finger extension is often impaired in spastic patients. This study aims to demonstrate the feasibility of BR motor branch to posterior interosseous nerve (PIN) during BR selective neurectomies, and to describe fascicles topography inside the radial nerve to facilitate PIN dissection.</p></div><div><h3>Material and method</h3><p>Ten upper limbs from 10 fresh frozen anatomical specimens were dissected. Motor branches to the BR, wrist extensors, supinator, PIN and radial sensory branch were identified. BR to PIN transfer was realized and its feasibility was studies (donor length, tensionless suture).</p></div><div><h3>Results</h3><p>BR to PIN transfer was achievable in 9 out of 10 cases. The position of the sensory branch of the radial nerve was inferior or medial in all cases. The position of the PIN was lateral in 90% of the cases.</p></div><div><h3>Conclusion</h3><p>BR to PIN ","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"La première chirurgie de reassignation sexuelle réussie : Magnus, Dora et l’institut de sexologie de Berlin en 1931","authors":"","doi":"10.1016/j.anplas.2024.06.003","DOIUrl":"10.1016/j.anplas.2024.06.003","url":null,"abstract":"<div><p>Magnus Hirschfeld fut un brillant médecin allemand militant pour la dépénalisation et la déstigmatisation de l’homosexualité. Pendant la très libérale République de Weimar (1918–1933) il publia ses articles avant-gardistes, il créa son Institut des sciences sexuelles (<em>Institut für Sexualwissenschaft)</em>, où eût lieu la première chirurgie transgenre publiée, réalisée sur Dora Richter en 1931 (nous nous intéresserons à ce premier compte rendu d’intervention réussie) et multiplia les interventions pour faire abolir le paragraphe 175 du code penal imperial, pénalisant « la sodomie ». Finalement la montée du nazisme l’obligea à fuir son pays et à finir sa vie en France. L’œuvre d’Hirschfeld resta inachevée. Son activisme politique, sa surmédiatisation lui valurent de nombreuses critiques au sein même du mouvement gay et lesbien de l’époque. Qui était cet étrange médecin (<em>l’Einstein du sexe</em>, comme le présentait un promoteur américain lors de ses conférences en 1930) qui cumulait les défauts, pour l’époque, d’être à la fois juif, homosexuel et gauchiste ?</p></div><div><p>Magnus Hirschfeld was a brilliant German doctor campaigning for the decriminalization and destigmatization of homosexuality. During the very liberal Weimar Republic (1918–1933) he published his avant-garde articles, he created his Institute of Sexual Sciences (Institut für Sexualwissenschaft), where the first published transgender surgery took place, performed on Dora Richter in 1931 (we will be interested in this first report of successful intervention) and multiplied the interventions to abolish paragraph 175, penalizing “sodomy”. Ultimately the rise of Nazism forced him to flee his country and end his life in France. Hirschfeld's work remained unfinished. His political activism and his over-media coverage earned him numerous criticisms even within the gay and lesbian movement of the time. Who was this strange doctor (the Einstein of sex, as an American promoter presented him during his conferences in 1930) who combined the faults, for the time, of being at the same time Jewish, homosexual and leftist?</p></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of perfusion device for free flap salvage after ischemia in swine","authors":"","doi":"10.1016/j.anplas.2024.07.004","DOIUrl":"10.1016/j.anplas.2024.07.004","url":null,"abstract":"<div><h3>Introduction</h3><p>In free flap reconstruction, improving flap tolerance to warm ischemia (WI) is fundamental. WI is the result of a venous or arterial thrombosis, which can only be addressed through surgical revision. No additional treatments have shown superior efficacy at salvaging free flaps after or during WI. Custom perfusion machines (PM), used to reduce the intensity of lesions of the flap stored in cold ischemia, have not been evaluated for WI flap salvage. This proof-of-concept study assessed whether the Lifeport® perfusion machine could improve the salvage procedure's success rates after one hour of venous WI.</p></div><div><h3>Methods</h3><p>Five different groups were evaluated with four porcine latissimus dorsi free flaps included in each group. Depending on the group, the flaps were subjected to one hour of WI followed by revascularization, static hypothermic submersion, or dynamic Lifeport® perfusion. Additionally, two flap perfusion liquids were evaluated: KPS-1® and IGL-1®. Biopsies were performed before <em>in vivo</em> warm ischemia of the flap, after <em>in vivo</em> warm ischemia of the flap, and after one and two hours of preservation. Interstitial edema, muscular cell size and muscular diffuse necrosis were quantified by histological assessment.