The Impact of Race, Age, Gender, Income, and Level of Education on Motivations to Pursue Cosmetic Surgery and Surgeon Selection at an Academic Institution.

Background: Aesthetic surgery is a personal choice that appeals to a wide population of individuals. The authors investigated how race and ethnicity, age, gender, income, and education level affect patient motivation to pursue cosmetic surgery and selection of a plastic surgeon.

Methods: One hundred seventy-two consecutive patients from two surgeons (an African American man and a Caucasian woman) completed surveys from 2016 to 2017 that assessed their decision to pursue cosmetic surgery.

The Effects of Adjunctive Pain Medications on Postoperative Inpatient Opioid Use in Abdominally Based Microsurgical Breast Reconstruction.

Background: The purposes of this study were to quantify the amount of opioid medication used postoperatively in the hospital setting after abdominally based microsurgical breast reconstruction, to determine factors that are associated with increased opioid use, and to identify other adjunctive medications that may contribute to decreased opioid use.

Methods: An electronic medical record data pull was performed at the University of Pennsylvania from November 2016 to October 2018. Cases were identified using Current Procedural Terminology code 19364.

Analysis of Outcomes in Living Donor Liver Transplants Involving Reconstructive Microsurgeons.

Background:  Living donor transplantation is becoming increasingly popular as a modality for patients necessitating liver transplantation. Hepatic artery thrombosis (HAT) remains the most feared acute postoperative complication associated with living-donor liver transplantation. Preoperative planning, including scheduling reconstructive microsurgeons to perform the hepatic artery anastomosis using a surgical microscope or loupes, can decrease HAT rates.

Sphenoid Dysplasia in Neurofibromatosis: Patterns of Presentation and Outcomes of Treatment.

Background: Sphenoid wing dysplasia in patients with neurofibromatosis type 1 may result in challenging and significant changes, including ultimately vision loss. The authors describe the radiographic patterns of sphenoid dysmorphology with time and age, and the impact of surgical intervention on preservation of vision.

Methods: A retrospective study was performed at a single pediatric hospital, identifying subjects with neurofibromatosis type 1.

A Morphological Classification Scheme for the Mandibular Hypoplasia in Treacher Collins Syndrome.

Background: Mandibular hypoplasia is a hallmark of Treacher Collins syndrome (TCS), and its severity accounts for significant functional morbidity. The purpose of this study is to develop a mandibular classification scheme.

Methods: A classification scheme was designed based on three-dimensional computed tomography (3D-CT) scans to assess 3 characteristic features: degree of condylar hypoplasia, mandibular plane angle (condylion-gonion-menton), and degree of retrognathia (sella-nasion-B point angle).

The Effectiveness of Free Vascularized Fibular Flaps in Osteonecrosis of the Femoral Head and Neck: A Systematic Review.

 Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability.  The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms.  We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords.

Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery.

Background: This study compares hospital-based care and associated charges among children with cleft lip, cleft palate, or both, and identifies subgroups generating the greatest cumulative hospital charges.

Methods: The authors conducted a retrospective cohort study of cleft lip, cleft palate, or cleft lip and palate who underwent initial surgery from 2006 to 2008 in four U.S.

An analysis of early oncologic head and neck free flap reoperations from the 2005-2012 ACS-NSQIP dataset.

Background: There are limited population-based studies that examine perioperative factors that influence postoperative surgical take-backs to the OR following free flap (FF) reconstruction for head/neck cancer extirpation. The purpose of this study was to critically analyse head/neck free flaps (HNFF) captured in the ACS-NSQIP dataset with a specific focus on postoperative complications and the incidence of factors associated with re-operation.

Methods: The 2005-2012 ACS-NSQIP datasets were accessed to identify patients undergoing FF reconstruction after a diagnosis of head/neck cancer.

Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm.

Multiligament knee injuries account for <0.02% of all orthopaedic injuries, and 16% to 40% of these patients suffer associated injury to the common peroneal nerve (CPN). The proximity of the CPN to the proximal fibula predisposes the nerve to injury during local trauma and dislocation; the nerve is highly vulnerable to stretch injury during varus stress, particularly in posterolateral corner injuries.

Case reports: unusual cause of shoulder pain in a collegiate baseball player.

The objective of reporting this case was to introduce a unique cause of shoulder pain in a high-level Division I NCAA collegiate baseball player. Various neurovascular causes of shoulder pain have been described in the overhead athlete, including quadrilateral space syndrome, thoracic outlet syndrome, effort thrombosis, and suprascapular nerve entrapment. All of these syndromes are uncommon and frequently are missed as a result of their rarity and the need for specialized tests to confirm the diagnosis.