Pub Date : 2025-12-13DOI: 10.1016/j.jpra.2025.12.008
Martin Lhuaire , Victor Pozzo , Enrica Bentivegna , Henri Azais , Tamer Awan , Ignacio Garrido , Laurent Lantieri
Postmastectomy skin-flap necrosis after nipple-sparing mastectomy (NSM) is common and exceeds rates after skin-sparing mastectomy (SSM) (0–19.5 %), influenced by patient factors and modifiable intraoperative variables. Presentations range from superficial necrosis to full-thickness necrosis requiring surgical debridement. These events drive reoperation or implant loss, may delay adjuvant therapy, and burden patients psychologically. Clinical examination and ancillary tests poorly discriminate depth; thus, management usually entails close observation until demarcation, followed by targeted intervention. M101, a hemoglobin-based oxygen carrier, demonstrates anti–ischemia–reperfusion effects and promise in advanced wounds. We report two NSM cases with partial skin-flap and nipple–areola complex necrosis managed with an M101-based oxygenating dressing (HemHealing®; Hemarina SA, Morlaix, France), with ultimately no surgical debridement required.
保留乳头乳房切除术（NSM）后皮瓣坏死是常见的，超过保留皮肤乳房切除术（SSM）后的发生率（0 - 19.5%），受患者因素和术中可变因素的影响。表现从表面坏死到全层坏死，需要手术清创。这些事件会导致再次手术或植入物丢失，可能会延迟辅助治疗，并给患者带来心理负担。临床检查及辅助检查区分深度差；因此，管理通常需要密切观察直至划界，然后进行有针对性的干预。M101是一种基于血红蛋白的氧载体，在晚期伤口中具有抗缺血再灌注作用和前景。我们报告了两例NSM患者，部分皮瓣和乳头乳晕复合坏死采用m101氧合敷料（HemHealing®；Hemarina SA, Morlaix, France）治疗，最终不需要手术清创。
{"title":"Medical management of acute partial skin necrosis following nipple-sparing mastectomy using an M101-based oxygenating dressing: Two case reports","authors":"Martin Lhuaire , Victor Pozzo , Enrica Bentivegna , Henri Azais , Tamer Awan , Ignacio Garrido , Laurent Lantieri","doi":"10.1016/j.jpra.2025.12.008","DOIUrl":"10.1016/j.jpra.2025.12.008","url":null,"abstract":"<div><div>Postmastectomy skin-flap necrosis after nipple-sparing mastectomy (NSM) is common and exceeds rates after skin-sparing mastectomy (SSM) (0–19.5 %), influenced by patient factors and modifiable intraoperative variables. Presentations range from superficial necrosis to full-thickness necrosis requiring surgical debridement. These events drive reoperation or implant loss, may delay adjuvant therapy, and burden patients psychologically. Clinical examination and ancillary tests poorly discriminate depth; thus, management usually entails close observation until demarcation, followed by targeted intervention. M101, a hemoglobin-based oxygen carrier, demonstrates anti–ischemia–reperfusion effects and promise in advanced wounds. We report two NSM cases with partial skin-flap and nipple–areola complex necrosis managed with an M101-based oxygenating dressing (HemHealing®; Hemarina SA, Morlaix, France), with ultimately no surgical debridement required.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 434-437"},"PeriodicalIF":1.8,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.1016/j.jpra.2025.11.034
Kyu-Ho Yi , Jin-Hyun Kim , Jong-Keun Song , Jeremy B. Green , Thomas Rappl , Michael H. Gold , Jeongho Sohn , Benjamin Ascher , Roya Zarmehr Zamin , Rosa Sigrist , Ximena Wortsman
Background
A slim ankle is considered a hallmark of beauty in modern aesthetics. Excessive muscular hypertrophy, particularly of the deep calf muscle (soleus), can lead to a thick ankle appearance that detracts from an overall refined leg contour. Although surgical approaches have been used historically, they carry risks such as scarring, contracture, and unpredictable outcomes.
Objective
This study aimed to evaluate the efficacy and safety of ultrasound-guided botulinum toxin type A (JETEMA THE TOXIN, JETEMA Co., Ltd. Korea) injections for improving ankle contour in patients with thick ankles.
