The K-Wire Fixation Technique for Endoscopic Brow Lift: A Long-Term Follow-Up

2019 ◽  
Vol 40 (10) ◽  
pp. 1051-1060 ◽  
Author(s):  
Paul E Chasan ◽  
Adam T Hauch
Keyword(s):  
Fixation Technique ◽  
Effective Technique ◽  
Level Of Evidence ◽  
Brow Lift ◽  
Wire Fixation ◽  
Aesthetic Results ◽  
Long Term Follow Up ◽  
Endoscopic Brow Lift

Abstract Background Many techniques have been presented for fixation during endoscopic brow lift, but no singular technique has become dominant. Objectives The authors described a technique for fixation for endoscopic brow lift that is inexpensive, easy to use, and versatile and has minimal morbidity. Methods The charts of 284 patients who underwent the K-wire fixation technique between December 1996 and September 2018 were reviewed. This technique employs a transcutaneous K-wire to hold the brow in position until tissue adhesion creates a lasting elevation of the brow. Results A total of 284 patients underwent K-wire fixation for endoscopic brow lifting. Two patients had hematomas and 5 patients (1.8%) required a second unilateral brow lift procedure. Long-term elevation of the brow was maintained in all patients. Conclusions K-wire fixation for endoscopic brow lift is a simple, safe, and effective technique for fixation during endoscopic brow lifting that provides long-term aesthetic results. Level of Evidence: 4

scholarly journals Reduction and Association of the Scaphoid and Lunate: A Functional and Radiographical Outcome Study

2018 ◽  
Vol 08 (01) ◽  
pp. 037-042
Author(s):  
William Aibinder ◽  
Ali Izadpanah ◽  
Bassem Elhassan
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
High Rate ◽  
Salvage Procedure ◽  
Level Of Evidence ◽  
Long Term Follow Up ◽  
The Mean ◽  
Ligament Disruption

Background Management of scapholunate (SL) ligament disruption is a challenging problem. The reduction and association of the scaphoid and lunate (RASL) procedure has been described with varying results. This study assessed the outcomes of the RASL procedure. Purpose The objective of this study was to assess the outcomes of patients undergoing the RASL procedure at our institution in regard to pain relief, range of motion, radiographic and functional outcomes, complications, and reoperations. Materials and Methods Twelve patients with symptomatic chronic SL instability underwent the RASL procedure. The mean age was 35 years. The mean time from injury to surgery was 40 weeks. The mean follow-up was 89 months. Outcomes included visual analog score for pain, wrist range of motion, grip strength, and Mayo Wrist Scores. Preoperative and postoperative radiographs were reviewed. Results Pain scores improved in 10 wrists. Range of motion and grip strength worsened. The average Mayo Wrist Score was 63.3. The mean SL diastasis and angle improved, but seven wrists developed progressive degenerative changes, with two requiring a salvage procedure. Symptomatic progressive screw lucency occurred in eight wrists requiring screw removal. Conclusion The RASL procedure can improve SL widening but has a high rate of early failure and reoperation. Following reoperation, long-term follow-up demonstrates reasonable long-term durability in some cases. Level of Evidence This is a Level IV, therapeutic case study.

Non-vascularized toe phalanx transfer for correction of severe clinodactyly of the thumb in Rubinstein–Taybi syndrome

2020 ◽  
Vol 45 (7) ◽  
pp. 715-721
Author(s):  
Marie Le Mapihan ◽  
Alina Badina ◽  
Stéphanie Pannier ◽  
Arielle Salon ◽  
Chrisophe Glorion ◽  
...  
Keyword(s):  
New Method ◽  
New Technique ◽  
Level Of Evidence ◽  
Before And After ◽  
Long Term Follow Up ◽  
Osteotomy Technique ◽  
Toe Transfer ◽  
Delta Phalanx

In Rubinstein–Taybi syndrome, patients may have a particularly severe clinodactyly of the thumb. We evaluated a new method for correction of these severe clinodactylies using non-vascularized toe phalanx transfer as a replacement for the abnormal delta phalanx. Results of the new technique are presented, together with those of an osteotomy technique. We retrospectively recorded the angle of the clinodactyly before and after surgery and at long-term follow-up of 11 osteotomies and five transfers in nine patients from 1990 to 2017. The pre-operative angle of clinodactyli was similar between the two groups with a mean of 59°. After surgery, the correction was equivalent (7° and 11°). At the last follow-up (7 and 18 years), the relapse of clinodactyly was 17° for osteotomies and 1° for phalanx transfers. We noticed growth of the transferred phalanx, resulting in an excellent thumb length. We conclude that non-vascularized toe transfer can be an effective correction of severe clinodactyly and may be more stable than osteotomy in the long-term. Level of evidence: IV

