Evolving Methods and Application of a 3D Printed Model in the Current Deep Inferior Epigastric Perforator Flap Elevation.

Background: The choice of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction has increased. Three-dimensional (3D) models of DIEP flaps have been introduced with advances in 3D technology to assist the tedious intramuscular dissection of the pedicle. This study presents the process of creating an ideal 3D model for a DIEP flap.

Proximal and Distal Nerve Transfers in the Management of Brachial Plexus Injuries.

Nerve transfer surgery utilizes the redundant and synergistic innervation of intact muscle groups to rehabilitate motor function. This is achieved by transferring functional nerves or fascicles to damaged nerves near the target area, thereby reducing the reinnervation distance and time. The techniques encompass both proximal and distal nerve transfers, customized according to the specific injury.

Correction of Congenital Syndactyly of the Hand with Minimal Full-Thickness Skin Graft from the Weight-Bearing Midline Plantar Area.

Background: Traditional skin grafts for syndactyly often cause color mismatches and unsightly donor sites, whereas no-skin graft methods leave noticeable dorsal hand scars. This study presents a plantar full-thickness skin graft (FTSG) from the weight-bearing midline area for syndactyly repair, a novel approach not previously reported in the literature.

Methods: The study included 3 groups of patients with congenital syndactyly of the hand who underwent primary operations with plantar FTSG ( n = 70), groin FTSG ( n = 20), and no-skin graft techniques ( n = 22).

Simultaneous or Delayed Free Tissue Transfer in Combination with Replantation Surgery.

In hand and upper extremity replantation surgery, simultaneous free flap reconstruction restores the physiologic circulation to the amputated part, ensuring its survival, and promotes wound healing through anatomic restoration. Especially in digit replantation, an arterialized venous flap serves to reconstruct both vessel and soft tissue defects simultaneously. Delayed free flap reconstruction aims to enhance both functional improvement and cosmetic acceptance in a successfully replanted part using flaps that include functioning muscle, bone, joint, nerve, and soft tissue.

Hybrid Lymphovenous Anastomosis Surgery Guided by Intraoperative Mesenteric Intranodal Lymphangiography for Refractory Nontraumatic Chylous Ascites: A Case Report.

Refractory chylous ascites can cause significant nutritional and immunologic morbidity, but no clear treatment has been established. This article introduces a case of a 22-year-old female patient with an underlying lymphatic anomaly who presented with refractory chylous ascites after laparoscopic adnexectomy for ovarian teratoma which aggravated after thoracic duct embolization. Ascites (>3,000 mL/d) had to be drained via a percutaneous catheter to relieve abdominal distention and consequent dyspnea, leading to significant cachexia and weight loss.

The Expanded Application of the Acellular Dermal Matrix: Traumatic Nail Bed Defect of the Digits.

Reconstruction of traumatic nail bed defects in the digits is a frequently encountered procedure, yet often presents many challenges. In such scenarios, staged procedures may be required with significant limitations in shape and increased donor site morbidity, particularly when multiple defects are present. In this study, we introduce a simple method for the reconstruction of nail bed defects using an acellular dermal matrix (ADM).

The Effect of Epiphysiodesis on the Longitudinal Bone Growth of Hands or Feet in Children With Macrodactyly Based on Long-term Quantitative Analysis.

Background: Treatment protocols for macrodactyly have not been elucidated due to its rarity and variety of clinical manifestations. This study aims to share our long-term clinical results of epiphysiodesis in children with macrodactyly.

Methods: A retrospective chart review was performed for 17 patients with isolated macrodactyly treated with epiphysiodesis over 20 years.

Surgical outcomes of reconstruction of soft tissue defects of the heel using various free flaps.

Background: The goals of heel reconstruction are functional and aesthetic. Primarily due to the particular function of the heel in supporting the entire weight of the body while standing, these goals can be achieved by providing the heel with a durable and weight-bearing surface with adequate contour. Various methods such as skin graft, fasciocutaneous, and musculocutaneous local flaps have been reported for reconstructing this area.

Medial Plantar Fasciocutaneous Flap Reconstruction for Load-Bearing Foot Defects in Patients With Acral Melanoma.

Background: Acral lentiginous melanoma (ALM) is a rare subtype of malignant melanoma that usually involves the weight-bearing plantar area. Plantar defect reconstruction has traditionally been performed with skin grafts or free flaps. This study examined the efficacy and safety of a medial plantar artery perforator flap (MPAPF) for plantar defect reconstruction after wide excision of an ALM.

Case-control study of the treatment of postaxial polysyndactyly of the foot: Comparison of surgical results after removal of the fifth or sixth toe.

Background: In postaxial polysyndactyly of the foot, the choice of which toe to excise is controversial. It is often treated by resection of the fifth toe to save the lateral neurovascular bundles of the sixth toe. However, the sixth toe is often short and laterally deviated, which may require wedge osteotomy, potentially shortening the phalanx and compromising circulation.

Giant Ventral Lipoma of the Neck.

Giant lipomas are rarely found in the head and neck region. A 67-year-old male patient presented with a massive ventral swelling of his neck extending from the lower margin of the mandible to the clavicle. The mass had slowly grown over 20 years without causing any symptoms, except for considerable psychological stress because of the disfiguration of the patient's profile appearance.