Methods
Three adult female patients with noticeably hypertrophic calf muscles underwent ultrasound-guided injection of 20 units of botulinum toxin into the soleus muscles. Needles were inserted with ultrasound guidance to ensure precise real-time visualization and accurate injection into the soleus muscles. Ankle circumference and soleus muscle thickness were measured pre-treatment and at 8 weeks post-treatment using standardized methods. Wilcoxon signed-rank test was applied to evaluate statistical significance.
The manuscript was checked against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (Supplemental Appendix).
Results
All patients exhibited a reduction in ankle circumference (approximately 6.7–7.1 %) and soleus muscle thickness (around 14–15 %) at the 8-week follow-up. The Wilcoxon test revealed statistically significant differences (p = 0.001) between pre- and post-treatment values. Visual assessment of photographic records further confirmed a noticeably slimmer and more refined ankle contour.
Conclusion
Ultrasound-guided botulinum toxin injections appear to be a safe and effective minimally invasive approach for ankle contouring, achieving clinically meaningful reductions in muscle bulk with high patient satisfaction.
{"title":"Ultrasound-guided injection of ankle contouring with botulinum neurotoxin","authors":"Kyu-Ho Yi , Jin-Hyun Kim , Jong-Keun Song , Jeremy B. Green , Thomas Rappl , Michael H. Gold , Jeongho Sohn , Benjamin Ascher , Roya Zarmehr Zamin , Rosa Sigrist , Ximena Wortsman","doi":"10.1016/j.jpra.2025.11.034","DOIUrl":"10.1016/j.jpra.2025.11.034","url":null,"abstract":"<div><h3>Background</h3><div>A slim ankle is considered a hallmark of beauty in modern aesthetics. Excessive muscular hypertrophy, particularly of the deep calf muscle (soleus), can lead to a thick ankle appearance that detracts from an overall refined leg contour. Although surgical approaches have been used historically, they carry risks such as scarring, contracture, and unpredictable outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy and safety of ultrasound-guided botulinum toxin type A (JETEMA THE TOXIN, JETEMA Co., Ltd. Korea) injections for improving ankle contour in patients with thick ankles.</div></div><div><h3>Methods</h3><div>Three adult female patients with noticeably hypertrophic calf muscles underwent ultrasound-guided injection of 20 units of botulinum toxin into the soleus muscles. Needles were inserted with ultrasound guidance to ensure precise real-time visualization and accurate injection into the soleus muscles. Ankle circumference and soleus muscle thickness were measured pre-treatment and at 8 weeks post-treatment using standardized methods. Wilcoxon signed-rank test was applied to evaluate statistical significance.</div><div>The manuscript was checked against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (Supplemental Appendix).</div></div><div><h3>Results</h3><div>All patients exhibited a reduction in ankle circumference (approximately 6.7–7.1 %) and soleus muscle thickness (around 14–15 %) at the 8-week follow-up. The Wilcoxon test revealed statistically significant differences (<em>p</em> = 0.001) between pre- and post-treatment values. Visual assessment of photographic records further confirmed a noticeably slimmer and more refined ankle contour.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided botulinum toxin injections appear to be a safe and effective minimally invasive approach for ankle contouring, achieving clinically meaningful reductions in muscle bulk with high patient satisfaction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 425-433"},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.1016/j.jpra.2025.12.007
Julia De Freitas, Augustin Reynard, Catherine Guérin-Charbonnel, Valérie Seegers, Alizée Contant, Jean-Luc Raoul, Pedro Raro
Purpose
Muscle-sparing latissimus dorsi (MSLD) flap breast reconstruction offers a minimally invasive alternative to traditional latissimus dorsi flap procedures. By preserving muscle integrity, MSLD aims to reduce morbidity while maintaining esthetic and functional outcomes. This study retrospectively analyzes the outcomes of MSLD breast reconstruction in terms of scapula-humeral function and esthetic satisfaction.
Methods
Ninety patients undergoing MSLD flap reconstruction between January 2017 and February 2022 at the Institut de Cancérologie de l’Ouest, Angers, were included. Data collected included demographics, clinical history, surgical details, post-operative complications, esthetic satisfaction (evaluated by patients and health professionals), and shoulder functionality assessed using the DASH questionnaire.
