Innovating Flexor Tendon Repair Training with a Three-dimensional Printed Model.

Background: Flexor tendon repair is a technically demanding procedure, with functional outcome directly proportional to skillful execution. A repair must be strong to manage early mobilization and precise to allow for gliding through the tendon sheath. As a result, junior residents face a steep learning curve that may be mitigated by exposure to surgical simulators.

Dupuytren Cords Do Not Undergo Significant Histopathological Change After Collagenase Clostridium Histolyticum Injection.

Dupuytren disease creates thickened cords of the palmar fascia, leading to progressive flexion contractures that severely hinder hand function. Collagenase clostridium histolyticum (CCH) injection is a common, minimally invasive alternative to surgical excision of these cords. The impact of CCH injection on the histological architecture of Dupuytren cords has not been studied extensively.

Changes in Nerve Conduction Studies After Distal Radius Fracture Fixation Using a Volar Approach and Locked Plate.

Purpose: To determine whether there are changes in nerve conduction studies (NCS) of the median nerve after distal radius fracture (DRF) and to determine how operative fixation through a volar approach with a locking plate contributes to nerve conduction changes. We hypothesized that a considerable percentage of patients would have electrodiagnostic evidence of median neuropathy at the wrist after fracture, but fixation with a volar locked plate would not worsen the electrodiagnostic findings.

Methods: This was a prospective cohort study of 14 neurologically asymptomatic patients who underwent surgical treatment of an isolated DRF using a volar plate.

A Novel Surgical Technique for Resuspension of Digital Pulp Tissue after Degloving Injuries.

Adherence of pulp tissue to the underlying distal phalanx is required for fundamental actions including grip, proprioception, and fine motor skills. Disruption of the fibrous septa causes sliding between the distal phalanx and overlying soft tissues, hindering basic hand function. The authors present a novel surgical technique in which the fibrous pulp septa are resuspended to the distal phalanx with bone anchors and sclerosing agents after a closed degloving injury.

Complications of Cosmetic Surgery Tourism: Case Series and Cost Analysis.

Background: Cosmetic surgery tourism is increasing exponentially. Patients seek cosmetic procedures within the United States and abroad, lured by lower cost procedures, shorter waiting lists, and affordable airfare and hotel accommodations. Unfortunately, operations are often performed by non-board-certified plastic surgeons, sometimes not even by plastic surgeons.

Carpal Tunnel Syndrome in the Setting of Mucopolysaccharidosis II (Hunter Syndrome).

Background: Carpal tunnel syndrome (CTS) is a rare finding in children, but heavily represented in pediatric patients with mucopolysaccharidoses. Diagnosis is a challenge due to lack of the stereotypical symptomatic complaints and relies on examination and objective nerve conduction studies.

Methods: We present a case of delayed presentation of CTS in a 12-year-old boy with Hunter syndrome, followed by a review of the literature.

Burn Management in the Developing World: International Volunteerism.

The burden of burn injury falls predominantly on the world's poor, with low-income and middle-income countries accounting for 96% of burn injuries. These vulnerable populations are the least likely to have access to adequate medical care and are the most reliant on volunteer organizations. Every underserved area has a unique set of needs, circumstances, customs, resources, and challenges.

Prevalence and antimicrobial susceptibility of non-fermenting Gram-negative bacilli isolated from clinical samples at a tertiary care hospital.

Introduction:: We compared the prevalence and antimicrobial susceptibility of non-fermenting gram-negative bacilli (NFGNB) isolated from clinical samples at a Brazilian tertiary care hospital in 2008 and 2013.

Methods:: Collected data included patient's name, age, sex, inpatient unit, laboratory record number, type of biological material, culture test result, and antimicrobial susceptibility of isolated strains.

Results:: Out of 19,112 culture tests analyzed, 926 (4.

Unusual Volar Pulp Location of Glomus Tumor.

Glomus tumors are benign, painful growths originating from glomus bodies and comprise just 1% of tumors arising in the hand, with fewer than 10% in the volar pulp of digits. Hallmark symptoms of glomus tumors include hypersensitivity to cold, heightened pinprick sensitivity, and paroxysmal pain. We report a 72-year-old, right-hand dominant man who presented with pain in the left middle finger, localized to the tip.

Local Application of Probiotic Bacteria Prophylaxes against Sepsis and Death Resulting from Burn Wound Infection.

Objective: To determine if local prophylactic application of probiotic bacteria to burn wounds will prevent death in a mouse model of burn wound sepsis.

Background: Infection remains the most common complication after burn injury and can result in sepsis and death, despite the use of topical and systemic antibiotics. Pseudomonas aeruginosa is a frequently implicated pathogen.

Administration of adipose-derived stem cells enhances vascularity, induces collagen deposition, and dermal adipogenesis in burn wounds.

