Periprosthetic Ulna Fractures Following Aptis Distal Radioulnar Joint Arthroplasty: A Series of Four Cases.

Purpose: This case series presents four cases of periprosthetic ulna fractures following Aptis distal radioulnar joint (DRUJ) arthroplasty to elucidate clinical characteristics, contributing factors, management challenges, and short-term outcomes following this rare complication and to propose prevention and optimal treatment strategies.

Methods: We conducted a retrospective review of 239 Aptis DRUJ prostheses implanted between 2012 and 2022 at a single institution. We identified four cases of periprosthetic ulna fractures and assessed demographics, surgical indications, time to fracture, mechanism of injury, radiographic findings, treatment modalities, associated complications, and outcomes.

Management of osteochondritis dissecans lesions of the elbow including return to sport remains variable among orthopaedic surgeons.

Introduction: Management of osteochondritis dissecans (OCD) lesions of the capitellum is challenging. Historically, variability exists between surgeons in the evaluation, treatment, and return to sport criteria. The purpose of this study was to define the current trends regarding evaluation, nonoperative and surgical management, and return to sport criteria for capitellar OCD lesions among surgeons.

Optimizing continuous passive motion duration following arthroscopic release of elbow contracture: a retrospective study.

Background: The anatomical structure of the elbow joint makes it vulnerable to contractures. While elbow arthroscopy minimizes soft tissue damage and enhances early rehabilitation, the optimal duration for postoperative Continuous Passive Motion (CPM) therapy is unclear. This retrospective study aims to establish the appropriate duration of CPM following arthroscopic elbow contracture release.

Navigating the Complexities of Radiation Injuries: Therapeutic Principles and Reconstructive Strategies.

Radiation injuries, particularly those resulting from therapeutic or accidental exposure, present complex challenges for medical management. These injuries can manifest localized skin damage or extend to deeper tissues, presenting as various clinical entities that require treatment strategies, ranging from conservative management to complex surgical interventions. Radiation treatment constitutes a fundamental component of neoplastic management, with nearly two out of three oncological instances undergoing it as an element of their therapeutic strategy.

Functional mechanism and clinical implications of mir-1271-5p in pilon fracture healing processes.

Background: Pilon fractures are challenging to treat and carry a risk of delayed healing. MicroRNA (miRNA) is closely associated with various diseases due to its ability to regulate gene expression. Consequently, this study aimed to examine the connection between miR-1271-5p expression levels and pilon fracture healing processes, while also exploring the underlying mechanisms.

[Carcinologic surgery of the forehead].

This chapter deals with the guiding principles of small forehead carcinology in routine hospital-based and private practice, as well as more complex microsurgical reconstruction following severe loss of cutaneous substance. This article also affords an occasion to pay tribute to Professor Jean Marie Servant, whose case studies were never published.

Linked Flaps of the Thoracodorsal Vascular Tree for Correcting Extensive Post-Burn Deformities and Achieving Optimal Reconstruction Outcomes.

Background: Autologous skin grafting has been the popular method for reconstructing post-burn defects. However, this technique has limitations such as high contracture rates and inadequate volume coverage. This report aims to propose the principles and advantages of utilizing microsurgically linked perforator flaps for the reconstruction of extensive burn defects and associated post-burn scar contracture in the lower and upper extremities and trunk.

Direct muscle neurotization: Previous advancements in animal models.

Peripheral nerve repair is daily activity for several microsurgeons. Numerous nerve repair techniques are applied, including neurorrhaphy, nerve grafting and nerve transfer, depending on the nature and extent of the injury. However, these techniques become unfeasible when the distal nerve end is not preserved during the peripheral nerve injury or a segment of the muscle is transferred without the nerve supplying it.

The Mangled Upper Extremity-Algorithm for Salvage: My Workhorse Flaps.

Mangling injuries of the upper extremity are severe, high-energy traumas that damage multiple functional systems including skin, nerves, vascular, tendon, and bone. Management requires familiarity with various techniques in orthopedic, vascular, and plastic surgery. A specific technique cannot be described due to the various combinations of injuries that can occur with mangled upper extremities, but we present principles and recommendations for treatment and judgment.

The Godina Principle in the 21st Century: Free Flap Timing after Isolated Lower Extremity Trauma in a Retrospective National Cohort.

Background:  The timing of free flap reconstruction after lower extremity trauma has been a controversial debate since Marko Godina's original 72-hour recommendation. Recent advances in microsurgery warrant an evaluation of the optimal time to reconstruction.

Methods:  The Nationwide Readmission Database (2014-2019) was used to identify patients undergoing free flap reconstruction after lower extremity trauma.

How to conduct a meta-analysis in hand surgery. Part I: principles and procedures.

Meta-analysis (MA) is a fundamental statistical tool for combining the results of different studies to obtain potentially high-level evidence that can be implemented in clinical practice. Although its use in clinical research is increasing, MAs are still relatively rare in hand surgery. Therefore, it should be important for every hand surgeon to not only know how to interpret a MA, but also how to perform one.

