Annals of plastic surgery
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The purpose of this article is to report the use of the 5-flap Z plasty in the management of long-standing flexion contractures of the proximal interphalangeal joint of the digits (the 5-flap Z plasty has been originally described by Hirshowitz et al for the lengthening of thumb web contractures). Nine fingers in 5 patients with Stern grade I and II contractures of the proximal interphalangeal joint were included. The defect following release of the contracture was covered with the 5-flap Z plasty and Kirschner wires temporarily maintained the corrected position. ⋯ The improvement in extension lag ranged from 15 to 60 degrees (mean: 40.5 degrees). Minimal complications were encountered. The technique described is useful in the management of Stern grade I and II digital contracture.
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Annals of plastic surgery · Nov 2009
Review Case ReportsThe world's experience with facial transplantation: what have we learned thus far?
The objective of this review article is to summarize the published details and media citations for all seven face transplants performed to date to point out deficiencies in those reports so as to provide the basis for examining where the field of face transplantation stands, and to act as a stimulus to enhance the quality of future reports and functional outcomes. Overall long-term function of facial alloflaps has been reported satisfactorily in all seven cases. ⋯ The risks and benefits of facial composite tissue allotransplantation, which involves mandatory lifelong immunosuppression analogous to kidney transplants, should be deliberated by each institution's multidisciplinary face transplant team. Face transplantation has been shown thus far to be a viable option in some patients suffering severe facial deficits which are not amenable to modern-day reconstructive technique.
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Annals of plastic surgery · Nov 2009
Historical ArticleAchieving growth and excellence in medicine: the case history of armed conflict and modern reconstructive surgery.
November 11, 2009 will mark over 90 years of commemorating Armistice Day, the end of World War I. Although conflict in the Middle East reminds us that WWI failed to end all wars, it did serve as both substrate and catalyst for the development of modern plastic and reconstructive surgery. This article will outline those ingredients most directly responsible for the growth of the specialty, tracing its development in response to armed conflict, and implications for continued excellence both in reconstructive surgery and other fields in the future.