Focal Neurotoxicity Associated With Topical 5-Fluorouracil.

Topical 5-Fluorouracil (5-FU) is an antineoplastic chemotherapy drug used to treat precancerous and cancerous skin growths, such as actinic keratoses (AKs), squamous cell carcinoma in situ, and superficial basal cell carcinoma. The topical agent may rarely cause neurotoxic adverse effects. Multiple cases of systemic 5-FU and capecitabine chemotherapy-induced neuropathies have been reported.

Outcomes After Use of the Induced Membrane Technique for Fractures of the Upper Extremity.

Purpose: The purpose of this study was to review a series of cases in which the induced membrane technique was used for fractures with segmental bone loss in the upper extremity. We aimed to examine patient indications, outcomes based on union rates, and complications associated with this technique.

Methods: An institutional review board-approved database at our institution was used to identify patients based on either diagnosis or procedure codes commonly used during the induced membrane treatment.

Percutaneous Treatment of Unstable Scaphoid Waist Fractures.

Background: Percutaneous techniques have been described for the treatment of nondisplaced scaphoid fractures, although less information has been reported about outcomes for unstable, displaced fractures. The aim of this study was to evaluate the union and complication rates following manual closed reduction and percutaneous screw placement for a consecutive series of unstable, displaced scaphoid fractures.

Methods: A total of 28 patients (average age, 27 years; 22 male/6 female) were treated for isolated unstable displaced scaphoid waist fractures.

Free Flap Functional Muscle Transfers.

Free functional muscle transfers remain a powerful reconstructive tool to restore upper extremity function when other options such as tendon or nerve transfers are not available. This reconstructive technique is commonly used for patients following trauma, ischemic contractures, and brachial plexopathies. Variable outcomes have been reported following free functional muscle transfers that are related to motor nerve availability and reinnervation.

Current Concepts in Lower Extremity Reconstruction.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand the existing principles for lower extremity reconstruction for both traumatic and ablative defects. 2.

Microvascular Anastomoses Using End-to-End versus End-to-Side Technique in Lower Extremity Free Tissue Transfer.

Background: The decision to perform an end-to-end (ETE) or end-to-side (ETS) arterial anastomosis in lower extremity free tissue transfer has not been thoroughly evaluated in a large multisurgeon setting. The authors compared the reconstructive outcomes of lower extremity free flaps with ETE and ETS arterial anastomoses.

Methods: The authors retrospectively reviewed their 17-year institutional experience with lower extremity free flaps to determine whether ETE or ETS arterial anastomoses were associated with foot ischemic complications and flap failure.

Early Postoperative Complications following Gracilis Free Muscle Transfer for Facial Reanimation: A Systematic Review and Pooled Data Analysis.

Background: Multiple studies have detailed promising smile restoration following gracilis free muscle transfer for facial reanimation but information detailing the potential complications is lacking. The aim of this study is to systematically review the literature to evaluate the reported complication rate associated with this procedure. We also aim to determine the most common occurring complications.

Contemporary solutions for the treatment of facial nerve paralysis.

Learning Objectives: After reviewing this article, the participant should be able to: 1. Understand the most modern indications and technique for neurotization, including masseter-to-facial nerve transfer (fifth-to-seventh cranial nerve transfer). 2.

Vascular considerations in foot and ankle free tissue transfer: Analysis of 231 free flaps.

Objective: Successful foot and ankle soft tissue reconstruction is dependent on a clear understanding of the vascular supply to the foot. The aim of this study was to identify risk factors for reconstructive failure following foot and ankle free tissue transfer.

Methods: The authors retrospectively reviewed their 17-year institutional experience with 231 foot and ankle free flaps performed in 225 patients to determine predictors of postoperative foot ischemia and flap failure.

Sexual and Overall Quality of Life Improvements After Surgical Correction of "Buried Penis".

Background: "Buried penis" is an increasing burden in our population with many possible etiologies. Although surgical correction of buried penis can be rewarding and successful for the surgeon, the psychological and functional impact of buried penis on the patient is less understood.

Methods: The study's aim was to evaluate the sexual satisfaction and overall quality of life before and after buried penis surgery in a single-surgeon's patient population using a validated questionnaire (Changes in Sexual Functioning Questionnaire short-form).

Patient perceptions on physician reimbursement in plastic surgery.

Background: Public perception on physician reimbursement may be that considerable payments are received for procedures: a direct contrast to the actual decline. We aim to investigate patient perceptions toward plastic surgeon reimbursements from insurance companies.

Methods: A survey of 4 common, single-staged procedures was administered to 140 patients.

Scaphoid nonunions treated with 2 headless compression screws and bone grafting.

Purpose: To evaluate union and complication rates associated with the use of 2 headless compression screws and bone grafting for the treatment of scaphoid nonunions.

Methods: A total of 19 patients (18 male and 1 female) at an average age of 21 years were treated with open reduction and internal fixation with 2 cannulated, headless, compression screws for scaphoid nonunions. Bone grafting techniques included corticocancellous autograft from the iliac crest in 14 patients, capsular-based vascularized distal radius graft in 3, and medial femoral condyle free vascularized bone graft in 2.

