Abstract Introduction Wrist parameters measured on direct radiography are essential in diagnosing scaphoid-related pathologies and treatment. Although computed tomography has been used to establish normative for scaphoid measurement, no research has focused on Indian norms. This study aimed to determine the distribution and normal limits of parameters measured in our population's posteroanterior (PA) and direct lateral radiographs of the wrist. Materials and Methods Two investigators conducted a prospective analysis of normal wrist radiographs in a single center. Radiology information system-picture archiving and communication system was used to collect standard digitized normal X-rays without significant osseous pathology over a year. The sample size was 600, distributed among age groups 18 to 30, 31 to 50, and 51 years and above. Scaphoid length, scaphoid width, scapholunate ratio, and scapholunate distance using both Cautilli and Gilula techniques were measured on a PA view, and scapholunate, radioscaphoid, and intrascaphoid angles were measured on a lateral view. As the lunate morphology is supposed to affect carpal kinematics with the scaphoid, the same was evaluated using the Viegas classification. Results A total of eight measurements were documented. Scaphoid length, scaphoid width measurements, and lateral intrascaphoid angle were more in males than in females and were found to be statistically significant. No other parameters showed any significance in terms of age and relation to lunate morphology. Conclusion The study offers a comprehensive analysis of measuring parameters specific to the Indian population. For the first time, the measurement of scapholunate distance was conducted utilizing two distinct methodologies. The normative intrascaphoid angle range and clinical implications were determined.
摘要 引言 直接放射摄影测量的腕部参数对于诊断肩胛骨相关病症和治疗至关重要。虽然计算机断层扫描已被用于建立肩胛骨测量的标准，但还没有针对印度标准的研究。本研究旨在确定我国人群腕关节后正位（PA）和直接侧位X光片测量参数的分布和正常范围。材料和方法 两名研究人员在一个中心对正常腕部 X 光片进行了前瞻性分析。使用放射学信息系统-图片存档和通信系统收集一年内无明显骨质病变的标准数字化正常 X 光片。样本量为 600 份，分布在 18 至 30 岁、31 至 50 岁和 51 岁及以上年龄组。采用 Cautilli 和 Gilula 技术在 PA 切面上测量肩胛骨长度、肩胛骨宽度、肩胛骨比例和肩胛骨间距，并在侧视图上测量肩胛骨角、肩胛骨放射角和肩胛骨内角。由于月骨形态会影响腕骨与肩胛骨的运动学，因此采用 Viegas 分类法对月骨形态进行评估。结果 共记录了八项测量结果。男性的肩胛骨长度、肩胛骨宽度和肩胛骨外侧内角的测量值均高于女性，且具有统计学意义。其他参数在年龄和与月骨形态的关系方面均无明显意义。结论 该研究对印度人群特有的测量参数进行了全面分析。该研究首次采用两种不同的方法测量肩胛骨距离。确定了肩胛骨内角的标准范围和临床意义。
{"title":"Normative Radiographic Measurements of Scaphoid in a Sample Indian Population","authors":"Anil K. Bhat, Mithun Pai G., Amanpreet Singh","doi":"10.1055/s-0044-1787689","DOIUrl":"https://doi.org/10.1055/s-0044-1787689","url":null,"abstract":"Abstract Introduction Wrist parameters measured on direct radiography are essential in diagnosing scaphoid-related pathologies and treatment. Although computed tomography has been used to establish normative for scaphoid measurement, no research has focused on Indian norms. This study aimed to determine the distribution and normal limits of parameters measured in our population's posteroanterior (PA) and direct lateral radiographs of the wrist. Materials and Methods Two investigators conducted a prospective analysis of normal wrist radiographs in a single center. Radiology information system-picture archiving and communication system was used to collect standard digitized normal X-rays without significant osseous pathology over a year. The sample size was 600, distributed among age groups 18 to 30, 31 to 50, and 51 years and above. Scaphoid length, scaphoid width, scapholunate ratio, and scapholunate distance using both Cautilli and Gilula techniques were measured on a PA view, and scapholunate, radioscaphoid, and intrascaphoid angles were measured on a lateral view. As the lunate morphology is supposed to affect carpal kinematics with the scaphoid, the same was evaluated using the Viegas classification. Results A total of eight measurements were documented. Scaphoid length, scaphoid width measurements, and lateral intrascaphoid angle were more in males than in females and were found to be statistically significant. No other parameters showed any significance in terms of age and relation to lunate morphology. Conclusion The study offers a comprehensive analysis of measuring parameters specific to the Indian population. For the first time, the measurement of scapholunate distance was conducted utilizing two distinct methodologies. The normative intrascaphoid angle range and clinical implications were determined.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344833","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}
Abstract Background Kite string injuries (manja cut injuries), particularly those caused by Chinese manja, are new culprit of emergencies especially in the month of January in Maharashtra region. These injuries commonly affect the neck, face, hands, and legs, especially among individuals traveling on two wheelers. The visibility challenge, where the kite's thread is difficult to see, further exacerbates the risk. Methods We have studied 10 cases of manja cut injuries presented to a tertiary care center in Nagpur during the last 2 years. Result A total of 10 patients reported kite string-related injuries to our department over a period of 2 years. All patients were male. The majority of patients presented in the younger age group with the mean age of presentation was 25 years. Majority of the patients had injuries in zone 2 of the hand. Conclusion Kite flying is a traditional festival celebrated in the month of January in Gujarat and Maharashtra for years. However, the introduction of Chinese or nylon manja has led to serious injuries and fate, affecting not only kite flyers but also bystanders, animals, and birds. This study seeks to highlight the harmful consequences of Chinese manja and deceptive appearance of manja giving false impression of simple lacerated wound which could be just a tip of the iceberg.
