IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-07 DOI: 10.1016/j.jpra.2025.12.024

Mai Nishijo , Rawan Jaibaji , Calver Pang , Charles Yuen Yung Loh

Background

The HARMONIC Shears is an ultrasonic surgical device enabling precise tissue dissection with simultaneous hemostasis. Its application in lower limb free flap reconstruction following trauma is underexplored.

Methods

A retrospective cohort study compared nine patients undergoing lower limb free flap reconstruction with HARMONIC FOCUS™+ Shears to nine patients using conventional dissection (diathermy and LIGACLIP clips). Patients were matched by flap type and concomitant orthopedic procedures. Primary outcome was total operative time. Secondary outcomes included flap survival, postoperative complications, length of hospital stay, and a comprehensive cost analysis encompassing theater time, consumables, and inpatient stay.

Results

HARMONIC Shears significantly reduced operative time in cases without concomitant orthopedic procedures (262.8 ± 46.3 vs 364.2 ± 53.9 min; p = 0.012). Across all cases, mean operative time was shorter in the HARMONIC Shears group (322.0 ± 81.1 vs 380.4 ± 53.5 min; p = 0.09). Flap survival was higher with HARMONIC Shears, with higher reoperation rates in the conventional group reflecting flap failures; however, this difference was not statistically significant. Specific postoperative complications rates, including infection, wound dehiscence, and donor site morbidity, were slightly higher in the HARMONIC Shears group, but all differences were not statistically significant. Mean hospital stay was 8.5 days shorter in the HARMONIC Shears group (p = 0.31). Cost analysis revealed theater and inpatient savings of up to £8699 per case with the HARMONIC Shears after accounting for device costs.

Conclusions

HARMONIC Shears may enhance operative efficiency and reduce healthcare costs in lower limb free flap reconstruction without compromising clinical outcomes. However, findings should be interpreted cautiously given the small sample size and limited statistical power. Larger prospective studies are warranted to confirm these findings.

背景：HARMONIC剪切机是一种超声手术设备，可以在止血的同时进行精确的组织剥离。其在创伤后下肢游离皮瓣重建中的应用尚不充分。方法回顾性队列研究比较了9例使用HARMONIC FOCUS™+剪刀进行下肢游离皮瓣重建的患者和9例使用常规剥离（透热和LIGACLIP夹）的患者。患者通过皮瓣类型和伴随的矫形手术进行匹配。主要观察指标为总手术时间。次要结局包括皮瓣存活、术后并发症、住院时间和综合成本分析，包括手术时间、耗材和住院时间。结果在未合并矫形手术的病例中，sharmonic剪可显著缩短手术时间（262.8±46.3 vs 364.2±53.9 min; p = 0.012）。在所有病例中，harmoneshears组的平均手术时间较短（322.0±81.1 vs 380.4±53.5 min; p = 0.09）。harmoneshear组皮瓣存活率较高，反映皮瓣失败的常规组的再手术率较高；然而，这种差异在统计学上并不显著。术后特定并发症发生率，包括感染、伤口裂开和供体部位发病率，harmonesars组略高，但差异均无统计学意义。谐波剪组平均住院时间缩短8.5天（p = 0.31）。成本分析显示，在计算设备成本后，使用HARMONIC剪刀可以为剧院和住院病人节省高达8699英镑的费用。结论sharmonic剪切机可在不影响临床效果的前提下提高手术效率，降低医疗费用。然而，由于样本量小，统计能力有限，研究结果应谨慎解释。有必要进行更大规模的前瞻性研究来证实这些发现。

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引用次数: 0

Artificial intelligence as a surgical advisor before a DIEP breast reconstruction. A blinded comparative study of three large language models 人工智能在DIEP乳房重建前的手术顾问。三种大型语言模型的盲法比较研究

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-05 DOI: 10.1016/j.jpra.2025.12.029

Reza Tabrisi , Johann Zdolsek , Nathalie Mobargha , Stina Rittri , Åsa Edsander-Nord , Ann-Charlott Docherty Skogh , Oriana Haran , Mattias Lidén , Karin Säljö , Tava Barivan , Sebastian Holm

Introduction

Large language models (LLMs) are increasingly used in clinical communication, but their accuracy and readability in patient education remain unclear. This study compared three LLMs for preoperative counseling before a DIEP breast reconstruction.

