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Rotation flap

Tian Meng, Hai-Lin Zhang, Xiao Long, Xiao-Jun Wang
RATIONALE: A significant clinical issue for treating patients with large upper lip defects is how to reconstruct the lip functionally and aesthetically. Traditional methods usually lead to asymmetry of the nasal base, philtrum and the lips. PATIENT CONCERNS: A 22-year-old lady presented with a large congenital nevus on her upper lip which involved the cutaneous, vermilion, and the philtrum. Secondary deformity caused by previous partial excisions was also identified...
March 2018: Medicine (Baltimore)
Chi S Yoon, Chang G Kim, Hoon Kim, Kyu N Kim
This study aimed to present a simple, fast, and safe technique, called freestyle perforator-based peninsular flap (FPBPF), for pressure sore reconstruction.Among the 21 patients who underwent pressure sore reconstruction between May 2013 and October 2016, 12 patients (Group A) and 9 patients (Group B) were subjected to perforator-based island flap (PBIF) and FPBPF, respectively. We retrospectively reviewed and statistically analyzed the data of both groups.All flaps completely survived in both groups. No significant differences were found in patient demographics, complications, hospital stay, and follow-up period...
March 2018: Medicine (Baltimore)
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
Selam Yekta Sendul, Burcu Dirim, Cemile Ucgul Atılgan, Mehmet Demir, Ali Olgun, Semra Tiryaki Demir, Saniye Uke Uzun, Gurcan Dogukan Arsalan, Dilek Guven
PURPOSE: This study aimed to share the results of patients who underwent anterior tarsal flap rotation combined with anterior lamellar reposition because of cicatricial upper eyelid entropion, and to determine the effectiveness and reliability of this surgical technique. METHODS: Fifteen eyes of 11 patients (2 right eyes; 5 left eyes; and 4 bilateral eyes) on whom we performed anterior tarsal flap rotation surgery combined with anterior lamellar reposition because of cicatricial entropion were included in this study...
January 2018: Arquivos Brasileiros de Oftalmologia
Saul N Rajak, Shyamala C Huilgol, Masahiro Murakami, Dinesh Selva
PURPOSE: Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. METHODS: This is a retrospective review of the clinical case notes of eight patients that underwent tumour excision with reconstruction with a cutaneous propeller flap supplied by a non-perforator orbicularis pedicle between July and December 2016...
March 14, 2018: Eye
Talha Maqbool, Adam Binhammer, Paul Binhammer, Oleh M Antonyshyn
PURPOSE: Titanium mesh is used to reconstruct the neurocranium in cranioplasties. Though it is generally well-tolerated, erosion of the overlying soft tissue with exposure of the implant is a complication that adversely affects patient outcomes. The purpose of this study is to investigate potential risk factors for titanium mesh exposure. METHODS: This study comprises all consecutive patients who underwent titanium mesh cranioplasty between January 2000 and July 2016...
March 12, 2018: Journal of Craniofacial Surgery
Cimara Fortes Ferreira, Edival Barreto de Magalhães Junior, Barbara Zini
Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert class III with mal-aligned implants in the esthetic zone resolved with a cost-modified treatment plan to re-establish esthetics in the anterior maxilla using rotated palatal flap...
March 8, 2018: Journal of Oral Implantology
Carolina Posso, David Delgado Anaya, Jeison Aguilar Henao, Juan M Velasquez Gaviria
PURPOSE: The previous cadaveric studies of facial artery perforators have frequently reported high variability, and those results remain to be validated in the Colombian population. Thus, we aimed to describe the vascular anatomy of the lateral nasal artery cutaneous branches and their clinical applications using Colombian cadavers. MATERIALS AND METHODS: Nine hemifaces from six fresh cadavers were included in the study. Terminal branches of the facial artery and cutaneous perforators of the lateral nasal artery were dissected...
February 26, 2018: Journal of Surgical Oncology
Satoshi Usami, Kohei Inami, Yuichi Hirase
BACKGROUND: Reconstruction of the finger and thumb dorsum has been considered difficult because of the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps. METHODS: Thirty-two finger dorsum defects in 32 patients were covered with pedicled free-style perforator flaps...
February 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Christopher J Dy, Benjamin Aunins, David M Brogan
The physiological limitations of neural regeneration make peripheral nerve surgery challenging to both the surgeon and the patient. Presence of nerve gaps and local wound factors may all influence outcome, suggesting that barriers to reduce perineural scarring, minimize fibrosis, and avoid ischemia would be beneficial. To examine the evidence supporting their use, we reviewed the autologous and commercially-available options for barriers against scarring around a nerve. Numerous clinical case series demonstrated the effectiveness and safety of local/rotational flaps and autologous vein wrapping when used in the presence of recurrent compressive neuropathy...
February 24, 2018: Journal of Hand Surgery
Elisabetta A Matsumoto, Haiyi Liang, L Mahadevan
Reconstructive surgeries often use topological manipulation of tissue to minimize postoperative scarring. The most common version of this, Z-plasty, involves modifying a straight line cut into a Z shape, followed by a rotational transposition of the resulting triangular pedicle flaps, and a final restitching of the wound. This locally reorients the anisotropic stress field and reduces the potential for scarring. We analyze the planar geometry and mechanics of the Z-plasty to quantify the rotation of the overall stress field and the local forces on the restitched cut using theory, simulations, and simple physical Z-plasty experiments with foam sheets that corroborate each other...