</p></div><div><h3>Results</h3><p>Static submersion did not demonstrate any efficacy for venous flap salvage. Dynamic perfusion on Lifeport® machine showed a significant improvement in tissue parameters. Thrombi and fibrine, present during the WI period, were no longer visible inside vessels and the perfusion machine flow evacuated the inflammatory cells and their substrates from the flap. The flap weights did not increase during perfusion time, confirming the benefits of the Lifeport® perfusion machine.</p></div><div><h3>Conclusion</h3><p>Evaluating Lifeport® advantages on human free flap salvage is necessary to confirm the benefits for the tissue and to increase post-operative results after congestive free flap revision surgery.</p></div><div><h3>Introduction</h3><p>Dans la reconstruction par lambeau libre, améliorer la tolérance du lambeau à l’ischémie chaude (WI) est fondamental. L’ischémie chaude est le résultat d’une thrombose veineuse ou artérielle qui ne peut être traitée que par révision chirurgicale. Aucun traitement supplémentaire n’a montré une efficacité supérieure pour sauver les lambeaux libres après ou pendant l’ischémie chaude. Les machines de perfusion sur mesure (PM), utilisées pour réduire l’intensité des lésions du lambeau conservé en ischémie froide, n’ont pas été évaluées pour le sauvetage des lambeaux après ischémie chaude. Cette étude de preuve de concept a évalué si la machine de perfusion Lifeport® pourrait améliorer les taux de succès de la procédure de sauvetage après une heure d’ischémie veineuse.</p></div><div><h3>Méthodes</h3><p>Cinq groupes différents ont été évalués avec quatre lambeaux libres porcins inclus dans chaque groupe. Selon le gro","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparaison de la durée d’allaitement maternel chez les femmes avant et après mammoplastie de réduction","authors":"","doi":"10.1016/j.anplas.2024.06.013","DOIUrl":"10.1016/j.anplas.2024.06.013","url":null,"abstract":"<div><h3>Contexte</h3><p>La mammoplastie de réduction concerne en grande partie des femmes en âge de procréer et peut théoriquement interférer avec les capacités d’allaitement maternel (AM), alors que les bénéfices de l’AM ont bien été démontrés. Les données actuelles de la littérature ne permettent pas de fournir une information précise sur les possibilités d’AM après mammoplastie de réduction.</p></div><div><h3>Objectif</h3><p>L’objectif de cette étude est d’évaluer la capacité d’AM sur le long terme chez les femmes après mammoplastie de réduction réalisée dans le service de chirurgie plastique de l’hôpital Saint-Louis (AP-HP).</p></div><div><h3>Matériels et méthodes</h3><p>Il s’agit d’une étude rétrospective, comparative, concernant des patientes ayant bénéficié d’une mammoplastie de réduction à l’hôpital Saint Louis entre 2010 et 2017 et ayant eu des enfants avant ou après chirurgie. Les données concernant l’intervention ont été recueillies dans le dossier médical, et la capacité à allaiter a été évaluée à l’aide d’un questionnaire standardisé lors d’un entretien téléphonique. L’allaitement des enfants nés avant chirurgie a été comparé à l’allaitement des enfants nés après chirurgie.</p></div><div><h3>Résultats</h3><p>Nous avons analysé l’AM sur 21 naissances avant chirurgie et 35 naissances après chirurgie. Le taux d’initiation à l’AM était similaire entre les deux groups (83 % vs 90 %, <em>p</em> <!-->=<!--> <!-->0,7), la durée médiane d’AM était significativement réduite après chirurgie (10 semaines vs 3 semaines, <em>p</em> <!--><<!--> <!-->0,01), ainsi que le taux d’enfants allaités à 3 mois (43 % vs 11 %, <em>p</em> <!--><<!--> <!-->0,01). Le taux d’utilisation de préparations infantiles était plus élevé après chirurgie (74 % vs 100 %, <em>p</em> <!--><<!--> <!-->0,01), ainsi que le taux d’arrêt d’allaitement pour cause d’hypogalactie (11 % vs 69 %, <em>p</em> <!--><<!--> <!-->0,001)</p></div><div><h3>Conclusion</h3><p>L’allaitement après mammoplastie de réduction est possible, mais plus difficile à maintenir sur le long terme. Les patientes doivent en être informées avant la chirurgie, et celles qui souhaitent allaiter après la chirurgie doivent y être encouragées à la maternité.</p></div><div><h3>Background</h3><p>Breast reduction surgery often concern women of childbearing age. However, it can interfere with the ability to breastfeed, whereas the benefits of breastfeeding are well known. Current data in the literature do not provide precise information on the possibilities of breastfeeding after breast reduction surgery.</p></div><div><h3>Objectives</h3><p>The aim of this study was to assess long-term breastfeeding ability of women after breast reduction performed in our centre.