Graftless Syndactyly Release.

Syndactyly release aims to address skin deficits by resurfacing web spaces and sides of digits to allow independent digital motion while minimizing the risk of web creep and scar contractures. Conventional methods include the use of a dorsal and interdigitating flaps with full-thickness skin grafts. More recently, there have been several descriptions of "graftless" syndactyly release without skin grafts, thus avoiding a further (usually distant) donor site.

The effect of congenital hand differences on handedness in children.

We investigated whether handedness is influenced by the presence of a congenital hand difference (CHD). Among 31 children with right-sided CHDs, 13 were left-handed and 18 were right-handed, regardless of severity. This was significantly different from the normal population, suggesting that CHD does influence handedness.

Re-examining the nomenclature of congenital failure of formation in the upper limb: a historical perspective.

In this study, we studied historical case notes to examine nomenclature of congenital upper limb anomalies and explore the changes in terminologies over time. Original diagnoses were reclassified according to previously published classifications and the most recent Oberg, Manske and Tonkin system. Two hundred and thirty-eight case notes were obtained from the period 1961-1991.

The Oberg, Manske, and Tonkin Classification of Congenital Upper Limb Anomalies: A Consensus Decision-Making Study for Difficult or Unclassifiable Cases.

Purpose: An ideal classification system promotes communication and guides treatment for congenital upper limb differences (CULDs). The Oberg, Manske, and Tonkin (OMT) classification utilizes phenotypic presentation and knowledge of developmental biology for the classification of CULDs. In this consensus decision-making study, we hypothesized that CULDs that are difficult to classify would be identically classified by a group of experienced pediatric hand surgeons.

Changing face of medical education during a pandemic: tragedy or opportunity?

The COVID-19 pandemic has changed forever the way we do certain things. Although the race for a cure and vaccine has taken centre stage, traditional face-to-face medical education has slowly metamorphosised in the background to a virtual world with innumerable webinars, virtual tutorials and lectures in the World Wide Web. Despite this seemingly 'perfect' solution, there remains a hidden cost.

Hand Surgery in Cambodia.

As a lower middle-income nation, Cambodia has made significant improvements in basic health but hand surgery development continues to lag behind due to scarcity of trained and quality surgical manpower. Most of the hand surgery development locally has been due to surgical volunteers from Asia, Europe, and the United States. The introduction of a structured and systematic community-oriented hand surgery training over a 5-year period was successful in producing local surgeons to meet the basic needs of hand surgery patients.

Developing a Parental-Friendly Scoring System for Children with Congenital Hand Differences.

Congenital hand differences (CHD) exhibit enormous diversity and heterogeneity. Surgeons and parents often have different concepts of severity, making things difficult during parental consultation. This study aims to align surgeon/parental views on the severity of the child's CHD using a novel severity classification.

Congenital peripheral nerve hypoplasia: a report of seven cases.

We report the clinical findings of congenital peripheral nerve hypoplasia in seven patients. All seven children presented with unilateral ulnar or median nerve palsy or both. They were assessed clinically, and nerve diameters were assessed with ultrasonography and compared with the contralateral limb.

A model for surgical volunteerism: a qualitative study based in Cambodia.

Medical volunteerism continues to attract many doctors from high-income nations to low- or middle-income countries (LMIC). In spite of the wealth of positive experiences of these volunteers documented in the literature, there is little evidence concerning the impact and effectiveness of their activity. We documented our model of five-year experience in the delivery of hand surgery in Cambodia, attempting a qualitative approach with attempts to understand the perceptions of local and volunteer surgeons.

Compartment Syndrome of the Forearm Following Dermofasciectomy-A Rare and Devastating Complication.

We present a case of compartment syndrome of the forearm following harvesting of a full thickness skin graft from the medial forearm for a double digit dermofasciectomy. The patient underwent forearm fasciectomy followed by multiple surgical debridements. At 18 months, despite intensive physiotherapy, the patient was left with a very significant residual functional deficit.

