Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Apr 2009
Meniscus and discus lesions of triangular fibrocartilage complex (TFCC): treatment by laser-assisted wrist arthroscopy.
Meniscus and disc lesions in the triangular fibrocartilage complex (TFCC) are generally caused by falling accidents with pronated, hyperextended wrists, or by distraction injuries that pull the ulnar side of the wrist out of place. Characteristic clinical signs are swelling and pain in the distal radioulnar joint (DRUJ) and a 'clicking' noise in the meniscus lesion. If untreated, loss of mobility and grip strength as well as progressive arthritic changes ensue. We investigated in this study the laser-assisted arthroscopic debridement of the central TFCC and meniscus to compare the advantages and disadvantages of such treatment to conventional arthroscopic debridement. ⋯ We have demonstrated that the TFCC laser debridement technique is easy and safe to perform. The outcome was excellent with less pain and good ROM. In particular, the laser technique enabled a good intra-articular haemostasis and allowed an exact tear debridement.
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J Plast Reconstr Aesthet Surg · Apr 2009
Review Case ReportsAn unusual case of galactorrhea in a postmenopausal woman complicating breast reduction.
Galactorrhea is a relatively common condition, but has rarely been seen following breast reduction surgery. To date there are only seven cases reported in the literature, all in premenopausal women. Postsurgical galactorrhea is a diagnosis of exclusion and differential diagnosis is extensive. ⋯ She was on long-term hormonal replacement therapy. Because of suspected nerve-related pain in her right breast she was commenced on amitriptyline. We hypothesise that galactorrhea may have been caused by underlying neuroma or irritation of the anterior branch of the T4 intercostal nerve or hormonal replacement therapy or a combination of both.
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J Plast Reconstr Aesthet Surg · Apr 2009
The influence of pre-surgical delay on functional outcome after reconstruction of brachial plexus injuries.
It has been proposed that delayed surgery after traumatic brachial plexus injury may adversely affect functional outcome. In this study the influence of pre-surgical delay on the outcome of brachial plexus reconstruction was examined retrospectively. All patients who underwent surgery for traumatic brachial plexus injury in the Leeds Plastic and Reconstructive Surgery unit (UK), between 1987 and 2002, were identified. ⋯ Functionally better results were obtained with early surgery. When surgery was delayed beyond 2 months there was no significant difference between mean pre- and postoperative elbow grades. We therefore believe that early exploration and reconstruction of adult traumatic brachial plexus injuries minimises the pernicious adverse effects of delay attributable to recent findings of the neurobiological effects of axonal damage.