Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Apr 2007
Scaphoid nonunions: management with vascularized bone grafts from the distal radius: a clinical and functional outcome study.
Scaphoid nonunions remain controversial with regard to optimal management, especially for those located at the proximal third. In this study, the authors aim to assess the union rate, avascular proximal pole revascularization, and functional outcome of scaphoid nonunions managed with distal radius vascularized bone grafts. ⋯ This series demonstrates the efficacy of distal radius vascularized bone grafts in union enhancement, proximal pole revascularization, pain relief, improved wrist function, and carpal alignment. Vascularized bone grafts are a reliable therapeutic alternative for scaphoid nonunions.
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Plast. Reconstr. Surg. · Apr 2007
ReviewThe surgical treatment of brachial plexus injuries in adults.
After studying this article, the participant should be able to: 1. Evaluate clinically a patient with brachial plexus paralysis and define the appropriate electrophysiologic and radiographic studies. 2. ⋯ Describe various nerve reconstructive strategies and make appropriate selection of secondary procedures for shoulder stability, elbow flexion, and hand reanimation. 4. Anticipate the possible functional outcome.
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Plast. Reconstr. Surg. · Apr 2007
Incidence and management of abdominal wall defects after intestinal and multivisceral transplantation.
Successful primary closure of the abdominal wall following visceral organ transplantation is not always feasible. Primary closure under tension can lead to fascial ischemia or necrosis, with subsequent dehiscence. Thus, alternate techniques to achieve abdominal wall closure are an important technical aspect in intestinal transplantation. The authors review their experience managing abdominal wall defects following intestinal or multivisceral transplantation. ⋯ Abdominal wall defect after intestinal and multivisceral transplantation is a common problem without an ideal solution. Use of a skin graft on granulating abdominal viscera frozen with adhesions is a simple and reasonable solution to a complex problem.
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Plast. Reconstr. Surg. · Mar 2007
Comparative StudyEndoscopic versus open tissue-expander placement: is less invasive better?
Skin tissue expansion provides an excellent option for reconstruction of large cutaneous defects. Unfortunately, the complication rate with tissue-expander reconstruction is very high. One potential alternative to reduce these complications and improve recovery time is to place the tissue expanders endoscopically. The authors hypothesize that endoscopic placement of tissue expanders will reduce the complication rate, operative time, and time to full expansion. ⋯ Endoscopic tissue-expander placement significantly reduced operative time for placement of each expander, major complication rate, time to full expansion, and length of hospital stay for this reconstructive technique. The authors conclude that endoscopic placement of tissue expanders is a safe and effective method for tissue-expander reconstructions of large, difficult wounds.