Results
Median follow-up was 3.7 years. Most patients were under 65 years (91.1 %), with a median body mass index of 26 kg/m². Immediate reconstruction was performed in 74 % of cases, with a mean mastectomy weight of 576.7 g. Complications were rare, with a necrosis rate of 3.3 % and reoperation in 5.6 % of cases. Esthetic satisfaction was high, with a median score of 4 (out of 5) from both patients and evaluators. Functional outcomes demonstrated minimal impact on shoulder mobility, with a median DASH score of 11.
Conclusion
MSLD flap reconstruction is a reliable technique that balances functional preservation with esthetic satisfaction. It is suitable for a diverse patient population and demonstrates low complication rates. Future prospective studies comparing MSLD with prosthetic reconstruction may further confirm its advantages.
{"title":"Oncoplastic breast reconstruction using a muscle sparing latissimus dorsi flap: A retrospective analysis of esthetic results and scapula-humeral function","authors":"Julia De Freitas, Augustin Reynard, Catherine Guérin-Charbonnel, Valérie Seegers, Alizée Contant, Jean-Luc Raoul, Pedro Raro","doi":"10.1016/j.jpra.2025.12.007","DOIUrl":"10.1016/j.jpra.2025.12.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Muscle-sparing latissimus dorsi (MSLD) flap breast reconstruction offers a minimally invasive alternative to traditional latissimus dorsi flap procedures. By preserving muscle integrity, MSLD aims to reduce morbidity while maintaining esthetic and functional outcomes. This study retrospectively analyzes the outcomes of MSLD breast reconstruction in terms of scapula-humeral function and esthetic satisfaction.</div></div><div><h3>Methods</h3><div>Ninety patients undergoing MSLD flap reconstruction between January 2017 and February 2022 at the Institut de Cancérologie de l’Ouest, Angers, were included. Data collected included demographics, clinical history, surgical details, post-operative complications, esthetic satisfaction (evaluated by patients and health professionals), and shoulder functionality assessed using the DASH questionnaire.</div></div><div><h3>Results</h3><div>Median follow-up was 3.7 years. Most patients were under 65 years (91.1 %), with a median body mass index of 26 kg/m². Immediate reconstruction was performed in 74 % of cases, with a mean mastectomy weight of 576.7 g. Complications were rare, with a necrosis rate of 3.3 % and reoperation in 5.6 % of cases. Esthetic satisfaction was high, with a median score of 4 (out of 5) from both patients and evaluators. Functional outcomes demonstrated minimal impact on shoulder mobility, with a median DASH score of 11.</div></div><div><h3>Conclusion</h3><div>MSLD flap reconstruction is a reliable technique that balances functional preservation with esthetic satisfaction. It is suitable for a diverse patient population and demonstrates low complication rates. Future prospective studies comparing MSLD with prosthetic reconstruction may further confirm its advantages.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 679-690"},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.1016/j.jpra.2025.12.005
Kyu-Ho Yi , Isabella Rosellini , Jong Keun Song , Suyeon Lee , Carlos Bravo Rojas , Jin-Hyun Kim
Background
Clavicular augmentation using hyaluronic acid (HA) dermal fillers is an innovative aesthetic intervention for improving skeletal prominence through minimally invasive methods. Successful application requires a precise, structured technique targeting the subperiosteal plane.
Case presentation
We describe a novel standardized technique—the six-point technique for non-surgical clavicular augmentation and present the outcome in a 35-year-old female patient.
Technique/Methods
Under strict aseptic conditions, 2.0 mL of HA filler (Lorient No. 6) was injected per side into the subperiosteal plane using a fine-gauge needle. The Six-Point Technique involves structured, differential dosing to restore linear continuity (0.5 mL in concavities) and refine convex highlights (0.3 mL along curves).
Results
The procedure resulted in immediate and sustained enhancement of the clavicular line and improved upper-torso contour. At the 3-month follow-up, the patient reported high satisfaction (9/10), with no severe adverse events observed. Documented complications remained predominantly minor and temporary, including localized inflammation or discomfort, without any severe adverse outcomes reported.
Conclusions
The HA clavicular augmentation six-point technique is a safe, versatile, and reversible option for achieving predictable skeletal definition. This structured, minimally invasive treatment provides consistent, aesthetically pleasing outcomes, underscoring the potential for injectable solutions in skeletal contouring.