Sterile Draping of Operative Microscopes in Breast Free Flaps and Surgical Site Infections.

Background: Operative microscopes are traditionally draped in single-use plastic to prevent infection theoretically. The necessity of this routine in breast free flap surgery is unclear. Alternatively, sterile wrapping of microscope handles would reduce operating room waste and provide a more cost-effective and environmentally sustainable approach to sterility.

Innovative surgical precision: The electronic pen needle holder based on neurophysiological principles.

Background: The electronic pen needle holder (EPNH) was developed to enhance surgical precision, reduce operative time, and improve patient outcomes. By integrating microergonomics, penization, and electronics with surgical instruments, the EPNH aims to provide surgeons with a tool that minimizes hand strain and maximizes control during delicate procedures.

Methods: The EPNH was ergonomically designed to fit the surgeon's hand, using titanium for its strength and biocompatibility.

[Surgical Treatment of Oropharyngeal Cancer - Recommendations of the Current German S3 Guideline, Part I].

In general, a trend towards transoral resection (as opposed to classic open approaches) + neck dissection + adjuvant radio- (chemo-) therapy has been observed for oropharyngeal carcinoma over the last 20 years. Techniques of transoral surgery (TOS), including transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) have been propagated in retrospective comparisons with conventional surgery or primary radiochemotherapy as gentle, minimally invasive procedures with good late functional results. Meta-analyses of mostly uncontrolled retrospective analyses suggest that TORS may have better disease-free survival (DFS) and a reduced risk of free flap reconstruction compared with open surgery.

A Microsurgical Skills Curriculum to Develop Unconscious Competence.

The attainment of microsurgical competency is an important milestone for plastic surgery trainees. Technical skill and a practiced disposition are required to successfully perform microsurgical procedures. Microsurgical skills curricula may foster both proficiency with technical movements and facilitate performance with minimal cognitive burden while using the operating microscope.

Comparative Optics of the Surgical Microscope and Rigid Endoscopes in Neurosurgery.

This chapter is intended to provide a brief overview of the optics of surgical microscopes and rigid endoscopes, with the aim of providing the reader with the principles dictating the nature of surgical visualization when either of the visual control systems is used. It is not by any means geared toward elaborating on the detailed optical physics of these systems, which is beyond the scope and objective of this chapter.

Current Surgical Methods in Local Rectal Excision.

Background: The treatment of rectal cancer has evolved with the advancement of surgical techniques. Less invasive approaches are becoming more accepted as the primary treatment method.

Summary: Such methods as transanal excision, transanal endoscopic microsurgery, and transanal minimally invasive surgery can reduce morbidity and mortality rates.

Laboratory animal ethics education improves medical students' awareness of laboratory animal ethics.

Objective: In this study, we added laboratory animal ethics education into both didactic sessions and practical sessions the general surgery laboratory course, with the didactic sessions focus on teaching the fundamental principles of laboratory animal ethics, while the practical sessions emphasize the application of these principles in laboratory classes and have assessed the changes in medical students' perception of laboratory animal ethics following medical students exposure to such education.

Methods: One hundred and eighty-nine third-year medical students from Wuhan University's Second Clinical College completed a laboratory animal ethics awareness questionnaire and a laboratory animal ethics written examination before and after laboratory animal ethics education.

Results: After receiving laboratory animal ethics education, the percentage of students who supported euthanasia for the execution of animals and humane treatment of laboratory animals were 95.

Open Dislocation of the Lunate and Triquetrum: A Case Report.

The Mayfield sequence of progressive perilunar instability is commonly encountered. A reverse-perilunate sequence has also been described, where forces are transmitted from the ulnar wrist, resulting in progressive disruption of the ulnocarpal and lunotriquetral intervals. A concomitant dislocation of both the lunate and triquetrum together is a rare injury and has not been reproduced in cadaver models nor widely encountered in clinical cases.

Management of failed flow diversion for intracranial aneurysm beyond the first 6 months of follow-up: an international Delphi consensus.

Objective: The placement of flow-diverting devices has become a common method of treating unruptured intracranial aneurysms of the internal carotid artery. The progressive improvement of aneurysm occlusion after treatment-with low complication and rupture rates-has led to a dilemma regarding the management of aneurysms in which occlusion has not occurred within 6-24 months. The authors aimed to identify clinical consensus regarding management of intracranial aneurysms displaying persistent filling 6-24 months after flow diversion and to ascertain questions that may drive future investigation.

Individualized design program of multiple flaps for adapting different zones to repair large irregular wounds in children.

Objective: Management of large irregular wounds in children had been confusing plastic and reconstructive surgeons. Herein, this study was aimed to propose a new treatment method based on the principle of adapting different recipient zones to overcome the intractable wounds, simplifying and programing the design process of targeted flaps for covering large irregular soft-tissue defects.

Patients And Methods: From January 2009 to December 2020, 31 children (9 girls and 22 boys) aged 3-16 years (mean 9.