Methods

A total of 40 frequently asked preoperative questions regarding DIEP breast reconstruction were collected and categorized using the BREAST-Q framework. These were submitted in English to three LLMs: ChatGPT, Gemini and Copilot (anonymized as Model A-C). Each question was submitted to all three models and the responses were anonymized. An expert panel of eight board-certified plastic surgeons from both Europe and USA. Ratings were made of a 5-point Likert scale for accuracy, informativeness and readability. Together with a general evaluation (easiness, problematic content, incorrectness) and information-material specific evaluation (relevance and lowest reading level).

Results

Significant differences were found between models across all domains. ChatGPT achieved the highest accuracy (p = 0.019), Copilot was the most informative (p = 0.041), and both ChatGPT and Copilot produced more readable responses than Gemini (p < 0.001). Copilot had fewer problematic statements, while Gemini generated text at the simplest reading level but with lower accuracy. Agreement among raters was strong for accuracy (κ = 0.96) but weak for qualitative domains.

Conclusion

Each LLM showed distinct strength ChatGPT produced the most accurate answers, Copilot the most informative, and Gemini the simplest language. No model was uniformly superior. These findings support supervised, task-specific use of LLMs in patient education for breast reconstruction.

大型语言模型（llm）越来越多地用于临床交流，但其在患者教育中的准确性和可读性尚不清楚。本研究比较了三名LLMs在DIEP乳房重建术前的术前咨询。方法收集DIEP乳房再造术术前常见问题40个，采用breast - q框架进行分类。这些以英文提交给三位法学硕士：ChatGPT、Gemini和Copilot（匿名为Model A-C）。每个问题都提交给所有三个模型，回答是匿名的。由来自欧洲和美国的8位认证整形外科医生组成的专家小组。对准确性、信息量和可读性进行了5分李克特评分。与一般评价（容易程度、有问题的内容、不正确）和信息材料特定评价（相关性和最低阅读水平）一起。结果各领域模型之间存在显著差异。ChatGPT的准确率最高（p = 0.019）， Copilot的信息量最大（p = 0.041）， ChatGPT和Copilot都比Gemini产生了更可读的回答（p < 0.001）。副驾驶有问题的语句较少，而双子座生成的文本以最简单的阅读水平生成，但准确性较低。评分者之间的一致性在准确性上很强（κ = 0.96），但在定性领域上较弱。结论每个LLM都有明显的优势，ChatGPT语言的答案最准确，副驾驶语言的信息量最大，而Gemini语言的回答最简单。没有一种模式是绝对优越的。这些发现支持在乳房重建患者教育中监督、特定任务使用法学硕士。

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引用次数: 0

A modified no vertical scar technique in gender reassignment mastectomy: A description and case report 一种改良的无垂直疤痕技术在性别再分配乳房切除术中的应用：一个描述和病例报告

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-05 DOI: 10.1016/j.jpra.2025.12.026

Roberto Grella , Marcello Molle , Raffele Rainone , Maria Maddalena Nicoletti , Francesco Paolo Gesuete , Giovanni Francesco Nicoletti

Background and introduction

Surgical interventions, such as mastectomies, play a key role in gender affirmation for female-to-male (FtM) transitions, helping to improve psychological well-being. This article explores a modified FtM mastectomy technique that minimizes scarring and maintains NAC integrity.

Materials and methods

A 28-year-old transgender male underwent chest masculinization surgery using an inferior pedicle technique. This approach aimed to reduce scarring by avoiding vertical incisions, while preserving the NAC. Liposuction was performed in the upper quadrants to further enhance the masculinization effect. The NAC was repositioned to approximate male chest proportions, with postoperative follow-ups conducted to assess healing and outcomes.