{"title":"Clavicular augmentation with hyaluronic acid six-point technique: A novel non-surgical approach to skeletal definition","authors":"Kyu-Ho Yi , Isabella Rosellini , Jong Keun Song , Suyeon Lee , Carlos Bravo Rojas , Jin-Hyun Kim","doi":"10.1016/j.jpra.2025.12.005","DOIUrl":"10.1016/j.jpra.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Clavicular augmentation using hyaluronic acid (HA) dermal fillers is an innovative aesthetic intervention for improving skeletal prominence through minimally invasive methods. Successful application requires a precise, structured technique targeting the subperiosteal plane.</div></div><div><h3>Case presentation</h3><div>We describe a novel standardized technique—the six-point technique for non-surgical clavicular augmentation and present the outcome in a 35-year-old female patient.</div></div><div><h3>Technique/Methods</h3><div>Under strict aseptic conditions, 2.0 mL of HA filler (Lorient No. 6) was injected per side into the subperiosteal plane using a fine-gauge needle. The Six-Point Technique involves structured, differential dosing to restore linear continuity (0.5 mL in concavities) and refine convex highlights (0.3 mL along curves).</div></div><div><h3>Results</h3><div>The procedure resulted in immediate and sustained enhancement of the clavicular line and improved upper-torso contour. At the 3-month follow-up, the patient reported high satisfaction (9/10), with no severe adverse events observed. Documented complications remained predominantly minor and temporary, including localized inflammation or discomfort, without any severe adverse outcomes reported.</div></div><div><h3>Conclusions</h3><div>The HA clavicular augmentation six-point technique is a safe, versatile, and reversible option for achieving predictable skeletal definition. This structured, minimally invasive treatment provides consistent, aesthetically pleasing outcomes, underscoring the potential for injectable solutions in skeletal contouring.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 691-696"},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.1016/j.jpra.2025.12.004
Paul Zaoui, Maurice Renom, Francois Loisel, Soline Vericel, Laurent Obert, Isabelle Pluvy
Objectives
To evaluate the clinical and functional outcomes of fingertip reconstruction with conservative treatment using occlusive dressings up to zone 3.
Patients and methods
A retrospective monocentric study was conducted on 26 patients (28 fingers) who presented an amputation in zones 1, 2, or 3, treated with occlusive dressings. The evaluation included epidemiological data on the trauma, the number of dressings required, healing time, satisfaction, recovery of sensation, regeneration of dermatoglyphs, pulp trophicity, complications, and functional scores.
Results
At a mean follow-up of 11.8 months, healing was achieved in 4.2 weeks after an average of four dressings. Pulp trophicity was excellent or good in 96.4 % of cases. Finger mobility was fully preserved in 89.3 % of fingers. Complete or partial dermatoglyphic regeneration was observed in all patients. Sensitivity tested by Weber's test was reduced by 24 % (4.6 mm vs. 3.5 mm contralateral). Nail dystrophies were noted in 60.4 % of fingers, mainly following amputations in zone 3. Cold intolerance was reported in 35.7 % of fingers. Functional scores confirmed satisfactory recovery. Satisfaction was high. The most frequently reported inconvenience was odor occasionally reported despite the use of charcoal dressings.
Conclusion
Occlusive dressings represent a reliable, non-invasive, and reproducible alternative in fingertip amputations in zones 1 and 2. Despite limitations in zone 3, the aesthetic and functional outcomes justify its use as a first-line treatment. Dermatoglyphic regeneration is a real phenomenon, with both functional and legal implications. These results support occlusive dressing as a first-line management option for selected fingertip amputations.
