Eplasty最新文献_第10页

Osteocutaneous Fibular Flap for Reconstruction of Composite Metacarpal Defects Due to Gunshot Wounds. 用于重建枪伤所致复合掌骨缺损的骨皮纤维瓣

Eplasty Pub Date : 2023-12-01 eCollection Date: 2023-01-01

Fatih Zor, Yalcin Bayram, Yalcin Kulahci

{"title":"Osteocutaneous Fibular Flap for Reconstruction of Composite Metacarpal Defects Due to Gunshot Wounds.","authors":"Fatih Zor, Yalcin Bayram, Yalcin Kulahci","doi":"","DOIUrl":"","url":null,"abstract":"Background: Gunshot wounds of the hand are challenging, as these injuries include bones, tendons neurovascular structures, and soft tissue. The osteocutaneous fibula flap has shown to be an excellent option for treating the composite defects, including bone and soft tissue. In this study, reconstructions of gunshot injuries of the metacarpal bones with a fibular flap are presented.Methods: Six patients with gunshot injuries to the hand were treated with free fibula flap. All patients had composite defects reconstructed with osteocutaneous fibula flap. Because of the size mismatch between fibula and metacarpal bone, a longitudinally split fibula was used in 2 patients. In 1 patient, the flap was used in a double-barrel fashion to reconstruct 2 metacarpal bone losses. Tendon repairs were performed either primarily or with tendon graft. All patients received hand rehabilitation. Hand function of the patients was evaluated by grip and pinch strength tests and Jebsen hand function test.Results: All flaps survived with no major postoperative complications. The mean follow-up period was 18 months. Web releasing and an arthrodesis procedure was performed in 1 patient, and tenolysis was performed in 2 others. All flaps adapted well to the recipient area. With respect to routine daily activities, overall hand function measured by grip and pinch strength tests and Jebsen hand function test was considered satisfactory in all patients.Conclusions: The fibular flap is a good alternative for reconstruction of the injured hand with composite defects, including metacarpal bone and soft tissue. It can be used longitudinally or transversely. Osteotomies can be performed to obtain split fibular flap or double-barrel fibular flap according to the bone defect.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e71"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479712","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}

引用次数: 0

Life-Threatening Bleeding Following Penile Inversion Vaginoplasty: Case Analysis and Practice Improvement. 阴茎内翻阴道成形术后危及生命的出血：病例分析与实践改进。

Eplasty Pub Date : 2023-12-01 eCollection Date: 2023-01-01

Rishub K Das, Patrick E Assi, Salam Al Kassis

{"title":"Life-Threatening Bleeding Following Penile Inversion Vaginoplasty: Case Analysis and Practice Improvement.","authors":"Rishub K Das, Patrick E Assi, Salam Al Kassis","doi":"","DOIUrl":"","url":null,"abstract":"Background: Gender-affirming surgery is a medically necessary treatment for transgender and gender diverse patients experiencing gender dysphoria. Preliminary data demonstrate an association between gender-affirming surgery and improved mental health outcomes. Penile inversion vaginoplasty is the most frequently performed feminizing bottom surgery in transwomen. Importantly, complications associated with penile inversion vaginoplasty are not uncommon and can be life-threatening. Surgeons and other members of the health care team must be aware of these potential harms. However, there is a paucity of high-quality evidence reported in the literature about the management and breadth of complications regarding feminizing bottom surgery.Case: A healthy 37-year-old woman who was assigned male at birth underwent gender-affirming orchiectomy, penile inversion vaginoplasty, and vulvar reconstruction. During routine vaginal packing removal in the postoperative period, there was an acute arterial bleed in the neovaginal canal, and hemostasis was achieved in the operating room.Conclusions: We review the associated periprostatic anatomy and describe several practice improvements to mitigate postoperative complications.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e72"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479696","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}

引用次数: 0

Breast Paraffinoma: A Case Report of 20-Year-Old Mineral Oil Injection in a Male Patient. 乳腺石蜡瘤：一名男性患者 20 年前注射矿物油的病例报告。

Eplasty Pub Date : 2023-11-13 eCollection Date: 2023-01-01

Bilal Koussayer, Sarah Moffitt, Meredith G Moore, Amra Kuc, Jake Laun

{"title":"Breast Paraffinoma: A Case Report of 20-Year-Old Mineral Oil Injection in a Male Patient.","authors":"Bilal Koussayer, Sarah Moffitt, Meredith G Moore, Amra Kuc, Jake Laun","doi":"","DOIUrl":"","url":null,"abstract":"Background: Mineral oil injection represents a dated practice of rapid and inexpensive breast augmentation. After a latency period, surrounding tissue becomes inflamed and fibrotic. Breast paraffinoma is well-documented in women; however, only 3 cases of such masses in male patients exist in the literature.Methods: We present a case of paraffinoma in a 63-year-old man from Puerto Rico who, desiring breasts, serially injected mineral oil into each breast daily for 13 years. Conservative management was initially attempted due to cardiac comorbidities and insurance authorization issues. The patient ultimately developed erosive wounds and therefore underwent excision of the bilateral breast masses as an en bloc specimen weighing 2.17 kg.Results: Pathology indicated sclerosing lipogranulomatosis (paraffinoma). The quality of the wounds remaining warranted negative pressure wound therapy with serial debridement. The patient went on to successful reconstruction with a reverse abdominoplasty preserving periumbilical and intercostal perforators.Conclusions: Plastic surgeons must educate patients against using exogenous injected materials for augmentation of the breasts, penis, or buttocks. Although uncommon in the US, certain populations like body builders and foreign immigrants are at higher risk for current or prior injection practices. Reverse abdominoplasty is a viable reconstructive modality for the large resulting defect.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e70"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479689","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}