Results

The patient’s postoperative recovery was smooth, with no complications. At follow-up, the patient reported high satisfaction with the surgical outcomes, and the TRANS-Q scores demonstrated substantial psychological and social improvements.

Discussion and conclusion

Chest masculinization is critical for FtM patients, enhancing self-image and social confidence. The inferior pedicle technique preserves NAC sensitivity and minimizes scarring. This approach represents a promising option for medium to large chest sizes, supporting both aesthetic goals and long-term satisfaction.

背景和介绍手术干预，如乳房切除术，在女性向男性（FtM）转变的性别确认中起着关键作用，有助于改善心理健康。本文探讨了一种改良的FtM乳房切除术技术，该技术可以最大限度地减少疤痕并保持NAC的完整性。材料与方法一位28岁的变性男性采用下椎弓根技术行胸部男性化手术。这种方法旨在通过避免垂直切口来减少疤痕，同时保留NAC。在上象限进行吸脂，进一步增强男性化效果。NAC复位以接近男性胸部比例，术后随访以评估愈合和预后。结果患者术后恢复顺利，无并发症发生。在随访中，患者报告了对手术结果的高满意度，TRANS-Q评分显示了心理和社会方面的实质性改善。讨论与结论胸部男性化对FtM患者至关重要，可以增强自我形象和社会信心。下椎弓根技术保留了NAC敏感性并使瘢痕最小化。这种方法对中大胸围来说是一个很有前途的选择，既能满足审美目标，又能让人长期满意。

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引用次数: 0

Reconstruction of an extensive gouty tophus ulceration at the wrist using a dermal matrix and autologous skin graft: A case report 应用真皮基质和自体皮肤移植重建腕部广泛痛风性痛风疮溃疡1例报告

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-05 DOI: 10.1016/j.jpra.2025.12.027

Tian-Hao Zhang , Zhi-Jiang Wang , Jian-Hong Huang , Jian Lin

Background

Ulcerated tophaceous gout of the wrist poses a major reconstructive challenge, owing to deep tissue infiltration by urate crystals, high infection risk, and the functional demands of the joint. Although local or free flaps are frequently used, these techniques are often associated with significant donor-site morbidity, technical complexity, and prolonged immobilization that may contribute to joint stiffness. This report presents a staged approach using a dermal regeneration matrix followed by autologous skin grafting, offering a less invasive and functionally advantageous alternative for reconstructing such complex defects.

Case Presentation

A 60-year-old male with a 25-year history of poorly controlled, treatment-refractory tophaceous gout presented with a 7-day history of a spontaneously ruptured ulcer on the dorsoradial aspect of the wrist, measuring 8 × 5 cm. The wound exhibited three hallmark features:

1. Tendon exposure with localized tendon necrosis;

2. Active tophaceous discharge, confirmed by microscopy to contain monosodium urate (MSU) crystals exhibiting needle-shaped morphology and negative birefringence;

3. Deep tissue invasion with intraoperative evidence of radiocarpal joint involvement.

Metabolic Parameters

Serum uric acid levels were 630 μmol/L preoperatively (during titration of febuxostat from 40 mg to 20 mg/day) and decreased to 500 ± 15 μmol/L at 24-month follow-up.

Aesthetic Outcomes

The Patient and Observer Scar Assessment Scale (POSAS) patient score was 2/10 (one representing normal skin).

Conclusion

The staged reconstruction protocol, which combines dermal substitution with autologous skin grafting, delivers durable soft tissue coverage and functional preservation in complex wrist gout ulcerations. This approach represents a less morbid and technically feasible alternative to traditional flap surgery, particularly in high-risk patients with multiple comorbidities. Excellent mid-term outcomes were observed, including 24-month recurrence-free survival.