Current treatment options for severe burn wounds are often insufficient in reconstructing skin and soft tissue defects. Adipose-derived stem cells (ASCs), a readily available source of multipotent stem cells, represent a promising therapy for the treatment of full-thickness burn wounds. Full-thickness burn wounds were created on the paraspinal region of athymic mice.

Obstetrical brachial plexus palsy: Can excision of upper trunk neuroma and nerve grafting improve function in babies with adequate elbow flexion at nine months of age?

Accepted indications for exploration in obstetrical brachial plexus palsy (OBPP) vary by center. Most agree that full elbow flexion against gravity at nine months of age implies high chance of spontaneous recovery and thus excludes a baby from surgical intervention. However, there are certain movements of the shoulder and forearm that may not be used frequently by the infant, but are extremely important functionally as they grow.

A review of eight unusual pediatric skin and soft-tissue lesions: Diagnosis, workup, and treatment.

The spectrum of clinical presentations in pediatric skin and soft-tissue lesions often makes diagnosis challenging. Delays in diagnosis and subsequent treatment can be life threatening, and they can subject patients to more complicated reconstruction. This retrospective case series reviews the presentation, management, and current literature on eight pediatric skin and soft-tissue lesions.

Improving speech outcomes after failed palate repair: evaluating the safety and efficacy of conversion Furlow palatoplasty.

Background: Velopharyngeal insufficiency occurs in a nontrivial number of cases following cleft palate repair. We hypothesize that a conversion Furlow palatoplasty allows for long-term correction of VPI resulting from a failed primary palate repair, obviating the need for pharyngoplasty and its attendant comorbidities.

Methods: A retrospective review of patients undergoing a conversion Furlow palatoplasty between 2003 and 2010 was performed.

Efficacy of passive helmet therapy for deformational plagiocephaly: report of 1050 cases.

Object: There has been a tremendous increase in the incidence of deformational plagiocephaly in children throughout the world. Therapeutic options include observation, active counterpositioning, external orthotics, and surgery. The current treatment in the US is highly debated, but it typically includes external orthotic helmets in patients with moderate to severe plagiocephaly presenting between 4 and 10 months of age or in children with significant comorbidities limiting passive (no-pressure) therapy.

Magnetic resonance imaging as a predictor of submucous cleft palate severity and guide for surgical intervention.

Background: Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outcomes. Previous studies show that MRI reliably identifies structural abnormalities in velopharyngeal musculature. This information has potential to assist with diagnosis and treatment decisions.

Outcome analysis of helmet therapy for positional plagiocephaly using a three-dimensional surface scanning laser.

Introduction: A dramatic rise in positional plagiocephaly has been noted over the last decade. Methods for treating and following outcomes are varied. We present our results from a passive soft helmet molding therapy using a surface scanning laser to provide objective outcomes.

Needle thoracostomy for tension pneumothorax: failure predicted by chest computed tomography.

Objective: Tension pneumothorax can lead to cardiovascular collapse and death. In the prehospital setting, needle thoracostomy for emergent decompression may be lifesaving. Taught throughout the United States to emergency medical technicians (EMTs) and physicians, the true efficacy of this procedure is unknown.

Dynamic spring mediated cranioplasty in an experimental model with resorbable foot plates.

Craniofacial surgery continues to be progressive in its approach to maximize function and aesthetic appearance while minimizing risks and complications. Dynamic springs are one way to minimize invasiveness while achieving favorable results. The purpose of this study was to show the safety and efficacy of dynamic springs with resorbable foot plates for treatment of metopic suture abnormalities in a swine model.

Vacuum-assisted closure: state of basic research and physiologic foundation.

A tremendous amount of research has been conducted in recent years investigating the mechanisms of action by which the application of subatmospheric pressure to wounds increases the rate of healing. Similarly, numerous studies have also been conducted examining the physiologic response of wounds to the applied subatmospheric pressure. However, many more need to be conducted.

Maintenance of inhibitory interneurons and boutons in sensorimotor cortex between middle and old age in Fischer 344 X Brown Norway rats.

Ultrastructurally identified inhibitory synapses in layer II of rat sensorimotor cortex decline between middle and old age [Poe, B.H., Linville, C.

Vacuum-assisted closure for the treatment of complex breast wounds.

Complex breast wounds are a constant problem for surgeons. Wound vacuum-assisted closure therapy (VAC) has been shown to be effective for a variety of complex wounds. Our goal was to evaluate our experience with the (VAC) device in the treatment of open breast wounds.

Stereological quantification of GAD-67-immunoreactive neurons and boutons in the hippocampus of middle-aged and old Fischer 344 x Brown Norway rats.

The aging process in rodents is associated with learning and memory impairments that are correlated with changes in multiple neurotransmitter systems in the hippocampus. For example, the gamma-aminobutyric acid (GABA)ergic system is compromised in old compared with young rats (Shetty and Turner [1998] J. Comp.