Functional bladder paraganglioma: An odd presentation of haematuria

2020 ◽  
pp. 205141582095476
Author(s):  
Gerald Tatenda Mataruka ◽  
Khayalethu Dlamini ◽  
Alain Mwamba Mukendi ◽  
Raphael Blumberg ◽  
Solomon Orsar ◽  
...  
Keyword(s):  
Level Of Evidence ◽  
Rare Tumour ◽  
Long Term Follow Up ◽  
Blood Pressures ◽  
Iodine 131 ◽  
Work Up ◽  
Urine Metanephrines ◽  
Bladder Mass

Introduction: Bladder paraganglioma is a rare tumour of chromaffin cell origin. Few cases have been reported in the literature. Case report: A 59-year-old female with no known co-morbidities presented with catecholamine-related symptoms, haematuria, elevated blood pressures and raised urine metanephrines. A sonar and computed tomography scan confirmed a bladder mass shown to be active on iodine-131 meta-iodobenzylguanidine. Partial cystectomy was performed. Conclusion: Although bladder paraganglioma is rare, clinicians need to be aware of how such cases may present and the necessary work-up to confirm the diagnosis. Surgery is the treatment of choice, and long-term follow-up of these patients is necessary to detect recurrence or metastases. Level of evidence: 4.

scholarly journals Treatment of terrible triad injuries at a mean follow-up of nine years

2018 ◽  
Vol 11 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Ezequiel E Zaidenberg ◽  
Mariano O Abrego ◽  
Agustin G Donndorff ◽  
Jorge G Boretto ◽  
Pablo De Carli ◽  
...  
Keyword(s):  
Terrible Triad ◽  
Performance Score ◽  
Level Of Evidence ◽  
Mayo Elbow Performance Score ◽  
Flexion Extension ◽  
Long Term Follow Up ◽  
Radiological Changes ◽  
One Year

Background To evaluate the sustainability of the early clinical and radiological outcomes of terrible triad injuries at long-term follow-up. Methods Twelve consecutive patients who underwent fixation of terrible triad injuries with minimum of seven years of follow-up. Functional and radiological outcomes at one year and final follow-up were compared. We assessed Mayo Elbow Performance Score, Quick-Disability of the Arm Shoulder and Hand, and modified-American Shoulder and Elbow Surgeons Scores. Radiological evaluation included Broberg and Morrey classification and Hastings classification for heterotopic ossification. Results The mean age of patients was 55 years, with a median follow-up of 9.3 years. At final evaluation, mean flexion, extension, supination, and pronation were 145°, 6°, 82°, and 80°, respectively; mean Mayo Elbow Performance Score, modified-American Shoulder and Elbow Surgeons Scores, and Quick-Disability of the Arm Shoulder and Hand scores were, respectively, 97, 92, and 4.9 points. There was no statistical difference between early and final follow-up range of motion, Mayo Elbow Performance Score, and Quick-Disability of the Arm Shoulder and Hand. However, radiological changes were observed in 66% of the patients at final follow-up. Two patients underwent reoperation, with final satisfactory results. Conclusion Our results suggested that using a standardized protocol, satisfactory clinical outcomes at early follow-up could be maintained over time. However, early complications and osteoarthritic changes at long-term follow-up can be expected. Level of evidence Therapeutic IV Cases series.

Radioscapholunate fusion with triquetrum and distal pole of scaphoid excision: long-term follow-up

2017 ◽  
Vol 43 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Ngoc B. Ha ◽  
Joideep Phadnis ◽  
Simon B. M. MacLean ◽  
Gregory I. Bain
Keyword(s):  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Distal Pole ◽  
Long Term Follow Up ◽  
Radioscapholunate Fusion ◽  
The Mean

The purpose of this study was to assess the long-term outcomes of radioscapholunate fusion, with and without distal pole of scaphoid excision and excision of the triquetrum. These compromised three operative groups. Seventeen patients were identified with a minimum of 10 years follow-up, with a mean of 15 years (range 10–19). Fifteen of the 17 patients were satisfied with their outcome. Two were converted to total wrist fusion. The mean outcomes scores were; pain visual analogue scale score 2.1/10, Quick Disabilities of the Arm, Shoulder, and Hand 29 and Modified Mayo Wrist score 60. Patients with excision of the triquetrum had a mean radial–ulnar arc increase of 10° compared with the other two groups, but this was not statistically significant. The mean space for the scaphocapitate joint was 1.7 mm and lunocapitate joint was 1.3 mm at latest follow-up. Close adherence to the indications and surgical technique provided a sustainable good clinical outcome. Patients who obtained a good result at 2 years were likely to achieve a good long-term outcome. Level of evidence: IV

Long-term follow-up of Dupuytren disease after injection of triamcinolone acetonide in Chinese patients in Taiwan

