The Journal of craniofacial surgery
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Composite tissue defects of the mandible and maxilla, after resection of head and neck malignancies, osteoradionecrosis, malformations, or traumas, cause functional and aesthetic problems. Nowadays, microvascular free flaps represent the main choice for the reconstruction of these defects. Among the various flaps proposed, the scapula flap has favorable characteristics that make it suitable for bone, soft tissue, or combined defects. ⋯ Although the fibula flap and the deep circumflex iliac artery flap remain the first choice for bone reconstructions of the mandible and maxilla, the scapula flap has some features that make its use extremely advantageous in some circumstances. In particular, we advocate the use of the osteomuscular latissimus dorsi-scapula flap for reconstruction of large-volume defects involving the bone and soft tissues, whereas fasciocutaneous parascapular flaps represent a valid alternative to forearm flap and anterolateral thigh flap in the reconstruction of soft tissue defects.
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We report a very unusual presentation of simultaneous pleomorphic adenomas of 2 different locations, hard palate and parapharyngeal space. Patient age of presentation is rare because these tumors are seen in younger patients. ⋯ Pleomorphic adenomas are frequent lesions, but in the literature reviewed, we have not found articles reporting 2 simultaneous pleomorphic adenomas of these locations. Complete surgical resection is very important to avoid recurrences.
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This retrospective study evaluates 391 patients with orbital bone fractures from a variety of accidents that were treated at the department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, South Korea, between February 1996 and April 2008. The medical records of these patients were reviewed and analyzed to determine the clinical characteristics and treatment of the orbital bone fractures. The following results were obtained. ⋯ The postoperative complication rate was 17.9%, and there were no statistically significant differences among the reconstruction materials with regard to complications. During follow-up, diplopia, hypoesthesia, and enophthalmos occurred as complications; however, there was no significant difference between porous polyethylene sheet (MEDPOR) and resorbable sheet groups. Long-term epidemiological data regarding the natural history of orbital bone fractures are important for the evaluation of existing preventative measures and for the development of new methods of injury prevention and treatment.
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Injuries to the flexor and extensor tendons in the hand are common and require cautious evaluation and treatment or repair. Flexor tendon injuries are often associated with neurovascular injury and thus must be considered in the differential workup. Extensor injuries may involve intra-articular damage, which must also be identified. The diagnosis and management of common flexor and extensor tendon injuries of the hand are described.
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Crush injuries of the fingertip are the most common hand injuries seen in children. Many involve fracture of the distal phalanx, whereas others result in either crush alone or complete or partial fingertip amputation. ⋯ Comparison of nail bed repair versus nail trephination for subungual hematomas in children. J Hand Surg [Am] 1999;24:1166-1170).