Case Reports in Plastic Surgery and Hand Surgery最新文献

Carpal tunnel release surgery is a common and relatively safe surgical procedure; however, rare complications such as pseudoaneurysms can occur. Treatment of palmar pseudoaneurysms typically includes endovascular embolization or open ligation. We present a case of open surgical excision and repair of a pseudoaneurysm of the superficial palmar arch following carpal tunnel release surgery. This case study demonstrates how common surgical procedures can yield serious complications, thus highlighting the importance of thorough evaluations in pre-and post-operative care.

Werner syndrome is a rare autosomal recessive disorder caused by WRN gene mutations, leading to premature aging and genomic instability. Clinical symptoms include diabetes, skin lesions, and microvascular issues, with patients frequently developing difficult-to-heal ulcers on the distal legs, feet, and elbows. Surgical treatments, such as flap surgery, are rarely reported. We present the case of a 45-year-old male with Werner syndrome who developed refractory ulcers on both elbows. Despite conservative treatments, the ulcers persisted, leading to successful radial forearm pedicle flap surgeries. Postoperative results were favorable, with no complications, ulcer recurrence, or infections over a 16-year follow-up period. The patient maintained a full range of motion in both elbows. This case highlights the challenges of managing ulcers in Werner syndrome and the successful long-term outcomes of flap surgery, providing valuable insights into this rare condition's treatment.

Patients with chronic patellar tendon ruptures, failed primary repair, injuries with significant loss of tendon tissue or skin coverage require a complex reconstruction. Several reconstructive options are available, but in the case of a revision surgery with an associated infection, most of them seems contraindicated. The use of a vascularized gastrocnemius tendon graft to reconstruct the knee extensor apparatus, is in our opinion, the most appropriate treatment option. We will report a complex case of chronical patellar tendon rupture (after failed allograft reconstruction) in the context of an infection with soft tissue defect. This 65-year-old patient was successfully treated with the reconstruction of the patellar tendon and a soft tissue coverage using a medial gastrocnemius flap. We followed her up for three years and the clinical outcome was recorded including several clinical scores and isokinetic strength measurements, showing an excellent result, with full patient satisfaction and without any limitation in daily activities. In addition, we will review the literature about patellar tendon reconstruction using a medial gastrocnemius flap, presenting the indications and advantages of this technique, sharing our personal experience and some technical aspects of the technique. Finally, we discuss why this flap, is our first choice in such cases.

Breast reduction surgery is a commonly performed procedure relieving physical discomfort and improving quality of life for individuals with macromastia. Despite its benefits, there are inherent risks associated with surgical intervention, one of which is the development of deep vein thrombosis (DVT). This relatively rare complication can lead to significant morbidity and mortality if not recognized and managed properly. We present a case of a 28-year-old female who underwent bilateral breast reduction surgery consequently developing swelling, pain and discoloration of her left arm. Duplex ultrasound confirmed the diagnosis of upper extremity DVT. The patient was immediately started on anticoagulation therapy and subsequently resolution of thrombosis and was confirmed by Duplex ultrasound. Lower extremity DVT is a rare complication following breast reduction surgery. Yet, we present the first case of upper extremity DVT following breast reduction, to our knowledge. Clinicians should maintain a high index of suspicion for this condition, particularly in patients with predisposing risk factors.

Marin Amat syndrome is a phenomenon in which eyelids close upon opening of the mouth during the recovery phase after facial nerve paralysis. In this report, we present two surgically treated cases of Marin Amat syndrome with aponeurotic ptosis. Case 1: A 66-year-old man had developed left Bell's palsy a year prior to presentation and underwent rehabilitation at the Neurology Department of Japan Community Healthcare Organization Chukyo Hospital. He was subsequently referred to the Ophthalmology Department for left eyelid ptosis. Case 2: A 75-year-old man developed left Bell's palsy more than 10 years prior to presentation and was referred to the Ophthalmology Department for left eyelid ptosis. Both patients had Marin Amat syndrome with aponeurotic ptosis. Levator aponeurosis advancement surgery and partial orbicularis oculi muscle resection were performed on the affected eyes. Both patients showed favorable postoperative outcomes. Simultaneous surgery involving levator aponeurosis advancement and partial orbicularis oculi muscle resection is effective for treating Marin Amat syndrome with aponeurotic ptosis.

