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https://www.readbyqxmd.com/read/28642191/new-aspects-in-free-flap-surgery-mini-perforator-flaps-and-extracorporeal-flap-perfusion
#1
Klaus-Dietrich Wolff
BACKGROUND: The scope of microvascular tissue transfer in the Head and Neck reaches from coverage of simple soft tissue defects to complex 3-D reconstructions using multiple or chimeric flaps. This paper summarises the presentation given at the Congress of the French Society of Oral and Maxillofacial Surgery in Marseille 2017. It was the aim of our work to add further elements to this wide spectrum of reconstructive possibilities. METHODS: For patients with small intraoral soft tissue defects in whom the use of a radial forearm flap would not be justified because of its donor site morbidity, but who nevertheless would take a benefit from a small free flap, we used mini-perforator flaps from the lower leg...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28582297/loco-regional-control-with-complete-resection-and-tongue-reconstruction-on-the-malignant-melanoma-in-the-tongue
#2
Tuqa Alkaff, Woo Shik Jeong, Soon Yuhl Nam, Jong Woo Choi
Primary malignant melanoma in the tongue is very uncommon disease that is considered low in comparison to cutaneous melanoma. In this report, the authors described a case of the hemitongue reconstruction with fasciocutaneous free flap on the patient who suffered from the malignant melanoma primarily originating from the base of the tongue that was treated with surgery and radiotherapy but developed a lung metastasis. A 76-year-old man was referred to the otorhinolaryngology clinic after complaining of a painful mass present for 3 months on the right side of the tongue...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28571928/free-tissue-flaps-in-head-and-neck-reconstruction-clinical-application-and-analysis-of-93-patients-of-a-single-institution
#3
Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
INTRODUCTION: Reconstruction with a free flap is routine in head and neck surgery because of better functional outcomes, improved esthetics, and generally higher success rates. OBJECTIVE: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions. METHODS: This was a retrospective study of 93 patients undergoing reconstructions with free flaps from 2007 to 2015. Four types of free flap were performed: Anterolateral Thigh (76...
May 13, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28567151/trends-in-management-of-radial-head-and-olecranon-fractures
#4
Matthew Motisi, Jennifer Kurowicki, Derek D Berglund, Jacob J Triplet, Shanell Disla, Timothy Niedzielak, Jonathan C Levy
BACKGROUND: Advancement in surgical techniques and implants has improved the ability to manage radial head and olecranon fractures. However, trends in management of these fractures are largely unstudied. OBJECTIVE: This purpose of this study is to evaluate management trends for these common fractures. METHODS: A retrospective review of a comprehensive Humana database was performed using Pearl Diver supercomputer (Warsaw, IN, USA) for radial head and neck (RHNF) and olecranon fractures (OF) between 2007 and 2014...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28538066/radial-forearm-osteocutaneous-free-flap-for-reconstruction-of-hard-palate-with-alveolar-defect
#5
Euicheol C Jeong, Sehoon Yoon, Young Ho Jung
The radial forearm free flap is beneficial for reconstruction of large palatal defect with oronasal fistula.A 51-year-old male patient who had anterior palate defect including alveolus after the radiation therapy of malignant cancer on the nasopharyngeal area undertook the radial forearm osteocutaneous free flap to close the oronasal fisula and restore the alveolar arch. The small radial bone segment was fixed in the alveolar defect and vascular anastomoses were performed with facial vessels in neck. The donor site was closed with split thickness skin graft...
May 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#6
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28531321/cortical-bone-size-deficit-in-adult-patients-with-type-1-diabetes-mellitus
#7
Charlotte Verroken, Wout Pieters, Loïc Beddeleem, Stefan Goemaere, Hans-Georg Zmierczak, Samyah Shadid, Jean-Marc Kaufman, Bruno Lapauw
CONTEXT: The increased fracture risk associated with type 1 diabetes mellitus (T1DM) remains unexplained by traditional risk factors such as low areal bone mineral density (aBMD). Nonetheless, few data exist on other determinants of bone strength in T1DM, including volumetric BMD (vBMD) and bone geometry. OBJECTIVE: We compared areal and volumetric bone parameters and cortical bone geometry in adult T1DM patients and gender- and age-matched controls. DESIGN: Cross-sectional study including 64 adult T1DM patients (38 men, 41...