February 9, 2018: Physical Review Letters
S Lerch, D Stark, O Rühmann
OBJECTIVE: Snapping of the iliotibial band over the greater trochanter should be eliminated by reducing tension via lengthening, release, and incision of the iliotibial band. INDICATIONS: Positive clinical examination and painful snapping of the iliotibial band over the greater trochanter, despite extensive conservative treatments, for over 6 months. CONTRAINDICATIONS: Weakness of the abductor muscles with positive Trendelenburg sign. SURGICAL TECHNIQUE: Direct approach to the iliotibial tract...
February 22, 2018: Operative Orthopädie und Traumatologie
Christopher Matthew Kroninger
Interest in biological locomotion and what advantages the principles governing it might offer in the design of manmade vehicles prompts one to consider the power requirements of flapping relative to rotary propulsion. The amount of work performed on the fluid surrounding a thrusting surface (wing or blade) is reflected in the kinetic energy of the wake. Consideration of the energy in the wake is sufficient to define absolute minimum limitations on the power requirement to generate a particular thrust. This work applies wake solutions to compare the minimum inviscid propulsive power requirement of wings flapping and in rotation at wing loading conditions reflective of hover through a state of lightly-loaded cruise...
February 20, 2018: Bioinspiration & Biomimetics
Rattan L Mittal
AIM/PURPOSE: Extreme congenital club foot deformities are common in developing countries, presenting at birth, persisting in children, adolescents and adults; as untreated/under-corrected by conservative and/or surgical means. Scores of confusing names exist in literature for such deformities with no good treatment available; mostly advocating unacceptable arthrodesis. The author researched this grey area for more than 40 years and successfully innovated improved surgical corrections, more acceptable to patients...
February 17, 2018: International Orthopaedics
Mahmoud Abdelnaby, Sameh Hany Emile, Mohamed El-Said, Ahmed AbdelMawla, Hesham Elgendy, Ahmed Sakr, Mostafa Shalaby
BACKGROUND: Sacrococcygeal pilonidal disease (SPND) is a common surgical condition with a multitude of surgical treatments. The aim of this study was to compare the outcome of modified Limberg flap (MLF) and that of rotational gluteal flap (RGF) in treatment of SPND. MATERIALS AND METHODS: This was a retrospective case-controlled study involving adult patients of both genders who were treated with either MLF or RGF for SPND. The main outcomes of the study were the recurrence of SPND, complications, operation time, hospital stay, time of healing, time to return to daily activities, and cosmetic outcomes...
March 2018: Journal of Surgical Research
Gao-Feng Li, Yi-Gao Hu, Wei Ding, Jun Tan, Xin Chen, Tao Luo, Bo Zhang, Xiao-Jia Liu
This article investigates an effective method with which to reconstruct the tragus and external auditory meatus for microtia reconstruction. The external ear was reconstructed using a delayed postauricular skin flap in patients with congenital microtia. After the first stage of delaying the postauricular skin flap and the second stage of otoplasty with ear framework fabricated from autogenous rib cartilage draping with the delayed skin flap, the third stage involved tragus and external auditory meatus canaloplasty...
February 12, 2018: Facial Plastic Surgery: FPS
James K Liu, Zachary S Mendelson, Gurkirat Kohli, Jean Anderson Eloy
BACKGROUND: Reconstruction of large anterior skull base (ASB) defects after an endoscopic endonasal transcribriform approach (EEA-TC) remains a challenge despite the advent of the vascularized pedicled nasoseptal flap (PNSF). OBJECTIVE: We describe a relaxing PNSF slit incision that extends the anterior and posterior reach of the PNSF to maximize tensionless flap coverage of transcribriform ASB defects. METHODS: A retrospective chart review was conducted on 20 consecutive patients who underwent EEA-TC and subsequent PNSF reconstruction with a relaxing slit incision...
February 5, 2018: World Neurosurgery
Marco Pappalardo, Vincent G Laurence, Yu-Te Lin
For painful, dysfunctional, posttraumatic metacarpophalangeal (MCP) joints, the free vascularized toe joint transfer may represent a good solution. Successful reconstruction is potentially limited, however, by 2 features of the traditional vascularized metatarsophalangeal (MTP) transfer: inadequate arc of flexion and insufficient soft tissue coverage. The solution to both of these dilemmas lies in the manner of utilizing the donor site. Because of its innate hyperextensibility, rotating the MTP 180° volar to dorsal provides the greatest arc of flexion in the reconstructed MCP...
February 2018: Journal of Hand Surgery
Barbara M Ling, Reto Wettstein, Daniel Staub, Dirk J Schaefer, Daniel F Kalbermatten
BACKGROUND: The gastrocnemius muscle flap may be considered the first choice in many cases of soft-tissue reconstruction about the knee. Limited arc of rotation and reach of the flap as well as unsightly muscle bulk are major disadvantages and were the impetus to look for a local alternative. The aim of this study is to present a consecutive series of patients with a reconstruction about the knee involving the medial sural artery perforator flap (MSAPF). METHODS: A consecutive series of 17 cases of defect reconstructions about the knee using the MSAPF is described, with an emphasis on early postoperative complications...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Mahmoud Messerer, Rodolfo Maduri, Roy Thomas Daniel
Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
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