Upper-Extremity Nerve Transfers for Sensation: A Systematic Review.

Purpose: Sensory nerve transfers may be performed to restore protective sensation and tactile perception after peripheral nerve injury in the upper extremity. There is a paucity of literature on the available donor-recipient configurations for sensory nerve transfers. This article presents a systematic review of reported sensory nerve transfers in the upper extremity.

Supinator to Anterior Interosseous Nerve Transfer to Restore Digital Flexion in Spinal Cord and Peripheral Nerve Injury.

Purpose: Restoration of pinch and grasp is a chief concern of patients with cervical spinal cord injury or peripheral nerve injury involving the anterior interosseous nerve (AIN). We hypothesize that supinator nerve-to-AIN (Sup-AIN) nerve transfer is a viable option for AIN neurotization.

Methods: We performed a retrospective review of patients who received Sup-AIN.

The Pendulum Movement of Orbital Fat and Retro-Orbicularis Oculi Fat: A New Strategy for Correction of Sunken Eyelid Deformity in Revision Upper Blepharoplasty for Asian Patients.

Background: With an increasing number of East Asians undergoing blepharoplasty, the number of patients with secondary upper eyelid deformities is increasing. The sunken eyelid deformity is a common deformity after upper blepharoplasty in Asians due to over-resection, retraction, or atrophy of the nasal and central orbital fat pads. Herein, we present a novel procedure, the pendulum movement of orbital fat and retro-orbicularis oculi fat ("POR" technique), for correction of sunken eyelid deformity in secondary Asian blepharoplasty.

Google Trends Analysis of Peripheral Nerve Disease and Surgery.

Background: Despite advances in the surgical management of peripheral nerve pathologies over the past several decades, it is unknown how public awareness of these procedures has changed. We hypothesize that Google searches for peripheral nerve surgery have increased over time.

Methods: Google Trends was queried for search volumes of a list of 40 keywords related to the following topics in peripheral nerve surgery: spasticity, nerve injury, prosthetics, and nerve pain.

USMLE Step 1 Pass/Fail is Here: Are Plastic Surgery Applicants Really Better Off?

Objective: As of January 26, 2022, the United States Medical Licensing Examination(USMLE) Step 1 score reporting will be changed from a numeric scoring system to pass/fail. Although the new scoring policy is expected to benefit medical students, there is concern that it will also amplify preexisting disadvantages and worsen disparities for students applying in the already-competitive plastic surgery match. Whether the reporting change will tangibly benefit applicants to plastic surgery has yet to be elucidated.

A History of Anatomical Eponyms of the Ulnar Nerve.

The ulnar nerve has a long and often misunderstood history with eponym usage. We describe the history of eponym usage in the anatomy of the ulnar nerve-who, when, what, where, and how. The relevant anatomy is investigated from proximal to distal, from the Arcade of Struthers to Osborne's band, to forearm ulnar nerve to median nerve connections, to Guyon's canal.

A Systematic Review of Muscle Synergies during a Walking Gait to Define Optimal Donor-Recipient Pairings for Lower Extremity Functional Reconstruction.

Unlabelled: Functional lower extremity reconstruction primarily aims to restore independent ambulation. We sought to define the synergies recruited during a walking gait to inform donor selection for various motor deficits. With these findings, we discuss the functional neuromuscular components of independent gait with the goal of informing lower extremity reconstruction.

Computer-aided Planning and Execution in Facial Gender Surgery: Approaches, Concepts, and Implementation.

Facial gender surgery (FGS) involves major surgical modification of the craniofacial soft tissues and skeleton. Computer-aided surgery (CAS) has improved precision and accuracy of osteotomies and decreased operative time in complex reconstructive craniofacial surgery. FGS is a natural application for CAS because the procedures are not only technically challenging but also demand a high standard of aesthetic results.

Early Clinical Outcomes of Polydioxanone Mesh for Prepectoral Prosthetic Breast Reconstruction.

Unlabelled: Many biologic matrices and synthetic meshes are available as adjuncts for prosthetic and autologous breast reconstructions to help control implant position and to reinforce abdominal flap donor sites. Absorbable synthetic meshes may have advantages over biologic matrices and permanent meshes, such as lower cost and better long-term biocompatibility. We present a prospective case series of patients undergoing two-stage, prepectoral breast reconstruction with polydioxanone (PDO) mesh.

Surprise Out-of-Network Bills for Hand and Upper Extremity Trauma Patients.

Purpose: Patients may receive surprise out-of-network bills even when they present to in-network facilities. Surprise bills are common following emergency care. We sought to characterize and determine risk factors for surprise billing in hand and upper extremity trauma patients in the emergency department (ED).