May 22, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28509822/fracture-prevention-in-the-orthopaedic-environment-outcomes-of-a-coordinator-based-fracture-liaison-service
#8
Earl R Bogoch, Victoria Elliot-Gibson, Dorcas Beaton, Joanna Sale, Robert G Josse
BACKGROUND: Fracture liaison services focus on secondary fracture prevention by identifying patients at risk for future fracture and initiating appropriate evaluation, risk assessment, education, and therapeutic intervention. This study describes key clinical outcomes including bone mineral densitometry, physician assessment, and pharmacotherapy initiation in pharmacotherapy-naïve patients undergoing treatment for fragility fracture in a Canadian fracture liaison service. METHODS: We determined rates of post-fracture investigation and treatment for inpatients and outpatients with a fragility fracture seen in a coordinator-based fracture liaison service at an urban university trauma hospital...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28507861/absence-of-ulnar-artery-inflow-detected-by-allen-s-test-prior-to-radial-forearm-free-flap
#9
Benjamin A Taylor, Faisal Alzahrani, Eric Levi, S Mark Taylor, Matthew H Rigby, Jonathan Trites, Robert D Hart
Radial forearm free flaps are commonly used for soft-tissue reconstruction after resection of head and neck cancer. It is perfused by the radial artery, leaving the ulnar artery for perfusion of the hand and digits. The absence of distal ulnar artery and associated superficial palmar arch, however, has not been reported in cadaveric dissection. We report a case of unilateral ulnar artery flow absence, detected by Allen's test, during preoperative preparation for a radial forearm free flap. Based on the simplicity, safety, and ease, we recommend Allen's test to be performed preoperatively on every patient for whom such a flap is a consideration...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28506490/early-range-of-motion-exercise-in-pediatric-patients-with-olecranon-fractures-treated-with-tension-band-suture-with-double-loops-and-double-knots
#10
Tae Hun Kim, Doo-Hyung Lee, Kyeong Jin Han, Wan Sun Choi, Jae Ho Cho
BACKGROUND: Pediatric patients with olecranon fractures are uncommon. The tension band suture technique was introduced to reduce the burden of implant removal and other complications. However, to our knowledge, early range of motion (ROM) exercise has not been introduced in this population of patients. Double Vicryl loops and knots with 2 cross-pins are used to maintain the benefits of the tension band suture technique and to enhance fixation tensile strength. We believe that early ROM exercises could be achieved without nonunion or fixation failure...
May 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28495573/spatial-mapping-of-humeral-head-bone-density
#11
Hamidreza Alidousti, Joshua W Giles, Roger J H Emery, Jonathan Jeffers
BACKGROUND: Short-stem humeral replacements achieve fixation by anchoring to the metaphyseal trabecular bone. Fixing the implant in high-density bone can provide strong fixation and reduce the risk of loosening. However, there is a lack of data mapping the bone density distribution in the proximal humerus. The aim of the study was to investigate the bone density in proximal humerus. METHODS: Eight computed tomography scans of healthy cadaveric humeri were used to map bone density distribution in the humeral head...
May 8, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28490685/-ruptured-c2-aneurysm-of-the-internal-carotid-artery-with-ipsilateral-unruptured-giant-internal-carotid-artery-aneurysm-a-case-report
#12
Saya Ozaki, Hideo Tanaka, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Noriyuki Fumoto, Hajime Miyazaki, Kanehisa Kohno
A giant intracranial internal carotid artery(ICA)aneurysm is difficult to treat. We encountered a case with an unruptured giant intracranial ICA aneurysm with a ruptured C2 aneurysm of the ipsilateral ICA. In this case report, we describe how the treatment and review the literature. A 59-year-old man presented with sudden-onset headache and vomiting. He was diagnosed at a local neurosurgical unit as having a subarachnoid hemorrhage and admitted to our hospital. Cerebral angiogram revealed an unruptured giant ICA C3-4 aneurysm with a ruptured aneurysm of the ipsilateral ICA C2...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28489627/radial-head-ingrowth-anatomic-implant-vs-smooth-stem-monoblock-implant-in-acute-terrible-triad-injury-a-prospective-comparative-study
#13
David Rodriguez-Quintana, David Beaton, Natalie Rodriguez-Quintana, Francisco Lopez-Gonzalez
OBJECTIVE: This study aimed to compare clinical outcomes and radiographic findings between patients who received two different implants (smooth stemmed modular implant or an anatomic press fit implant) on patients with acute terrible triad injuries. DESIGN: Prospective cohort SETTING:: Level II Trauma center, University hospitalPatients/Participants: 34 patients with an isolated terrible triad injury were divided into two study groups (n= 17 each) with different set of radial head implants and followed for 2 years...