背景：由于尿酸晶体对深层组织的浸润、高感染风险和关节的功能要求，手腕溃疡性痛风是一个重大的重建挑战。虽然经常使用局部或自由皮瓣，但这些技术通常与显著的供区发病率、技术复杂性和可能导致关节僵硬的长时间固定有关。本报告提出了一种分阶段的方法，使用真皮再生基质，然后进行自体皮肤移植，为重建这种复杂的缺陷提供了一种侵入性较小且功能优越的替代方法。病例表现：60岁男性，25年控制不良、难治性痛风病史，7天腕部背桡侧溃疡自发性破裂，大小为8 × 5 cm。伤口表现出三个特征：1。1 .肌腱暴露伴局部肌腱坏死；2 .活性石质分泌物，镜检证实含有尿酸钠（MSU）晶体，呈针状形态，双折射负；深部组织侵犯，术中有桡腕关节受累的证据。代谢指标术前（非布司他40 ~ 20 mg/d）血清尿酸水平为630 μmol/L，随访24个月降至500±15 μmol/L。患者和观察者疤痕评估量表（POSAS）患者评分为2/10（1代表正常皮肤）。结论分阶段重建方案结合真皮替代和自体皮肤移植，可在复杂的腕痛风溃疡中提供持久的软组织覆盖和功能保存。这种方法比传统的皮瓣手术更少病态，技术上更可行，特别是对于有多种合并症的高风险患者。观察到良好的中期结果，包括24个月无复发生存期。

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引用次数: 0

Microsurgical replantation of severely crushed and contaminated amputated limbs in children: Case reports and surgical insights 儿童严重挤压和污染截肢的显微外科再植：病例报告和手术见解

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-03 DOI: 10.1016/j.jpra.2025.12.031

Man Duc Minh Phan , Phi Duong Nguyen

Severely crushed and contaminated pediatric amputations present unique challenges for limb salvage, especially when critical structures are damaged. We report two pediatric cases—one hand and one foot amputation—successfully replanted using meticulous microsurgical techniques. A key component of our approach was microsurgical debridement under high magnification, which enabled removal of deeply embedded contaminants without sacrificing additional tissue. Both patients achieved limb survival and functional recovery after long-term follow-up. Detailed sensory outcomes, range of motion, skin coverage management, postoperative microbiological findings, and antibiotic regimens are presented. These cases underscore the importance of precise debridement, early revascularization, and comprehensive postoperative care in pediatric contaminated crush amputations.

严重挤压和污染的儿童截肢对肢体抢救提出了独特的挑战，特别是当关键结构受损时。我们报告两个儿童病例-一只手和一只脚截肢-成功地重新使用细致的显微外科技术。我们方法的一个关键组成部分是在高倍镜下的显微外科清创，它可以去除深埋的污染物而不牺牲额外的组织。经过长期随访，两例患者均获得肢体存活和功能恢复。详细的感觉结果，活动范围，皮肤覆盖管理，术后微生物学结果和抗生素方案提出。这些病例强调了精确清创，早期血运重建和综合护理在小儿污染挤压截肢术后的重要性。

引用次数: 0

Sleeping position affects the hairline recession in male patients with androgenetic alopecia 男性雄激素性脱发患者的体位对发际线衰退有影响

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2026-01-03 DOI: 10.1016/j.jpra.2025.12.028

Yi Wu , Tingru Dong , Tatiana Gomez Gomez , Yeqin Dai

Clinical observations indicate that some male patients with androgenic alopecia show varying degrees of hairline recession in the frontal and temporal regions on both sides, often with noticeable asymmetry between the left and right, which suggests a potential link to certain lifestyle habits. In this study, 161 male patients with androgenic alopecia were included, all exhibiting an “M”-shaped hairline. Patients' sleeping positions and combing directions were recorded and the areas of hairline recession in the frontal and temporal regions were calculated. Analysis of variance showed a significant difference in the ratio of the left and right receding hairline areas among patients with different sleeping positions (left lateral 1.19 ± 0.15 vs. right lateral 0.90 ± 0.10 vs. supine 1.00 ± 0.15 vs. no fixed position 1.00 ± 0.14, F = 24.84, p < 0.01). However, no significant difference in hairline recession was observed between patients who combed their hair to the left and those who combed to the right (p = 0.47). In conclusion, sleeping position may be an independent factor that influences the pattern of hairline recession of male patients with androgenic alopecia, particularly those with “M”-shaped hairlines, whereas combing direction appears to have no impact.