Background: This investigation explores the potential impact of Negative Pressure Wound Therapy (NPWT) dressing on mommy makeover surgical wounds. The focus is on optimizing the healing process and post-surgical care to mitigate complications like wound dehiscence, seroma, and hematoma.

Patients and methods: A prospective study spanned from October 2015 to April 2022, involving 40 patients undergoing mommy makeover surgery for aesthetic purposes. The randomized division resulted in two groups. Group one (n = 20) had donor sites covered with NPWT dressing, while group two (n = 20) received standard dressings lacking known healing-promoting agents. The assessment of complications served as an index of NPWT efficacy, and scars were evaluated using the Vancouver Scale.

Results: Immediate post-surgical use of NPWT dressings significantly expedited wound healing compared to fine-mesh gauze dressings. Furthermore, it almost eradicated discomfort and pain in all patients, indicating excellent compliance. Patients tolerated NPWT well, with no instances of dressing failure or non-compliance.

Conclusion: This study underscores the utility of NPWT dressing in managing mommy makeover surgery wounds. The dressing's bio-occlusive properties create an optimal environment for wound healing, simultaneously minimizing pain, discomfort, and preventing key complications such as seroma and unfavorable scar appearance.

Background: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a haematological malignancy which may occur in patients with textured breast implant history. While typically diagnosed at an early stage with good prognosis, it may present with local residual disease due to incomplete surgical excision.

Case presentation: We describe the case of a 42 year-old woman with a history of bilateral breast augmentation for cosmetic purposes 21 years prior, who developed recurring seroma of the left side. She sought help from her first surgeon who performed 2 breast implant exchange procedures placing textured devices and finally a bilateral breast implant removal over the course of two decades. The patient did not receive capsulectomies in the previous implant exchanges, and received sampling from the anterior capsule in the last procedure, where BIA-ALCL was diagnosed on the left side. She was referred to a tertiary cancer center where preoperative workup confirmed presence of local residual disease. Following multidisciplinary team management, she underwent revision of en-bloc capsulectomy of the left side without need for additional treatments. Post-operative course was uneventful with no signs of local recurrences at 18 months follow-up.

Conclusion: Residual disease in BIA-ALCL may be caused not only by tumor characteristics or extent, but also by misdiagnosis or late diagnosis. This case highlights the critical importance of thorough surgical excision in BIA-ALCL. The existence of guidelines and clinical practice recommendations direct surgeons on how to appropriately recognize and manage symptomatic patients in order to treat suspicious cases in a timely manner.

We report three rare cases of two-level skier's thumb injuries and explain the diagnostic challenges, surgical treatments, and anatomical explanations to emphasize the importance of a systematic diagnostic approach in every skier's thumb injury, including clinical examination, radiography, and ultrasonography. A surgical method to treat these rare cases is presented.

Dupuytren's disease is rare in children. We present the case of a 14-year-old boy who developed post-traumatic Dupuytren's contracture, which was treated by segmental fasciectomy. The disease was histologically confirmed. We review the literature describing similar cases, and this case-report provides an important reminder for clinicians reviewing similar presentations that paediatric post-traumatic Dupuytren's should be considered in the differential diagnosis and managed accordingly.

We herein report a case of traumatic tibial nerve defect involving the ankle joint. A 16-mm-long defect was observed in a 5-mm-diameter tibial nerve. Two 3-mm-inner-diameter PGA-collagen tubes were transferred to the bifurcated tibial nerve. Satisfactory recovery was achieved at 3 year and 9 months postoperatively.