</p></div><div><h3>Methods</h3><p>This is a retrospective comparative study including patients treated with breast reduction at Saint-Louis Hospital between 2010 and 2017 and who have had children before or after surgery. Operative details were ret","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Reconstruction of eyebrows by follicular transplantation].","authors":"E Bouhanna","doi":"10.1016/j.anplas.2024.06.018","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.06.018","url":null,"abstract":"<p><p>The eyebrow is an aesthetic unit playing an important role in the balance and expression of the face. It consists of hairs whose different orientations make its complexity. The main causes of eyebrow alopecia are repeated eyebrow plucking, reduced density due to age, and post-traumatic alopecia. Follicular transplantation is a simple surgical technique that corrects most cases of eyebrow alopecia. This involves implanting hair follicles, taken from the scalp or, more rarely, from a hairy region of the body, into the bare or sparse area of the eyebrow.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Forehead in craniosynostoses].","authors":"E Arnaud, R H Khonsari, S James, G Paternoster","doi":"10.1016/j.anplas.2024.06.027","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.06.027","url":null,"abstract":"<p><p>The forehead is the cranial part of the forehead, and represents an important component of facial esthetics. The deformations linked to craniosynostoses are characterized by modifications in height, width, and angulation. Their surgical correction during childhood is based on well-established techniques of remodeling using resorbable osteosynthesis. Today, distraction and springs allow less invasive procedures with good outcomes. Sequellae mainly correspond to hypotrophies of the temporal region, corrected with fat grafting. The presence of a mutation increases the risk of reoperation in the first six years of life.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Frontotemporal volumetry to rejuvenate and re-feminize the face].","authors":"Patrick Bui","doi":"10.1016/j.anplas.2024.06.016","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.06.016","url":null,"abstract":"<p><p>The author became interested in facial volume in the 1990s, during the period when he oversaw the feminization of the facial skeleton to improve the social integration of male transsexual patients. At that time, it was skeletal surgery. Very quickly, these techniques were extended to genetic women who wanted a more feminine face. The study of facial aging allowed the author to define criteria for frontotemporal aging, particularly an evolution with age towards a frontotemporal masculinization. The volumetric frontotemporal correction has thus become an essential element of facial rejuvenation. The evolution then, naturally took place towards the concept of frontotemporal beauty.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790054","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}
I L Labrot-Moreno, L Capitán, D Simon, F Capitán-Cañadas
{"title":"[Advanced Surgical Techniques in Forehead Feminization and Hairline Redefinition].","authors":"I L Labrot-Moreno, L Capitán, D Simon, F Capitán-Cañadas","doi":"10.1016/j.anplas.2024.06.014","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.06.014","url":null,"abstract":"<p><p>Facial Gender-Affirming Surgery (FGAS) has emerged as a transformative option for individuals who wish to align their external appearance with their asserted gender identity. This article delves into the surgical techniques employed in forehead feminization and hairline redefinition, highlighting the nuanced approaches used to modify specific facial characteristics to achieve the desired feminizing outcomes. Our extensive experience, encompassing over 2300 forehead feminization surgeries conducted over the past 16 years, provides a robust foundation for understanding the complexities and intricacies of these procedures. This knowledge is crucial for maxillofacial and plastic surgeons, as well as other healthcare professionals involved in comprehensive gender-affirming care, ensuring they are well-equipped to deliver optimal results for their patients.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[The MASK lift].","authors":"C Jamin, B Laure","doi":"10.1016/j.anplas.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.07.003","url":null,"abstract":"<p><p>The MASK lift or subperiosteal lift of the upper and middle thirds of the face is a procedure that can be performed alone for aesthetic purposes, but can also be combined with reconstructive surgery of this region to improve the result. This procedure will enable the overall result to be enhanced in the management of complex pathologies. The aim of this article is to present the MASK lift surgical technique in detail, to explain its indications and to show that this surgical technique still has a place in our practice.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768060","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}