引用次数: 0

Diagnosis and Management of a 4-Year-Old Male with Ulnar Artery Pseudoaneurysm. 一名 4 岁男性 Ulnar 动脉假性动脉瘤患者的诊断和治疗。

Eplasty Pub Date : 2023-11-13 eCollection Date: 2023-01-01

Nicolas Artz, Harel Scwartzberg, Aran Yoo, Matthew Cable, Charles Tuggle

{"title":"Diagnosis and Management of a 4-Year-Old Male with Ulnar Artery Pseudoaneurysm.","authors":"Nicolas Artz, Harel Scwartzberg, Aran Yoo, Matthew Cable, Charles Tuggle","doi":"","DOIUrl":"","url":null,"abstract":"Background: Pseudoaneurysms are a rare vascular phenomenon caused by an intimal tear leading to hemorrhaging into surrounding tissue. Upper extremity pseudoaneurysms are well documented in adult patients and are attributed to repetitive trauma. Pediatric pseudoaneurysms are rare and are frequently misdiagnosed, which could lead to serious complications.Methods: This report presents the case of a 4-year-old male patient with an ulnar pseudoaneurysm of the right upper extremity. The pseudoaneurysm was diagnosed by ultrasound and computed tomography angiography and subsequently resected. The ulnar artery was reconstructed with an arterial graft using the descending branch of the lateral circumflex femoral artery. Patency of the end-to-end anastomosis was confirmed by strip testing and Allen's test.Conclusions: The aim of this report is to provide a background of upper extremity pseudoaneurysms and describe their rare occurrence in pediatric patients and potential for complications upon misdiagnosis. Additionally, this report aims to highlight an alternative approach to management of pediatric pseudoaneurysms and advocate for reconstruction of the affected artery regardless of collateral flow being established.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e69"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479690","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}

引用次数: 0

Patient-Reported Mental Health Outcomes After Single-Digit Non-thumb Traumatic Amputation in Adults. 成人单数非拇指外伤性截肢后患者自述的心理健康结果。

Eplasty Pub Date : 2023-11-10 eCollection Date: 2023-01-01

Carrie L Roth Bettlach, Rachel Skladman, Ella Gibson, John M Daines, Emma R Payne, Linh N Vuong, Corrine M Merrill, Mitchell A Pet

{"title":"Patient-Reported Mental Health Outcomes After Single-Digit Non-thumb Traumatic Amputation in Adults.","authors":"Carrie L Roth Bettlach, Rachel Skladman, Ella Gibson, John M Daines, Emma R Payne, Linh N Vuong, Corrine M Merrill, Mitchell A Pet","doi":"","DOIUrl":"","url":null,"abstract":"Background: Though traumatic digital amputations are common, outcomes data are scarce. The FRANCHISE study clarified functional outcomes after digital amputation, but little information is available regarding mental health outcomes. The aims of this study were to document patient-reported mental health outcomes after traumatic digital amputation, elucidate the relationship between mental health and functional outcomes, and determine which patient/injury attributes conferred risk of unfavorable mental health outcomes.Methods: This was a descriptive, retrospective study of 77 patients with history of single digit, non-thumb traumatic amputation. Eligible patients completed Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity, Pain Interference, Anger, Anxiety, and Depression computer adaptive tests, and a short questionnaire recorded handedness, demographics, and worker's compensation status.Results: Correlation across the 3 PROMIS mental health domains (Anger, Anxiety, Depression) was uniformly strong and statistically significant. Correlation between the PROMIS mental health and functional (Upper Extremity and Pain Interference) scores was statistically significant but much weaker. Multivariable analysis revealed younger age and a worker's compensation claim had independent statistically significant predictive value for worse PROMIS Anger, Anxiety, and Depression scores. Female sex was also found to independently predict PROMIS Anxiety.Conclusions: By identifying patients at increased risk for feelings of anger, anxiety, and depression after digital amputation, anticipatory counseling can be provided. Anger, anxiety, and depression are very likely to coexist in the same patient; when responding to a patient who exhibits 1 element of this triad, the surgeon should be aware that the other 2 elements are likely to be present, even if not obvious.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e67"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479713","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}

引用次数: 0

The "Domino Flaps" Concept: Functional Composite Reconstruction for Traumatic Transmetacarpal Thumb Amputation. 多米诺皮瓣 "概念：外伤性经掌拇指截肢的功能性复合重建。