临床观察表明，一些男性雄激素性脱发患者在两侧额部和颞部出现不同程度的发际线衰退，经常出现明显的左右不对称，这可能与某些生活习惯有关。本研究纳入161例男性雄激素性脱发患者，均呈现“M”型发际线。记录患者的睡姿和梳理方向，计算额叶和颞叶发际线衰退面积。方差分析显示，不同睡姿患者左右侧发际线后退面积比例（左侧卧位1.19±0.15 vs右侧卧位0.90±0.10 vs仰卧位1.00±0.15 vs未固定卧位1.00±0.14,F = 24.84, p < 0.01）差异有统计学意义。然而，在发际线衰退方面，向左梳头和向右梳头的患者没有显著差异（p = 0.47）。综上所述，睡眠姿势可能是影响男性雄激素性脱发患者，尤其是“M”型发际线患者发际线衰退模式的独立因素，而梳头方向似乎没有影响。

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引用次数: 0

Anatomical-based filler injection techniques for the midcheek groove and infraorbital region: Narrative review 基于解剖的颊中沟和眶下区域填充剂注射技术：叙述回顾

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-12-24 DOI: 10.1016/j.jpra.2025.12.014

Gi-Woong Hong , Isaac Kai Jie Wong , Jin-Hyun Kim , Kyu-Ho Yi

Background

The infraorbital hollow and midcheek groove (“Indian bands”) are anatomically complex transition zones where ligamentous, vascular, and fat compartments converge. Safe and predictable correction with hyaluronic acid (HA) fillers requires precise, layer-specific anatomical understanding.

Objectives

To synthesize anatomy-based injection strategies for the infraorbital–midcheek continuum, including diagnostic triage, technique selection, complication mitigation, and ethnic-specific considerations.

Methods

We conducted a narrative review based on a structured search of MEDLINE, PubMed, and Ovid databases using predefined keywords related to “Dark Circle,” “Midcheek Groove,” “Indian Band,” “Dermal Fillers,” and “Facial Anatomy.” Eligible anatomical dissections, imaging-based mappings, and clinical outcome studies were qualitatively synthesized; no original patient data were collected, and no PRISMA flow diagram or quantitative meta-analysis was performed.

Results

Cannula-assisted subcision to partially release fibrous retaining bands, followed by deep support (deep malar fat pad/suborbicularis oculi fat [SOOF]) and selective superficial blending, appears to improve midcheek groove correction in published series using Maili Volume and Precise. Management of overfill or surface irregularity relies on hyaluronidase and an understanding of product rheology (elastic modulus G′, cohesivity, elasticity). However, the available evidence remains heterogeneous and predominantly case-series level, with limited standardized outcomes, patient-reported measures, and long-term follow-up.

Conclusion

An anatomy-based, layer-specific approach can enhance predictability and safety for infraorbital–midcheek rejuvenation, but current recommendations are largely experience-driven. Future work should prioritize controlled clinical validation, complication registries, and population-specific optimization of technique with robust, quantitative and patient-centered outcomes.

眶下空心沟和颊中沟（“印度带”）是解剖学上复杂的过渡区，韧带、血管和脂肪室在此会聚。透明质酸（HA）填充物的安全、可预测的矫正需要精确的、层特异性的解剖理解。目的综合基于解剖的眶下-颊中连续体注射策略，包括诊断分诊、技术选择、并发症缓解和种族特异性考虑。方法基于MEDLINE、PubMed和Ovid数据库的结构化搜索，使用与“黑眼圈”、“中颊沟”、“印第安乐队”、“真皮填填物”和“面部解剖”相关的预定义关键词进行叙述综述。合格的解剖解剖、基于成像的映射和临床结果研究被定性地合成；未收集原始患者资料，未进行PRISMA流程图或定量荟萃分析。结果扫描辅助下切入部分释放纤维保留带，然后进行深度支持（颧深脂肪垫/眼轮匝肌脂肪[SOOF]）和选择性表面混合，可以改善麦力Volume和Precise的中颊沟矫正。过度填充或表面不规则的管理依赖于透明质酸酶和对产品流变学的理解（弹性模量G '，黏结性，弹性）。然而，现有的证据仍然是异构的，主要是病例系列水平，标准化结果有限，患者报告的措施和长期随访。结论基于解剖结构的分层方法可以提高眶下颊中部年轻化的可预测性和安全性，但目前的建议主要是由经验驱动的。未来的工作应优先考虑对照临床验证、并发症登记和针对特定人群的技术优化，以获得稳健、定量和以患者为中心的结果。