2017 ◽  
Vol 42 (7) ◽  
pp. 678-682 ◽  
Author(s):  
C.-Y. Yin ◽  
H.-H. M. Yu ◽  
J.-P. Wang ◽  
Y.-C. Huang ◽  
T.-F. Huang ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Ultrasound Examination ◽  
Early Stage ◽  
Chinese Patients ◽  
Level Of Evidence ◽  
Long Term Follow Up ◽  
Nodular Growth ◽  
Dupuytren Disease

Injection of triamcinolone acetonide is a non-operative treatment for early-stage Dupuytren disease in Caucasians, but its effectiveness in non-Caucasians is unclear. We report averaged 5-year follow-up results of 37 patients (49 affected hands) with early-stage Dupuytren disease for patients in Taiwan (non-Caucasian) who received a single dose of 5 mg triamcinolone acetonide injection into nodules monthly for 3 months. Using ultrasound, we recorded no progression of sizes of the modules following injection after 6 months. After an average 5-year follow-up, two patients with three hands (6%) experienced reactivation of the treated nodules. None required surgical intervention. Ultrasound examination showed that sizes of the treated Dupuytren nodules decreased significantly by 40% 6 months after injection and 56% at the final follow-up. We conclude that in these Chinese patients in Taiwan with early Dupuytren nodules, triamcinolone acetonide injection was effective in reducing the size of the Dupuytren nodules and maintaining long-term durable control of the nodular growth. Level of evidence: III

Immediate Gore-Tex Sling Suspension for Management of Facial Paralysis in Head and Neck Extirpative Surgery

2007 ◽  
Vol 137 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Mia E. Skourtis ◽  
Stephen M. Weber ◽  
J. David Kriet ◽  
Douglas A. Girod ◽  
Terance T. Tsue ◽  
...  
Keyword(s):  
Head And Neck ◽  
Late Complications ◽  
Facial Reconstruction ◽  
High Rate ◽  
Wound Complications ◽  
Early Results ◽  
Aesthetic Results ◽  
Long Term Follow Up

OBJECTIVE: We sought to evaluate the functional and aesthetic outcomes of immediate facial reconstruction with a Gore-Tex (expanded polytetrofluoroethylene) sling in irradiated patients undergoing large head and neck tumor extirpation with facial nerve resection. STUDY DESIGN AND SETTING: We conducted a retrospective study of 17 patients at two academic institutions who underwent extirpative surgery with immediate Gore-Tex sling reconstruction and completed radiotherapy. Functional and aesthetic results were evaluated at three intervals. RESULTS: All patients had excellent immediate results and good or excellent intermediate-term results. At long-term follow-up, results were good to excellent in 47% and unacceptable in 35% of patients. CONCLUSION: In irradiated patients undergoing total parotidectomy with immediate facial reconstruction using Gore-Tex slings, early results are excellent, but there is a high incidence of major wound complications and unacceptable results in long-term follow-up. SIGNIFICANCE: There is a high rate of late complications associated with immediate facial reconstruction with Gore-Tex slings in irradiated patients.

scholarly journals BROAD PECTUS EXCAVATUM TREATMENT: LONG TERM RESULTS OF A BRAZILIAN TECHNIQUE

2021 ◽  
Vol 29 (4) ◽  
pp. 197-202
Author(s):  
Davi de Podestá Haje ◽  
Sydney Abrão Haje ◽  
José Batista Volpon ◽  
Ana Carolina Oliveira da Silva ◽  
Leonardo Ferreira Braz Lima ◽  
...  
Keyword(s):  
Pectus Excavatum ◽  
Skeletal Maturity ◽  
Long Term Results ◽  
Treatment Results ◽  
Level Of Evidence ◽  
End Of Treatment ◽  
Long Term Follow Up ◽  
And Performance

ABSTRACT Objective: This study aims the treatment results of broad pectus excavatum after a long-term follow-up and skeletal maturity. Methods: Eighty-four children and adolescents with broad-type pectus excavatum were selected for evaluation after treatment with a dynamic orthosis that applies compression to the lower rib projections and prescription of exercises. The broad pectus excavatum was defined as a deformity that the depressed area was greater and covered the area above and below the nipple line. All patients were evaluated for more than 1 year after the end of treatment and skeletal maturity. Post-treatment results were categorized as mild, moderate and severe. Statistic correlations between results and deformity flexibility, deformity severity, and adherence to treatment were assessed. Results: The mean age at the beginning of treatment was 13.3 years, and the follow-up duration was 25.7 months after suspension of orthosis use. Forty-eight percent of patients showed good results. With regular use of orthoses and performance of exercises, this rate increased to 70% (p < 0,001). Mild cases showed more success than severe cases (p = 0,007). Initial flexibility didn’t influence the results (p = 0,63). Conclusion: Treatment of broad pectus excavatum with orthoses and exercises led to good definitive results in most resilient patients, especially in those with mild deformities. Level of Evidence V, Expert Opinion.

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