Molecular Biology of Flexor Tendon Healing in Relation to Reduction of Tendon Adhesions.

Tendon injuries are encountered after major and minor hand trauma. Despite meticulous repair technique, adhesion formation can occur, limiting recovery. Although a great deal of progress has been made toward understanding the mechanism of tendon healing and adhesions, clinically applicable solutions to prevent adhesions remain elusive.

Biomechanical evaluation of double-strand (looped) and single-strand polyamide multifilament suture: influence of knot and suture size.

Background: Flexor tendon repair in zone II remains a vexing problem. Repair techniques have been developed to strengthen and optimize the number of core strands crossing a repair. A polyamide looped suture doubles the number of core strands for every needle path.

First Description of Oral Causing Osteomyelitis of the Mandible, Manubrium and Third Rib with Associated Soft Tissue Abscesses in an Immunocompetent Host.

The majority of disseminated cryptococcal infections occur in patients with acquired immunodeficiency syndrome (AIDS), with only 11-14% of cases occurring in patients without AIDS. Most non-AIDS related cases (75%) occur in patients with another immune deficiency. Here, we present the first case of mucocutaneous cryptococcal disease in an immunocompetent host, review the epidemiology of risk factors associated with disseminated cryptococcal disease, and describe a rational workup for a possible acquired immunodeficiency.

Breast Reinnervation: DIEP Neurotization Using the Third Anterior Intercostal Nerve.

Background: The purpose of this article is to evaluate a new method of DIEP flap neurotization using a reliably located recipient nerve. We hypothesize that neurotization by this method (with either nerve conduit or direct nerve coaptation) will have a positive effect on sensory recovery.

Methods: Fifty-seven deep inferior epigastric perforator (DIEP) flaps were performed on 35 patients.

Local foreign-body reaction to commercial biodegradable implants: an in vivo animal study.

Biodegradable plates have been used extensively in fracture fixation since the 1960s. They rarely cause stress-protection atrophy or problems requiring secondary plate removal, common complications seen with metallic plates. However, aseptic foreign-body reactions have been reported, sometimes years after the original implantation.

Cleft nasal deformity and rhinoplasty.

The cleft nasal deformity is a complex challenge in plastic surgery involving the skin, cartilage, mucosa, and skeletal platform. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. In this article, the authors review the literature and summarize the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity.

Breast implant infections: is cefazolin enough?

Background: Bacterial infection is a well-known risk of breast implant surgery, occurring in 2.0 to 2.5 percent of cosmetic cases and up to 20 percent of reconstructive cases.

A modified technique for inferior turbinate reduction: the integration of coblation technology.

Background: Many procedures have been described for the surgical management of inferior turbinate hypertrophy. Coblation is a relatively new technology that uses radiofrequency energy to ablate hypertrophied tissues. The standard method of using this technology has been shown to be effective; however, it only partially relieves symptoms of obstruction.

Laser therapy in ethnic populations.

Today, laser therapy is standard treatment for a wide variety of dermatologic complaints. From skin rejuvenation to the management of complex vascular malformations, laser treatment has proved to be an effective, innovative solution to once-challenging dilemmas. However, laser application in those with darker complexions remains a topic of great concern.

Facial clefting and oroauditory pathway manifestations in ankyloblepharon-ectodermal defects-cleft lip/palate (AEC) syndrome.

Ankyloblepharon-ectodermal defects-cleft lip/palate (AEC) Syndrome is a rare disorder characterized by ectodermal dysplasia, along with other malformations such as cleft lip and palate, and various secondary issues such as chronic sinusitis, otitis media, and conductive hearing loss (CHL). The International Research Symposium for AEC Syndrome convened at Baylor College of Medicine in Houston, Texas. Patients with a suspected diagnosis of AEC syndrome attended, and members of the dental, dermatology, plastic surgery, otolaryngology, and audiology services examined each patient.

Peripheral nerve injuries of the pediatric hand: issues in diagnosis and management.

