Long Term Follow-Up of Composite Non-Vascularized Toe Phalanx Transfers for Aphalangia

2005 ◽  
Vol 30 (5) ◽  
pp. 452-458 ◽  
Author(s):  
M. A. TONKIN ◽  
A. K. DEVA ◽  
S. L. FILAN
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
Joint Motion ◽  
Active Joint ◽  
Long Term Follow Up

The results of 21 non-vascularized toe phalanx transfers in 13 patients were reviewed radiologically with respect to function, physeal patency, growth and donor site morbidity at a mean follow-up of 7.4 (range 2.9–13.6) years. Physeal patency was maintained in 4 of 18 surviving transfers. The length of the transferred phalanx averaged 75% of the contralateral comparable toe phalanx and 44% of the contralateral digit proximal phalanx. Most patients had good or simple use of the hand with active joint motion. There was universal shortening of the donor toe with hypoplasia of the middle and distal phalanges. This review suggests that transfer of a non-vascularized toe phalanx provides a reliable but limited means for increasing length of a digit, stabilizing soft tissue “nubbins” and improving function. Longer follow-up has shown more modest gains in growth than in some previous reports.

scholarly journals Case Report

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. NP38-NP40 ◽  
Author(s):  
Sanjay Naran ◽  
Joseph E. Imbriglia
Keyword(s):  
Case Report ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Metacarpophalangeal Joints ◽  
Active Function ◽  
Patient Reported ◽  
Long Term Follow Up

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

scholarly journals Nipple Reconstruction Techniques: Which is the Best Choice?

2018 ◽  
Vol 5 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Nicolò Bertozzi ◽  
Francesco Simonacci ◽  
Marianna Pesce ◽  
PierLuigi Santi ◽  
Edoardo Raposio
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Contralateral Side ◽  
Skin Thickness ◽  
Nipple Reconstruction ◽  
Areolar Complex ◽  
Long Term Follow Up ◽  
Case Basis

Nipple-Areolar Complex (NAC) reconstruction represents the final, concluding journey of breast reconstruction by being able to give to reconstructed breasts the shape of a natural breast mound. Nevertheless an enormous amount of nipple reconstruction techniques are described in literature, given the fact that most reconstructive options fail to give satisfactory outcomes in relation to the long-term nipple projection. In this review, the authors will browse most common nipple reconstruction techniques, taking into account: Indication, outcome, and side effect. Composite nipple grafts, traditional flaps, flaps with autologous graft augmentation, flaps with allograft augmentation, and flaps with alloplastic augmentation are the main strategies employed nowadays. Composite nipple grafts give the best guarantee of color-texture match with the contralateral side and show satisfactory nipple projection even at long-term follow-up. Skate, star, C-V, and arrow flap are by far the most commonly employed and the most reliable local flaps, however loss of projection of up to 70 percent are reported in literature. Alloplastic grafts were associated with the lowest rates of projection loss followed by autologous and allogenic ones. Nevertheless allogenic grafts are also associated with the highest complication rate, while autologous and allogenic ones have similar rates. Infection, seroma, and fat necrosis are the more commonly reported complications of autologous grafting along with donor site morbidity, while allogenic and alloplastic augmentation grafts may also experience the risk of overcorrection and graft exposure. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn’t been found yet. Whereas it should be chosen on case to case basis depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients’ expectations to ensure the best cosmetic outcome.

Auricular composite grafting to repair nasal vestibular stenosis

2000 ◽  
Vol 122 (4) ◽  
pp. 529-532 ◽  
Author(s):  
Matthew Karen ◽  
Edward Chang ◽  
Monte S. Keen
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Senior Author ◽  
Nasal Surgery ◽  
Common Causes ◽  
Long Term Follow Up ◽  
Nasal Trauma ◽  
Surgical Treatments

Nasal vestibular stenosis is defined as a narrowing of the nasal inlet resulting in airway obstruction. Causes include nasal trauma, infection, and iatrogenic insults. The objectives of this article are to illustrate nasal vestibular stenosis and to analyze common causes and surgical treatments. The operative technique of the senior author (M.S.K.), will be presented. Donor site morbidity and patient outcomes will be discussed. Sixteen patients were seen during a 5-year period. Eleven women and 5 men were evaluated and found to have nasal vestibular stenosis. Three patients had stenosis as a result of nasal fracture or laceration. Stenosis developed in the remaining 13 as a result of nasal surgery. All patients underwent auricular composite grafting, and grafts took in 100%. Partial skin slough occurred in up to 50%; however, re-epithelialization was seen within 3 weeks. Complications were seen at the donor site. Immediate patient satisfaction was seen and continues during long-term follow-up.

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

scholarly journals Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yi-Lin Liao ◽  
Shu-Ya Wu ◽  
Yueh-Ju Tsai
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Long Term Results ◽  
Chang Gung Memorial Hospital ◽  
Cartilage Graft ◽  
Auricular Cartilage ◽  
Prosthesis Fitting ◽  
Prosthesis Retention

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.

scholarly journals Modified IVAN Technique: Long-term Follow-up of 20 Cases Over 2 to 11 Years

2020 ◽  
pp. 0000-0000
Author(s):  
Snjezana Pohl ◽  
Gregori M. Kurtzman
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Augmentation ◽  
Extraction Socket ◽  
Immediate Placement ◽  
Long Term Follow Up ◽  
A Site ◽  
Natural Tooth ◽  
Implant Reconstruction

Failure of a natural tooth may not permit placement of an implant at the time of extraction due to insufficiency in available bone to house the implant. Reconstruction of the extraction socket frequently involves both hard and soft tissue augmentation to provide a site that can house the implant and ridge contours that mimic the adjacent natural anatomy. The modified IVAN technique achieves those goals and may be used in both delayed and immediate placement situations. The technique will be discussed as well as long-term follow-up on 20 cases treated by the author.

scholarly journals Long-term follow-up of patients treated with neoadjuvant chemotherapy and radiotherapy for large, extremity soft tissue sarcomas

Cancer ◽  
2011 ◽  
Vol 118 (15) ◽  
pp. 3758-3765 ◽  
Author(s):  
John T. Mullen ◽  
Wendy Kobayashi ◽  
Jing Jing Wang ◽  
David C. Harmon ◽  
Edwin Choy ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Soft Tissue Sarcomas ◽  
Long Term Follow Up
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