Management of scaphoid fractures in the athlete: open and percutaneous fixation.

Scaphoid fractures occur commonly in the athlete and should be treated with urgency to avoid undesired late complications. Magnetic resonance imaging may be helpful to make a prompt diagnosis so that an appropriate early treatment plan can be initiated. Cast immobilization in acute, nondisplaced scaphoid fractures seems to have an equivalent union rate to surgical modalities.

Vascularized fibula-based physis transfer for pediatric proximal humerus reconstruction.

Unlabelled: Free vascularized fibular transfer has become a standard procedure in upper extremity reconstruction after resection of osteogenic tumors. The authors present two rare pediatric cases of high-grade osteosarcoma resection of the proximal humerus. A free vascularized fibula autograft including the physis based on the anterior tibial artery and vein was used for reconstruction in a delayed (case 1) and immediate (case 2) approach.

A multimodal approach for postoperative pain management after lumbar decompression surgery: a prospective, randomized study.

Study Design: A prospective and randomized study.

Objectives: The objective of this study was to assess the efficacy of a novel multimodal analgesic regimen in reducing postoperative pain and intravenous morphine requirements after primary multilevel lumbar decompression surgery.

Summary Of Background Data: The use of opioid medications after surgery can lead to incomplete analgesia and may cause undesired side effects such as respiratory depression, somnolence, urinary retention, and nausea.

Free flap reconstruction of the knee: an outcome study of 34 cases.

Background: Open wounds around the knee joint can often be managed with local flaps; however, free tissue transfer may be required when local tissue options are unavailable or inadequate. Free tissue transfer around the knee can be challenging due to unique anatomic features of the joint. The outcomes of such procedures remain largely unreported.

Lumbar decompression and fusion in a centenarian.

The incidence of chronic and debilitating conditions in the aging population is steadily increasing, and the treatment of extreme elderly patients with spinal conditions can be challenging. Spinal stenosis and spondylolisthesis can dramatically affect patient quality of life, and patients commonly seek a surgical solution for their condition. Many extreme elderly patients are cautioned against surgery secondary due to their high complication and in-hospital mortality rates when compared with younger patients.

A socioeconomic analysis of surgical treatment of migraine headaches.

Background: This study is meant to compare the direct and indirect cost of migraine headache care before and after migraine surgery and to evaluate any postoperative changes in patient participation in daily activities.

Methods: Eighty-nine patients enrolled in a migraine surgery clinical trial completed the Migraine-Specific Quality-of-Life Questionnaire, the Migraine Disability Assessment questionnaire, and a financial cost report preoperatively and 5 years postoperatively.

Results: Mean follow-up was 63.

An evaluation of information on the internet about a new device: the cervical artificial disc replacement.

Study Design: Cross-sectional survey.

Objective: The objective of this study was to investigate the authorship, content, and quality of information available to the public on the Internet pertaining to the cervical artificial disc replacement device.

Summary Of Background Data: The Internet is widely used by patients as an educational tool for health care information.

Detection of postoperative neurologic deficits using somatosensory-evoked potentials alone during posterior cervical laminoplasty.

Background Context: The use of neurophysiologic monitoring during anterior and posterior cervical decompression procedures in patients with spondylotic myelopathy remains controversial. The ideal neurophysiologic monitoring modality of choice is also highly debated.

Purpose: The purpose of this study was to evaluate the utility of neurophysiologic monitoring with only somatosensory-evoked potentials (SSEPs) in a consecutive series of laminoplasty procedures with regard to the detection of new postoperative neurologic deficits.

Revision total knee arthroplasty for aseptic and septic causes in patients with rheumatoid arthritis.

Unlabelled: Revision total knee arthroplasty in patients with rheumatoid arthritis can be challenging. We asked whether we could confirm previously reported high failure rates following revision total knee arthroplasty in patients with rheumatoid arthritis. We therefore determined the Knee Society knee score and function scores, radiographic evidence of failure, and overall survival of the revision procedure in these patients.

Osteosarcoma.

Osteosarcoma, the most common bone sarcoma, affects approximately 560 children and adolescents annually in the United States. The incidence of new diagnoses peaks in the second decade of life. Twenty percent of patients present with clinically detectable metastases, with micrometastases presumed to be present in many of the remaining patients.

Isolated resurfacing of the previously unresurfaced patella total knee arthroplasty.

Postoperative anterior knee pain can be challenging after primary total knee arthroplasty. Isolated patellar resurfacing may provide symptomatic improvement in those patients with an unresurfaced patella. Seventeen isolated patellar resurfacing procedures were performed.

An evaluation of information on the Internet of a new device: the lumbar artificial disc replacement.

Study Design: An analysis of websites, accessible to the public, was conducted pertaining to the lumbar artificial disc replacement.

Objective: The objective was to investigate the content of information available on the Internet pertaining to the lumbar artificial disc replacement.

Summary Of Background Data: The Internet is widely used by patients as an educational tool for health care information.