Results and complications of operative and non-operative navicular fracture treatment.

Background: Navicular fractures (NF) are uncommon. The purpose of this study was to compare results of operative (ORIF) and non-operative (NOT) treatment in NF.

Methods: A retrospective analysis was undertaken on patients diagnosed with NF between March 2002 and June 2007 at a Level I teaching trauma centre.

Results of 70 consecutive ulnar nightstick fractures.

Background: Adult isolated ulnar shaft fractures (IUSFs) are uncommon, and treatment remains controversial. The purpose of this study was to compare results of operative (reduction internal fixation (RIF)) and nonoperative treatment (NOT) in patients with IUSF.

Material And Methods: A retrospective case-control analysis was undertaken on patients diagnosed with IUSF between 2002 and 2008 at a Level I teaching trauma center.

Barbed sutures in plastic surgery: a personal experience.

Secure closure of wounds is vital to any plastic surgery procedure. Recent developments in suture design have incorporated the creation of small barbs along the suture strand that are intended to engage the surrounding soft tissue and "lock" the suture (and, therefore, the wound closure) into place. Early experience with this type of modified suture has shown promise for a host of wound closure indications, including the closure of skin and fat as well as superficial and deep fascia.

Outcomes of traditional cosmetic abdominoplasty in a community setting: a retrospective analysis of 1008 patients.

Background: Abdominoplasty is one of the most commonly performed cosmetic operative procedures. Few large studies have examined outcomes of cosmetic abdominoplasty in a community setting. The authors explored postoperative outcome and the preoperative and intraoperative factors that may contribute to these complications.

Cosmetic rhinoplasty: revision rates revisited.

Background: Cosmetic rhinoplasty has great potential to change a patient's appearance. It also carries the very real risk of patient dissatisfaction and request for revision. Although there have been many published patient series studying various aspects of rhinoplasty, questions remain regarding revision rates, as well as risk factors for complications, dissatisfaction, and revision.

A new method for estimation of involved BSAs for obese and normal-weight patients with burn injury.

An accurate measurement of BSA involved in patients injured by burns is critical in determining initial fluid requirements, nutritional needs, and criteria for tertiary center admissions. The rule of nines and the Lund-Browder chart are commonly used to calculate the BSA involved. However, their accuracy in all patient populations, namely obese patients, remains to be proven.

Complication rates for percutaneous lower extremity arterial antegrade access.

Hypothesis: The antegrade access (AA) for percutaneous arterial interventions is associated with a higher complication rate than is the retrograde access (RA).

Design: Retrospective case review.

Setting: A statewide consortium for peripheral vascular interventions consisting of 13 Michigan hospitals collecting data on their endovascular procedures.

A novel technique for performing a tongue-lip adhesion-the tongue suspension technique.

Background: The tongue-lip adhesion has undergone several modifications in an attempt to reduce surgical complications and failure rates. Current techniques rely on the use of a button at the tongue base for suspension, which raises concerns about possible aspiration and interference with oral motor function and bottle-feeding. A new technique for tongue-lip adhesion is proposed that adds a tongue suspension to the standard surgical adhesion.

Rupture rate and patterns of shell failure with the McGhan Style 153 double-lumen breast implant.

Background: In 2005, the McGhan Style 153 double-lumen breast implant was removed from the market secondary to a higher rupture rate when contrasted with other implants in the Core Study group. The high rupture rate was attributed to the development of a posterior tear in the shell where the inner implant is bonded to the posterior wall of the device. The purpose of this study was to report the existing rupture rate and describe the apparent mechanism of failure in the Style 153 double-lumen breast implant.

Recent advances in the use of serological bone formation markers to monitor callus development and fracture healing.

The failure of an osseous fracture to heal, or the development of a nonunion, is common; however, current diagnostic measures lack the capability of early and reliable detection of such events. Analyses of radiographic imaging and clinical examination, in combination, remain the gold standard for diagnosis; however, these methods are not reliable for early detection. Delayed diagnosis of a nonunion is costly from both the patient and treatment standpoints.

Outcomes of fractional CO2 laser application in aesthetic surgery: a retrospective review.

Background: Despite the effectiveness of ablative CO(2) laser resurfacing for facial rejuvenation, its application has been limited owing to an undesirable side-effect profile, including prolonged hyperemia and potential pigmentary changes. However, newer fractional CO(2) laser technology has reduced the recovery time and led to decreases in postprocedural hypo- and hyperpigmentation.

Objectives: The authors investigate the application and outcomes of ablative fractional technology in a private cosmetic surgery practice.

Outdoor recreational fires: a review of 329 adult and pediatric patients.

Outdoor recreational fires are a frequent occurrence during the summer months and can be associated with burns resulting in significant morbidity. Both pediatric and adult populations can be affected, and their mechanism of injury is often different. Understanding these mechanisms is important when designing prevention programs.

Plastic surgery chief resident clinics: the current state of affairs.

Background: One of the goals of plastic surgery residency programs is to provide effective training in aesthetic surgery. Recently, programs have adopted the idea of chief clinics to provide senior residents with the opportunity to perform cosmetic surgery with an increased level of autonomy. The goal of this article is to characterize chief clinics currently in place and their usefulness in providing effective training in plastic surgery under the precepts set forth by the Accreditation Council for Graduate Medical Education.

Bilateral and multinodular signet-ring stromal tumor of the ovary.

Background: Signet-ring stromal tumor of the ovary is a rare, benign sex cord stromal tumor that is typically unilateral. Its distinction from malignant signet-ring cell adenocarcinoma metastatic to the ovary (Krukenberg tumor), is critical.

Case: A 69-year-old gravida 5 woman presented with a 1-week history of right lower abdominal pain.

Bariatric surgery outcomes in patients aged 65 years and older at an American Society for Metabolic and Bariatric Surgery Center of Excellence.

Background: Although morbid obesity rates in patients >or=65 years of age are increasing, few centers have reported weight loss surgery outcomes in elderly patients, resulting in a paucity of literature on perioperative mortality and morbidity.

Methods: A retrospective analysis was performed on 197 consecutive patients >or=65 years old who underwent weight loss surgery from January 2000 to December 2007. Primary data points included 30-day and 1-year mortality rates, length of stay (LOS), percent excess weight loss (EWL), change in daily medication use, and quality of life (QOL).

Randomized, double-blind, placebo-controlled trial using lidocaine patch 5% in traumatic rib fractures.

Background: The lidocaine patch 5% was developed to treat postherpetic neuralgia. Anecdotal experience at our institution suggests the lidocaine patch 5% decreases narcotic usage in patients with traumatic rib fractures. This trial was developed to define the patch's efficacy.

Safety of laparoscopic ventral hernia repair in octogenarians.

Background And Objectives: The recurrence rate after laparoscopic ventral hernia repair is lower than the rate of recurrence via the open approach in many series. Studies have demonstrated the safety and efficacy of this procedure but have had relatively young patient populations. We present our experience in a significantly older population.

Mucormycosis of the face.

As burn wound sepsis continues to be one of the most common causes of death in burn patients, it is important to note the trend of increased involvement of fungal pathogens. Very little exists in the literature regarding management of such fungal infections. We report invasive cutaneous mucormycosis involving the face of an extensively burned patient with no prior medical history that would otherwise predispose her to such infection.

Office-based vascular lab: is it worth the effort?

The vascular laboratory is an essential part of any contemporary clinical vascular practice. The prototype of the vascular laboratory consisted mainly of instruments designed to understand the hemodynamics of the vascular tree. Earlier versions also played important roles in clinical research.