{"title":"Occlusive dressings for fingertip amputations: Clinical outcomes, pulp regeneration, and dermatoglyphic recovery","authors":"Paul Zaoui, Maurice Renom, Francois Loisel, Soline Vericel, Laurent Obert, Isabelle Pluvy","doi":"10.1016/j.jpra.2025.12.004","DOIUrl":"10.1016/j.jpra.2025.12.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the clinical and functional outcomes of fingertip reconstruction with conservative treatment using occlusive dressings up to zone 3.</div></div><div><h3>Patients and methods</h3><div>A retrospective monocentric study was conducted on 26 patients (28 fingers) who presented an amputation in zones 1, 2, or 3, treated with occlusive dressings. The evaluation included epidemiological data on the trauma, the number of dressings required, healing time, satisfaction, recovery of sensation, regeneration of dermatoglyphs, pulp trophicity, complications, and functional scores.</div></div><div><h3>Results</h3><div>At a mean follow-up of 11.8 months, healing was achieved in 4.2 weeks after an average of four dressings. Pulp trophicity was excellent or good in 96.4 % of cases. Finger mobility was fully preserved in 89.3 % of fingers. Complete or partial dermatoglyphic regeneration was observed in all patients. Sensitivity tested by Weber's test was reduced by 24 % (4.6 mm vs. 3.5 mm contralateral). Nail dystrophies were noted in 60.4 % of fingers, mainly following amputations in zone 3. Cold intolerance was reported in 35.7 % of fingers. Functional scores confirmed satisfactory recovery. Satisfaction was high. The most frequently reported inconvenience was odor occasionally reported despite the use of charcoal dressings.</div></div><div><h3>Conclusion</h3><div>Occlusive dressings represent a reliable, non-invasive, and reproducible alternative in fingertip amputations in zones 1 and 2. Despite limitations in zone 3, the aesthetic and functional outcomes justify its use as a first-line treatment. Dermatoglyphic regeneration is a real phenomenon, with both functional and legal implications. These results support occlusive dressing as a first-line management option for selected fingertip amputations.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 593-602"},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.jpra.2025.11.032
Zhihu Ma , Xingsheng Zhang , Yantao Pei , Lei Zhu , Gang Wang , Yuliang Sun
Objective
To evaluate the therapeutic efficacy and clinical outcomes of wrist arthroscopy in the management of intraosseous carpal bone cysts through a retrospective analysis of surgical cases.
Methods
A case series analysis was performed on 14 patients with intraosseous carpal bone cysts treated in the Department of Hand and Foot Surgery at Qilu Hospital of Shandong University between January 2019 and August 2022. The cyst distribution was as follows: 11 cases in the lunate bone, 1 case involving both the scaphoid and lunate bones, 1 case in the scaphoid bone, and 1 case in the hamate bone. Preoperative imaging assessments included standard radiography (X-ray), computed tomography (CT), and magnetic resonance imaging (MRI). All patients underwent wrist arthroscopic cyst debridement with autologous iliac bone grafting. Intraoperative evaluation of wrist stability was performed, followed by Kirschner wire fixation or external fixation as indicated. Pathological specimens were obtained for histopathological examination. Postoperative rehabilitation protocols were implemented under supervised guidance.
Results
All patients were followed up for 3–6 months postoperatively. Following structured rehabilitation, significant alleviation of wrist pain was observed in all cases, with full functional recovery enabling a return to normal occupational activities.
Conclusion
Wrist arthroscopic surgery combined with bone grafting represents an effective treatment modality for intraosseous carpal bone cysts, facilitating accurate pathological diagnosis and promoting rapid functional recovery when supplemented with postoperative rehabilitation.
{"title":"Wrist-arthroscopy treatment of carpal bone cysts","authors":"Zhihu Ma , Xingsheng Zhang , Yantao Pei , Lei Zhu , Gang Wang , Yuliang Sun","doi":"10.1016/j.jpra.2025.11.032","DOIUrl":"10.1016/j.jpra.2025.11.032","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the therapeutic efficacy and clinical outcomes of wrist arthroscopy in the management of intraosseous carpal bone cysts through a retrospective analysis of surgical cases.</div></div><div><h3>Methods</h3><div>A case series analysis was performed on 14 patients with intraosseous carpal bone cysts treated in the Department of Hand and Foot Surgery at Qilu Hospital of Shandong University between January 2019 and August 2022. The cyst distribution was as follows: 11 cases in the lunate bone, 1 case involving both the scaphoid and lunate bones, 1 case in the scaphoid bone, and 1 case in the hamate bone. Preoperative imaging assessments included standard radiography (X-ray), computed tomography (CT), and magnetic resonance imaging (MRI). All patients underwent wrist arthroscopic cyst debridement with autologous iliac bone grafting. Intraoperative evaluation of wrist stability was performed, followed by Kirschner wire fixation or external fixation as indicated. Pathological specimens were obtained for histopathological examination. Postoperative rehabilitation protocols were implemented under supervised guidance.</div></div><div><h3>Results</h3><div>All patients were followed up for 3–6 months postoperatively. Following structured rehabilitation, significant alleviation of wrist pain was observed in all cases, with full functional recovery enabling a return to normal occupational activities.</div></div><div><h3>Conclusion</h3><div>Wrist arthroscopic surgery combined with bone grafting represents an effective treatment modality for intraosseous carpal bone cysts, facilitating accurate pathological diagnosis and promoting rapid functional recovery when supplemented with postoperative rehabilitation.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 473-482"},"PeriodicalIF":1.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.jpra.2025.12.002