May 10, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28471917/radial-neck-dilatory-remodeling-following-radial-head-arthroplasty-with-an-uncemented-press-fit-fully-chemically-etched-stem-design
#14
Matthew P Sullivan, Reza Firoozabadi, Stephen A Kennedy, Julie Agel, Eric Magnusson, Brett Schiffman, Matthew Folchert, Daphne Beingessner
OBJECTIVES: To compare the radiographic outcomes of two widely used side loading, press fit, radial head arthroplasty implants used to reconstruct complex elbow trauma. DESIGN: Retrospective cohort study SETTING:: Level 1 Academic trauma center PARTICIPANTS:: Patients undergoing radial head arthroplasty INTERVENTION:: Cohort 1 received Synthes Radial Head Prosthesis. Cohort 2 received Biomet ExploR Radial Head Replacement. MAIN OUTCOME MEASUREMENTS: Radial neck dilatory remodeling RESULTS:: 82 subjects were included in final analysis, 63 from the Biomet Cohort and 19 from Synthes cohort...
April 27, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28468144/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#15
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28465039/use-of-couplers-for-vascular-anastomoses-in-601-free-flaps-for-reconstruction-of-defects-of-the-head-and-neck-technique-and-two-year-retrospective-clinical-study
#16
A Assoumane, L Wang, K Liu, Z-J Shang
We describe our experience with the use of 854 couplers for venous or arterial anastomoses, or both, in 601 free flaps for reconstruction of defects of the head and neck. We reviewed 601 patients who had had free flaps (with the microvascular anastomoses being made with couplers in 519) between July 2013 and December 2015. Personal details, and clinical data including the site of the defect, the tumour excised, the types of flaps, the size of the couplers, the method of anastomosis (venous or arterial) in which the coupler was used, and postoperative complications were recorded...
April 29, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28449824/primary-mucosal-melanoma-of-the-palatine-tonsil-report-of-a-case-and-review-of-the-literature
#17
Marcela Osorio, Sami P Moubayed, Juan Hernandez-Prera, John C Scott, Mark L Urken
BACKGROUND: Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment. METHODS: A 62-year-old female presented with a deeply pigmented and exophytic lesion in the left tonsillar fossa. The patient underwent a partial pharyngectomy through a midline labio-mandibulotomy approach along with a left level I-V neck dissection. Reconstruction with a left radial forearm free flap and a pharyngeal constrictor advancement pharyngoplasty was performed...
April 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28449475/a-non-randomized-retrospective-observational-study-on-the-subcutaneous-esophageal-reconstruction-after-esophagectomy-is-it-feasible-in-high-risk-patients
#18
Jae Ho Chung, Sung Ho Lee, Eunjue Yi, Jae Seung Jung, Jung Wook Han, Tae Sik Kim, Ho Sung Son, Kwang Taik Kim
BACKGROUND: Esophageal reconstruction after esophagectomy is a complex procedure with high morbidity and mortality. Anastomotic leakage is more severe and frequent in patients with preoperative comorbidities and may present with septic conditions. Considering the possibility of an easier management of such cases, we evaluated the safety and feasibility of subcutaneous esophageal reconstruction in patients with high operative risks. METHODS: We performed a non-randomized retrospective observational study on the 75 (subcutaneous: 21, intrathoracic: 54) esophageal cancer patients who underwent esophageal reconstruction either through subcutaneous or intrathoracic route between January 2003 and February 2015...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28439432/posterior-interosseous-nerve-palsy-caused-by-a-ganglion-conservative-treatment-with-ultrasound-guided-needle-aspiration
#19
Yasuhiro Seki
Posterior interosseous nerve palsy caused by a ganglion is not common and most previous patients were treated with excisional surgery. We treated a case conservatively with needle aspiration using ultrasonography, after a nerve conduction study. A 77-year-old man presented with impaired active finger extension of the left metacarpophalangeal joints. The nerve conduction study revealed conduction block of the left radial nerve near the elbow. Ultrasonography demonstrated a hypoechoic mass anterior to the radial neck compressing the posterior interosseous nerve...
March 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28434539/evolutionary-anatomy-of-the-neandertal-ulna-and-radius-in-the-light-of-the-new-el-sidr%C3%A3-n-sample
#20
Laura Pérez-Criado, Antonio Rosas
This paper aims to improve our understanding of the phylogenetic trait polarity related to hominin forearm evolution, in particular those traits traditionally defined as "Neandertal features." To this aim, twelve adult and adolescent fragmented forelimb elements (including ulnae and radii) of Homo neanderthalensis recovered from the site of El Sidrón (Asturias, Spain) were examined comparatively using three-dimensional geometric and traditional morphometrics. Mean centroid size and shape comparisons, principal components analysis, and phylogenetic signal analysis were undertaken...
May 2017: Journal of Human Evolution
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