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引用次数: 0

Pilot study on the functional relevance of single versus double toe transfer in monodactyly: Analysis on functional integration and grasping 单趾与双趾转移功能相关性的初步研究：功能整合与抓握分析

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-12-24 DOI: 10.1016/j.jpra.2025.12.021

Veronica Fasoli, Chiara Parolo, Elisa Rosanda, Rossella Pagliaro, Silvia Minoia, Francesca Tolosa, Luigi Troisi, Giorgio Eugenio Pajardi

Monodactyly is a rare congenital anomaly of the upper limb, characterized by the presence of an isolated thumb. Although toe-to-hand transfer is a well-established surgical reconstructive procedure, there are currently no universally accepted guidelines clearly defining the optimal number of digits to be transferred. The aim of this pilot study is to evaluate whether performing a double toe transfer offers a significant functional advantage over a single toe transfer. We collected seven cases which were divided into two groups based on the number of digits transferred. All patients underwent the same standardized surgical and rehabilitative protocol. During follow-up, the motor patterns of each patient and the integration of the transferred digits during grasping were systematically evaluated.

In our series, while double toe transfer has enhanced grasp and function by providing a three-digit pinch, a single transferred toe combined with a structured thumb appeared able to perform most daily activities.

The second transferred digit has often shown to be stiffer as compared to the first toe transfer, limiting function while increasing donor site morbidity and operative time. Careful preoperative assessment of residual anatomy and spontaneous grasp strategies should guide surgical planning to maximize functional integration and minimize unnecessary morbidity. This study highlights the need for a selective, patient-specific approach in toe-to-hand transfer reconstruction in children affected by monodactyly.

单指畸形是一种罕见的上肢先天性畸形，其特征是存在孤立的拇指。虽然脚到手的转移是一种完善的外科重建手术，但目前还没有普遍接受的指导方针明确定义转移的最佳手指数量。本初步研究的目的是评估双趾移植是否比单趾移植具有显著的功能优势。我们收集了7个病例，根据转移的数字数量分为两组。所有患者都接受了相同的标准化手术和康复方案。在随访中，系统地评估了每位患者的运动模式和抓取过程中转移的手指的整合。在我们的研究中，虽然双脚趾转移通过提供三指捏来增强抓握和功能，但单脚趾转移结合结构化拇指似乎能够执行大多数日常活动。与第一个脚趾转移相比，第二个转移的手指经常表现得更僵硬，限制了功能，同时增加了供体部位的发病率和手术时间。仔细的术前评估残余解剖和自发抓握策略应指导手术计划，以最大限度地实现功能整合并减少不必要的发病率。本研究强调需要一个选择性的，患者特异性的方法，在影响儿童单指转移重建脚趾到手。

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引用次数: 0

Abdominal-based vs. alternative flaps: Surgical outcomes and quality of life following different techniques of autologous breast reconstruction 腹基皮瓣与替代皮瓣：不同自体乳房重建技术后的手术结果和生活质量

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-12-20 DOI: 10.1016/j.jpra.2025.12.011

Lisanne Grünherz , Stella Vocke , Laura C. Siegwart , Victoria Wlach , Anna Burger , Pietro Giovanoli , Nicole Lindenblatt , Duveken B.Y. Fontein

Abdominal-based flaps are considered the gold standard for autologous breast reconstruction (ABR). With the increasing number of women undergoing mastectomy, however, alternative free flaps from other regions have emerged as valuable alternatives when patients do not qualify for an abdominal-based flap. This single-center cohort study evaluates objective and subjective outcomes in patients who underwent abdominal-based versus alternative flaps for breast reconstruction.