Kar Wai Alvin Lee , Lisa Kwin Wah Chan , Cheuk Hung Lee , Jin-Hyun Kim , Isabella Rosellini , Irwan Junawanto , Kyu-Ho Yi
The choice between cannulas and needles for dermal filler injection has direct implications for safety, efficacy, and patient experience. This narrative review synthesizes evidence from randomized controlled trials, observational studies, cadaveric/anatomical work, and expert consensus to compare complication profiles and practical use-cases. Across multiple studies, cannulas—by virtue of their blunt tips and gliding technique—are associated with lower rates of bruising and a reduced signal for vascular occlusion in high-risk, vessel-dense regions, while also improving patient comfort and downtime. However, cannulas are not inherently risk-free: arterial wall penetration and ischemic events remain possible with improper plane selection, excessive injection pressure, or inadequate anatomical control. Needles retain advantages for precise, focal periosteal or ligamentous support and for select micro-bolus indications. Publication bias and heterogeneous endpoints likely underestimate true complication rates for both devices. Guided by anatomy and procedural goals, a tailored approach is recommended: preferential cannula use for broad, low-pressure distribution in vessel-dense areas; needle use for targeted structural points with strict low-volume, low-pressure technique. Ultrasound guidance further enhances plane confirmation and vascular avoidance. We conclude that device selection should be individualized to region, indication, and operator skill, coupled with slow injection, minimal aliquots, and ongoing training to optimize patient safety and outcomes.
{"title":"Cannula is safer than needle in filler injection?","authors":"Kar Wai Alvin Lee , Lisa Kwin Wah Chan , Cheuk Hung Lee , Jin-Hyun Kim , Isabella Rosellini , Irwan Junawanto , Kyu-Ho Yi","doi":"10.1016/j.jpra.2025.12.002","DOIUrl":"10.1016/j.jpra.2025.12.002","url":null,"abstract":"<div><div>The choice between cannulas and needles for dermal filler injection has direct implications for safety, efficacy, and patient experience. This narrative review synthesizes evidence from randomized controlled trials, observational studies, cadaveric/anatomical work, and expert consensus to compare complication profiles and practical use-cases. Across multiple studies, cannulas—by virtue of their blunt tips and gliding technique—are associated with lower rates of bruising and a reduced signal for vascular occlusion in high-risk, vessel-dense regions, while also improving patient comfort and downtime. However, cannulas are not inherently risk-free: arterial wall penetration and ischemic events remain possible with improper plane selection, excessive injection pressure, or inadequate anatomical control. Needles retain advantages for precise, focal periosteal or ligamentous support and for select micro-bolus indications. Publication bias and heterogeneous endpoints likely underestimate true complication rates for both devices. Guided by anatomy and procedural goals, a tailored approach is recommended: preferential cannula use for broad, low-pressure distribution in vessel-dense areas; needle use for targeted structural points with strict low-volume, low-pressure technique. Ultrasound guidance further enhances plane confirmation and vascular avoidance. We conclude that device selection should be individualized to region, indication, and operator skill, coupled with slow injection, minimal aliquots, and ongoing training to optimize patient safety and outcomes.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 415-424"},"PeriodicalIF":1.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Postoperative swelling of the eyelids surgery can cause discomfort and reduce patient satisfaction. This study is a retrospective analysis of factors associated with early postoperative swelling after blepharoptosis surgery.
Methods
The study included 105 patients who underwent primary bilateral ptosis surgery performed by the same plastic surgeon between April 2020 and December 2022. Aponeurotic repair, excess skin removal and lateral horn release were performed as needed, depending on the clinical findings in each case. Postoperative swelling was rated on a four-point scale: 0 (no swelling), 1 (mild), 2 (moderate), and 3 (severe).
Results
Postoperative swelling was significantly correlated in patients with a larger width of skin excision, diabetes, aging, hypertension, high intraoperative systolic blood pressure, and longer surgery duration. Detailed examination showed that the length of aponeurosis advancement and changes in margin reflex distance (MRD) did not significantly affect swelling.