Eplasty Pub Date : 2023-11-10 eCollection Date: 2023-01-01

Dajiang Song, Georgios Pafitanis, Yonghui Sheng, Danny Kazzazi, Fawz Kazzazi, Zhenglin Chi, Guang Feng

引用次数: 0

Alkali Burns of the Skin. 皮肤碱烧伤。

Eplasty Pub Date : 2023-11-10 eCollection Date: 2023-01-01

Stephen M Milner

引用次数: 0

Vascularized Sural Nerve Graft, Fascial Free Flap, and Regenerative Peripheral Nerve Interface in the Setting of Recurrent Thigh Liposarcoma: A Case Report. 带血管腓肠神经移植物、筋膜游离皮瓣及再生周围神经界面治疗复发性大腿脂肪肉瘤1例。

Eplasty Pub Date : 2023-10-31 eCollection Date: 2023-01-01

Zachary A Koenig, William Blanks, H James Williams, Jack J Gelman

{"title":"Vascularized Sural Nerve Graft, Fascial Free Flap, and Regenerative Peripheral Nerve Interface in the Setting of Recurrent Thigh Liposarcoma: A Case Report.","authors":"Zachary A Koenig, William Blanks, H James Williams, Jack J Gelman","doi":"","DOIUrl":"","url":null,"abstract":"Background: There is no clear consensus in the literature regarding clinical indications for vascularized nerve grafts. Most studies indicate that vascularized nerve grafting, rather than non-vascularized nerve grafting, is indicated for nerve gaps of greater than 7 cm. Vascularized nerve grafts are superior to non-vascularized nerve grafts because they possess an independent blood supply. However, not all nerve injuries can be repaired via vascularized nerve grafts.Methods: A 32-year-old female received a fascial free flap and vascularized sural nerve graft after having multiple reresections of a recurrent thigh liposarcoma.Results: A 25-cm segment of the sural nerve was isolated alongside the lesser saphenous vein and intervening fascia. The free fascial flap was subsequently reversed and placed into the thigh. Vascular anastomoses were created, and the sural nerve was anastomosed to the peroneal nerve. A small portion of muscle from the thigh was wrapped around tibial nerve fascicles of the sciatic nerve to create a regenerative nerve interface.Conclusions: Benefits of vascularized sural nerve graft compared with other vascularized nerve grafts include negligible sensory loss at the donor site and a nerve graft that can be designed on itself due to its vast length. Additionally, vascularized sural nerve grafts provided a better rate of axonal regeneration, rate of electromyographic return, and motor and sensory outcome compared with non-vascularized sural nerve grafts.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e62"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479846","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}

引用次数: 0

Biomechanical Evaluation of Additional Surgical Maneuvers to Improve Symmetry in Performing Nuss Procedure for Asymmetric Pectus Excavatum. 对不对称漏斗胸进行Nuss手术以改善对称性的其他手术手法的生物力学评价。

Eplasty Pub Date : 2023-10-31 eCollection Date: 2023-01-01

Tomohisa Nagasao, Tomoki Miyanagi, LinXuan Wu, Mio Akaike, Atsushi Hosokawa, Yoshiaki Sakamoto

{"title":"Biomechanical Evaluation of Additional Surgical Maneuvers to Improve Symmetry in Performing Nuss Procedure for Asymmetric Pectus Excavatum.","authors":"Tomohisa Nagasao, Tomoki Miyanagi, LinXuan Wu, Mio Akaike, Atsushi Hosokawa, Yoshiaki Sakamoto","doi":"","DOIUrl":"","url":null,"abstract":"Background: Severing part of the thorax prior to bar placement is effective to improve outcomes in performing the Nuss procedure for asymmetric pectus excavatum. This study aims to elucidate the patterns of severing to provide an ideal outcome.Methods: Three-dimensional biomechanical computer models were produced simulating the thoraxes of 10 actual patients with asymmetric pectus excavatum. Virtual surgical operation was performed on the 10 models in 4 patterns: group 1-no part of the thorax was severed (default group). Group 2-The sternum was severed (sternum-severing group). Group 3-The ribs on the affected side were severed (rib-severing group). Group 4-Both the sternum and ribs on the affected side were severed (sternum/rib-severing group). After performing this preparation, simulation of bar placement was performed. Comparing the pre- and postoperative shapes of the models, we examined whether symmetry improved for each group.Results: Symmetry of the chest wall improved for rib-severing group and sternum/rib-severing group. Asymmetry remained for default group and sternum-severing group.Conclusions: Performance of the Nuss procedure for asymmetric pectus excavatum does not greatly improve symmetry of the chest wall. Severing the ribs as an additional maneuver is effective to improve symmetry.","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"23 ","pages":"e65"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479882","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}

引用次数: 0

Utility of Ultrasound in Performing a Reverse Allen's Test in Patients At Risk for Radial Artery Occlusion. 超声波在对有桡动脉闭塞风险的患者进行反向阿伦氏试验中的实用性。

Eplasty Pub Date : 2023-10-02 eCollection Date: 2023-01-01

David T Cheng, Pramod K Chetty, Kevin B Gerold

引用次数: 0