The Role of Selective Peripheral Neurectomy in the Treatment of Upper Limb Spasticity.

Background: Management of upper limb spasticity remains challenging. Selective peripheral neurectomy (SPN) is a relatively recent intervention for cases refractory to medical therapy. The aim of this study was to conduct a systematic review looking at the efficacy and outcomes of SPN, in order to clarify the patient selection criteria and surgical technique.

Microsurgery Fellowships-Development of a Clinical Curriculum.

Background:  Microsurgery fellowships have become an integral part of every plastic surgery training program. While each subspecialty differs in terms of reconstructive requirements, the basic tenets and skill sets remain the same. We explore the possibility of designing a clinical curriculum for microsurgery that can provide residents and fellows with a more foundational and structured approach to microsurgical training.

Using pneumo-computerized tomography as a quantitative assessment of result in submucous fibrosis patients treated with surgical release and free flap reconstruction.

Objective: This study investigates the efficacy of oral submucous fibrosis release and free flap reconstruction.

Study Design: Pneumo-computerized tomography (pneumo-CT) was used to evaluate postoperative changes in the buccal vestibular volume during maximum blowing.

Methods: From March 2003 to November 2008, 9 patients underwent 18 microvascular flap reconstructions after oral submucous fibrosis release.

Sarcomatoid carcinoma in head and neck: a review of 30 years of experience--clinical outcomes and reconstructive results.

Problem Presented: Sarcomatoid carcinoma (SaCa) is a rare variant of squamous cell carcinoma (SCC) with sarcomatoid features. This study investigated the clinical presentation and outcomes of head and neck SaCa. In addition, reconstructive outcome for a subset of patients was also evaluated.

Improving the extensor lag and range of motion following free vascularized joint transfer to the proximal interphalangeal joint: Part 2. A clinical series.

Background: Free vascularized joint transfer for reconstructing the posttraumatic proximal interphalangeal joint has enjoyed limited popularity because of the low range of motion typically achieved after transfer. One of the commonest complaints is the significant extensor lag. Part 2 of this two-part study is focused on the clinical outcomes following a more anatomical approach to extensor tendon reconstruction.

Improving the extensor lag and range of motion following free vascularized joint transfer to the proximal interphalangeal joint: Part 1. An observational and cadaveric study.

Background: Extension lag is a common occurrence following free vascularized joint transfer reconstruction of the proximal interphalangeal joint, thus limiting the range of motion that is achievable. In this Part 1 study, the anatomical and biomechanical arrangements of the toe proximal interphalangeal joint extensor mechanism were investigated.

Methods: Twelve second toes from 12 fresh cadavers were dissected for examination of the extensor mechanism.

Anatomical basis and clinical application of the ulnar forearm free flap for head and neck reconstruction.

Objectives/hypothesis: This study was designed to investigate the anatomical features and applications of the ulnar forearm flap in head and neck reconstructive surgery.

Study Design: A prospective study was designed to include 50 ulnar forearm free flap transplants in 50 patients. Patient defects requiring reconstructive surgery involved the buccal mucosa, tongue, floor of the mouth, upper or lower gums, lips, soft palate, and scalp.

Subcutaneous tissue expansion and subsequent subpectoral implantation for breast reconstruction in Asian patients: safety and outcome.

Asian women are generally thin with smaller breasts. The objective was to investigate the outcomes for patients who underwent 2-stage breast reconstruction using subcutaneous expansion followed by subpectoral implantation. Between 2003 and 2008, 22 patients underwent subcutaneous expansion and subsequent submuscular implantation for 23 breast reconstructions.

Primary correction of nasal deformity in unilateral incomplete cleft lip: a comparative study between three techniques.

Introduction: Nasal deformities secondary to incomplete cleft lip are often underestimated in terms of their severity with resultant sub-optimal treatment. Constant refinements have led to the evolution of different surgical techniques in our institution for the treatment of these deformities. This study compared three different techniques in achieving nasal asymmetry for patients with unilateral incomplete cleft lip.