US Medical Student Perspectives on the Impact of a Pass/Fail USMLE Step 1.

Objective: The purpose of this study is to (1) gather US medical student attitudes regarding pass or fail score reporting of the USMLE Step 1 exam and (2) investigate the impact of this new policy on specialty interest and redistribution of efforts to enhance individual competitiveness.

Design: This is a cross-sectional analysis of US medical students surveyed from July to October 2020. Surveys were administered on social media and via medical school email list serv.

Lateral and Inferior Implant Malposition in Prosthetic Breast Reconstruction: Incidence and Risk Factors.

Unlabelled: Implant malposition is one of the most common causes for revision after prosthetic breast reconstruction. There is a paucity of research on the incidence, etiology and risk factors for implant malposition in this setting.

Methods: Retrospective review of a single surgeon's prosthetic breast reconstructions was performed.

Plastic Surgery Subinternships: Current Perspectives and Future Considerations.

Subinternships are an important feature of the integrated plastic and reconstructive surgery residency application process. In our experience, there exists institutional heterogeneity in how subinterns are evaluated, how they are given feedback, and how their performance is compared across institutions. In this report, we conducted standardized interviews with 9 past and present integrated plastic and reconstructive surgery residency program directors, eliciting their expert opinions on current limitations of subinternships as a method of medical student education and evaluation.

Judging an Expander by Its Cover: A Propensity-Matched Analysis of the Impact of Tissue Expander Surface Texture on First-Stage Breast Reconstruction Outcomes.

Background: There is increased scrutiny of texturing on implants and a paucity of data looking at texturing on expanders. Because of the difficulty in controlling potential confounders with these comparative studies, the authors performed propensity matching between smooth and textured tissue expander cohorts to provide definitive insight into the impact of expander texture on breast reconstruction outcomes.

Methods: A single-surgeon experience with immediate two-stage breast reconstruction was reviewed for 90-day postoperative complications after mastectomy and expander placement.

Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees.

Background: Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.

Questions/purposes: (1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?

Methods: Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis.

A Comparison of Fat Graft Processing Techniques: Outcomes in 1,158 Procedures in Prosthetic Breast Reconstructions.

Unlabelled: As fat grafting in breast reconstruction evolves, questions of technique and outcomes persist. We compared 2 common fat processing techniques-decantation (DEC) versus closed wash and filtration (CWF)-with regard to outcomes and efficacy.

Methods: Chart review of a single surgeon experience with breast fat grafting was performed.

The Relationship between Animation Deformity and Patient-Reported Outcomes: Application of the BREAST-Q to a Quantitative Stratification of Animation Severity.

Background: Animation deformity can occur following subpectoral breast reconstruction and is an oft-touted rationale for prepectoral reconstruction. Despite increasing recognition, there is a paucity of patient-reported outcome studies in women with animation deformity.

Methods: Women presenting after subpectoral implant-based breast reconstruction were evaluated for animation deformity.

A Quantitative Analysis of Animation Deformity in Prosthetic Breast Reconstruction.

Background: Animation deformity is characterized by implant deformity with pectoralis contraction after subpectoral implant-based breast reconstruction. Extant methods to measure and analyze animation deformity are hampered by the paucity of objective, quantitative data. The authors endeavored to supplement subjective measures with an in-depth quantitative analysis.

Prophylactic Use of Buccal Fat Flaps to Improve Oral Mucosal Healing following Furlow Palatoplasty.

Furlow palatoplasty is increasingly used both for primary palatoplasty and for secondary correction of velopharyngeal insufficiency. Although Furlow palatoplasty offers the advantage of lengthening the palate, the most tenuous component of the oral mucosal repair is anterior transposition of the oral mucosal Z-plasty flap, with superficial separation of the oral mucosa observed in up to 53 percent of cases of secondary Furlow palatoplasty. To mitigate this problem, the authors prophylactically placed pedicled buccal fat pad flaps to provide an additional vascular layer to promote healing of the overlying oral mucosal Z-plasty flap.

A Quantitative Analysis of Online Plastic Surgeon Reviews for Abdominoplasty.

Background: Online reviews increasingly influence patients' decision-making. This is the first systematic, quantitative analysis of online reviews for abdominoplasty.

Methods: Reviews for abdominoplasty were sampled from RealSelf, Yelp, and Google for six major metropolitan areas.

Intraoperative Perfusion Assessment in Mastectomy Skin Flaps: How Close are We to Preventing Complications?

Background:  Mastectomy flap necrosis is the source of considerable morbidity and cost following breast reconstruction. A great deal of effort has been put forth to predicting and even preventing its incidence intraoperatively.

Methods:  A review of the literature was performed evaluating the evidence of mastectomy skin flap perfusion technologies.