Patients who underwent ABR between 2010 and 2022 were included. Baseline patient characteristics and data on oncological and surgical treatment were collected. Since 2018, all patients received the validated BREAST-Q questionnaire evaluating satisfaction and quality of life preoperatively and at regular intervals following surgery. Multinomial logistic regression evaluated the probability of flap complications based on the type of flap. We also evaluated quality of life between abdominal-based and alternative flaps.

Of the 183 patients were included in this study (146 abdominal-based and 37 alternative flaps). We could not ascertain a relationship between type of flap and flap complications. More donor-site complications and more secondary aesthetic corrective surgery were noted in patients who underwent abdominal-based flaps. Our results did not show any differences between patients who underwent abdominal-based compared to alternative flap types for various satisfaction domains of the BREAST-Q.

Abdominal-based and alternative free flap types are both viable treatment options in ABR and several variables need to be considered when selecting the appropriate flap for the right patient. Careful flap selection and the shared decision-making process between patient and surgeon reflect high patient-satisfaction and an optimal aesthetic result.

腹部皮瓣被认为是自体乳房重建（ABR）的金标准。然而，随着越来越多的女性接受乳房切除术，当患者不符合腹部皮瓣的条件时，其他区域的自由皮瓣已成为有价值的选择。这项单中心队列研究评估了接受腹部皮瓣与替代皮瓣进行乳房重建的患者的客观和主观结果。包括2010年至2022年间接受ABR的患者。收集患者的基线特征以及肿瘤和手术治疗的数据。自2018年起，所有患者术前和术后定期接受经验证的BREAST-Q问卷，评估满意度和生活质量。根据皮瓣的类型，采用多项逻辑回归评估皮瓣并发症的发生概率。我们还评估了腹基皮瓣和替代皮瓣之间的生活质量。183例患者纳入本研究（146例腹部皮瓣和37例替代皮瓣）。我们不能确定皮瓣类型与皮瓣并发症之间的关系。更多的供区并发症和更多的二次美容矫正手术被注意到的患者接受腹部为基础的皮瓣。我们的结果并没有显示在接受腹部皮瓣的患者与其他皮瓣类型的患者相比，在不同的BREAST-Q满意域上有任何差异。基于腹部和其他自由皮瓣类型都是ABR可行的治疗选择，在为合适的患者选择合适的皮瓣时需要考虑几个变量。仔细的皮瓣选择和患者和外科医生之间的共同决策过程反映了高的患者满意度和最佳的美学结果。

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引用次数: 0

Flexor tendon avulsion and PIP joint fracture-dislocation in a 17-year-old football player: A case report 17岁足球运动员屈肌腱撕脱和PIP关节骨折脱位1例

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-12-19 DOI: 10.1016/j.jpra.2025.12.015

Summer Aldabbeh , Taylor Calicchia , Andrew Esterle

We present a rare case of flexor digitorum superficialis (FDS) avulsion and dorsal fracture-dislocation of the proximal interphalangeal (PIP) joint with an intact flexor digitorum profundus (FDP) in a 17-year-old high school football player. This unusual injury pattern, sustained during a sports collision, required prompt surgical intervention to restore tendon continuity and joint congruity. Early rehabilitation and an aggressive return-to-sport protocol yielded a successful outcome, with full functional recovery. A literature review reveals limited documentation of similar cases, underscoring the clinical importance of early recognition and operative management in athletes.

我们报告一个罕见的病例，指浅屈肌（FDS）撕脱和背侧骨折脱位近端指间关节（PIP）与完整的指深屈肌（FDP）在17岁的高中足球运动员。这种不寻常的损伤模式，持续在运动碰撞，需要及时手术干预，以恢复肌腱的连续性和关节的一致性。早期康复和积极的重返运动方案取得了成功的结果，功能完全恢复。一篇文献综述揭示了类似病例的有限文献，强调了运动员早期识别和手术管理的临床重要性。

引用次数: 0