Peripheral nerve injuries resulting in significant neural disruption frequently present complex management challenges. Typically the product of fracture, dislocation, or crush injuries, pediatric peripheral nerve injuries may be difficult to accurately characterize. Thorough clinical examination coupled with electromyogram and neurophysiologic studies are extremely useful.

Embryology of the hand and upper extremity.

As a universal means of communication and a critical tool for survival, the human hand is of extraordinary importance to our evolutionary survival. As the product of countless overlapping chemical signals, the upper extremity is highly dependent on a multifactoral web of genetic and environmental factors. At the molecular level, specialized signaling centers guide limb development along 3 spatial limb axes: (1) proximodistal, (2) anteroposterior, and (3) dorsoventral.

Popliteal pterygium: report of an anatomic variant.

The presence of a vertical fibrous cord along the posterior lower extremity is highly unusual. Because of its inflexible nature, cord structure may greatly limit leg extension, dorsiflexion, and general ambulation. Because of the paucity of such events, management strategies remain poorly defined.

Techniques in frontal sinus fracture repair.

Constituting only 5 percent of facial fractures, frontal sinus fractures are relatively uncommon. However, given the great amount of force required to produce them, substantial morbidity is often seen. A thorough understanding of corrective techniques is essential when approaching these challenging injuries.

Managing the pediatric facial fracture.

Facial fracture management is often complex and demanding, particularly within the pediatric population. Although facial fractures in this group are uncommon relative to their incidence in adult counterparts, a thorough understanding of issues relevant to pediatric facial fracture management is critical to optimal long-term success. Here, we discuss several issues germane to pediatric facial fractures and review significant factors in their evaluation, diagnosis, and management.

Principles of pediatric mandibular fracture management.

Mandible fractures are commonplace in today's craniofacial practice; however, managing the infrequent, operative pediatric mandible injury requires a thorough knowledge base and thoughtful approach. Not only do these patients demonstrate variable anatomy due to differing stages of dental eruption, but condylar disruption may translate into long-term growth disturbance. In addition, patient immaturity often complicates cooperation, and both fixation strategies and postoperative planning must take this into account.

Non-involuting congenital haemangioma associated with high-output cardiomyopathy.

Non-involuting congenital haemangioma (NICH) is a rare cutaneous vascular tumour about which little is known. Fully formed at birth, NICH enlarges proportionally with age but fails to involute as most infantile haemangiomas do. In addition to this unique clinical character, NICH demonstrates several distinct features.

Optimizing miniplate fixation for simple mandibular fractures.

Optimal management of the mandible fracture is directly dependent on thorough evaluation, correct injury assessment, and timely initiation of appropriate therapy. As the mandible is a complex three-dimensional bone, significant structural differences in mandibular regions must be appreciated. While the small cross-section of the mandibular condyle imparts a particular vulnerability to injury, fractures of the angle, body, or symphyseal regions are associated with greater force and the potential for more complex injury.

Principles of facial trauma: orbital fracture management.

Often, complex, optimal management of the orbital fracture is directly dependent on thorough initial evaluation, correct injury assessment, and timely initiation of chosen therapy. Most often, secondary to assault or motor vehicle collision, these fractures are frequently associated with additional traumatic injury. With recent advances in imaging, alloplastic materials, and bone fixation technology, the evolution of orbital fracture management now enables reconstruction of even the most severe injuries.

External distraction osteogenesis in the pediatric mandible.

Mandibular distraction osteogenesis is an effective tool with which to correct facial asymmetry, restore proper occlusion and, more importantly, create an appropriate airway in the micrognathic infant. As a component of many syndromes, micrognathia can impair feeding and speech development and can obstruct the neonatal airway. However, bony lengthening secondary to external mandibular distraction osteogenesis can provide added space, preventing oropharyngeal soft tissues from occluding the airway.

Bifid nose with cleft hand deformity: syndromic association or undescribed anomaly?

The simultaneous presentation of bifid nose and bilateral cleft hand defects has not previously been described. Already rare in presentation, the bifid nose continues to challenge reconstructive surgeons as to optimal management. Although cleft defects of the hand may be somewhat more common, the multitude of surgical approaches available to correct these deformities is a testament to their lack of optimal effect.