Conclusions
Starling’s law is important to consider in preventing postoperative swelling, as it explains which factors contribute to edema. Surgical manipulation also triggers factors that cause swelling. Bleeding, inflammation, and lymphatic damage further exacerbate swelling. Knowing the risk factors for swelling in advance helps predict postoperative outcomes and helps inform patients, which may also improve postoperative management. Future studies using multivariate analysis are expected to provide valuable insights into preventing and managing postoperative eyelid swelling.
{"title":"Risk factors for early eyelid swelling following blepharoptosis surgery: A retrospective study","authors":"Rieko Shimizu , Aiko Oka , Shiho Watanabe , Hiroko Ochiai","doi":"10.1016/j.jpra.2025.12.003","DOIUrl":"10.1016/j.jpra.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative swelling of the eyelids surgery can cause discomfort and reduce patient satisfaction. This study is a retrospective analysis of factors associated with early postoperative swelling after blepharoptosis surgery.</div></div><div><h3>Methods</h3><div>The study included 105 patients who underwent primary bilateral ptosis surgery performed by the same plastic surgeon between April 2020 and December 2022. Aponeurotic repair, excess skin removal and lateral horn release were performed as needed, depending on the clinical findings in each case. Postoperative swelling was rated on a four-point scale: 0 (no swelling), 1 (mild), 2 (moderate), and 3 (severe).</div></div><div><h3>Results</h3><div>Postoperative swelling was significantly correlated in patients with a larger width of skin excision, diabetes, aging, hypertension, high intraoperative systolic blood pressure, and longer surgery duration. Detailed examination showed that the length of aponeurosis advancement and changes in margin reflex distance (MRD) did not significantly affect swelling.</div></div><div><h3>Conclusions</h3><div>Starling’s law is important to consider in preventing postoperative swelling, as it explains which factors contribute to edema. Surgical manipulation also triggers factors that cause swelling. Bleeding, inflammation, and lymphatic damage further exacerbate swelling. Knowing the risk factors for swelling in advance helps predict postoperative outcomes and helps inform patients, which may also improve postoperative management. Future studies using multivariate analysis are expected to provide valuable insights into preventing and managing postoperative eyelid swelling.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 619-625"},"PeriodicalIF":1.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-07DOI: 10.1016/j.jpra.2025.11.035
Sébastien Durand, Yves Harder, Jessica Billy, Thomas Orthmann
The Nalebuff classification, widely used by hand surgeons, describes six different canonical patterns. However, combined deformities are rarely reported, despite their significant impact on surgical decision-making. We present a dual-purpose extensor pollicis longus (EPL) transfer designed to address combined type I Boutonnière deformity and type IV metacarpophalangeal (MP) joint ulnar instability in rheumatoid thumb deformities. In two cases, a transosseous tunnel was drilled from dorsal to ulnar at the base of the proximal phalanx of the thumb, allowing passage and dorsal fixation of the EPL tendon. The remaining EPL tendon was then anchored at the ulnar side of the metacarpal head to reconstruct the ulnar collateral ligament. This dual-purpose transfer restores active thumb extension and simultaneously stabilizes the MP joint, thereby eliminating compensatory adduction at the first carpometacarpal joint.
{"title":"Dual-purpose extensor pollicis longus transfer for combined type I and IV rheumatoid thumb deformities","authors":"Sébastien Durand, Yves Harder, Jessica Billy, Thomas Orthmann","doi":"10.1016/j.jpra.2025.11.035","DOIUrl":"10.1016/j.jpra.2025.11.035","url":null,"abstract":"<div><div>The Nalebuff classification, widely used by hand surgeons, describes six different canonical patterns. However, combined deformities are rarely reported, despite their significant impact on surgical decision-making. We present a dual-purpose extensor pollicis longus (EPL) transfer designed to address combined type I Boutonnière deformity and type IV metacarpophalangeal (MP) joint ulnar instability in rheumatoid thumb deformities. In two cases, a transosseous tunnel was drilled from dorsal to ulnar at the base of the proximal phalanx of the thumb, allowing passage and dorsal fixation of the EPL tendon. The remaining EPL tendon was then anchored at the ulnar side of the metacarpal head to reconstruct the ulnar collateral ligament. This dual-purpose transfer restores active thumb extension and simultaneously stabilizes the MP joint, thereby eliminating compensatory adduction at the first carpometacarpal joint.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 397-402"},"PeriodicalIF":1.8,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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