{"title":"Kite String or Manja Cut Injury: A New Culprit","authors":"Surendrakumar B. Patil, Neha Gupta, Anshoo Gandhi, Mayank Bhasin, Prabhakar Rakhonde, Sushil Machhale","doi":"10.1055/s-0044-1787656","DOIUrl":"https://doi.org/10.1055/s-0044-1787656","url":null,"abstract":"Abstract Background Kite string injuries (manja cut injuries), particularly those caused by Chinese manja, are new culprit of emergencies especially in the month of January in Maharashtra region. These injuries commonly affect the neck, face, hands, and legs, especially among individuals traveling on two wheelers. The visibility challenge, where the kite's thread is difficult to see, further exacerbates the risk. Methods We have studied 10 cases of manja cut injuries presented to a tertiary care center in Nagpur during the last 2 years. Result A total of 10 patients reported kite string-related injuries to our department over a period of 2 years. All patients were male. The majority of patients presented in the younger age group with the mean age of presentation was 25 years. Majority of the patients had injuries in zone 2 of the hand. Conclusion Kite flying is a traditional festival celebrated in the month of January in Gujarat and Maharashtra for years. However, the introduction of Chinese or nylon manja has led to serious injuries and fate, affecting not only kite flyers but also bystanders, animals, and birds. This study seeks to highlight the harmful consequences of Chinese manja and deceptive appearance of manja giving false impression of simple lacerated wound which could be just a tip of the iceberg.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353371","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}
Bulli Babu Boyidi, Sreeramaraju Vulchi, V. Babu, M. Sharma
Squamous cell carcinoma(SCC) in a neglected acrosyndactyly is not reported in the literature. Acrosyndactyly is a rare form of congenital anomalies of thehand with fusion of the distal digits and the proximal digits that are not fused have a fenestration, which is a characteristic of constriction ring syndrome. The most common skin malignancy of the hand is SCC. 1
{"title":"Squamous Cell Carcinoma in a Neglected Case of Acrosyndactyly","authors":"Bulli Babu Boyidi, Sreeramaraju Vulchi, V. Babu, M. Sharma","doi":"10.1055/s-0044-1787564","DOIUrl":"https://doi.org/10.1055/s-0044-1787564","url":null,"abstract":"Squamous cell carcinoma(SCC) in a neglected acrosyndactyly is not reported in the literature. Acrosyndactyly is a rare form of congenital anomalies of thehand with fusion of the distal digits and the proximal digits that are not fused have a fenestration, which is a characteristic of constriction ring syndrome. The most common skin malignancy of the hand is SCC. 1","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352793","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}
Maryada Venkateshwar Reddy, Mithun Pai G., Morum Mahendra Kumar, Anil K. Bhat, Adarsh Annapareddy, M. Thatte
Abstract Introduction Metacarpal fractures are common and have various treatment options, but understanding their morphometry is crucial for optimizing fixation techniques and reducing complications. Accurate assessment of metacarpal anatomy is challenging in conventional radiographs but feasible with computed tomography (CT) scans, which offer precise views. This study aimed to provide accurate anatomical data on metacarpals within an Indian population using CT scans and to compare the results with existing literature. The findings have implications for surgical procedures, including plating, pinning, and intramedullary screw fixation. Materials and Methods This retrospective analysis utilized CT scans of 100 hands, including 50 males and 50 females, from two hospitals in India. Inclusion criteria included complete metacarpal visualization with a slice thickness of 0.6 mm, while exclusion criteria involved trauma, deformity, or underlying pathologies. Various parameters of all metacarpals were measured using RadiAnt DICOM Viewer 2021.1, providing accurate anteroposterior and lateral views. Results Male and female cohorts had mean ages of 38.58 ± 12.02 and 43.60 ± 13.61 years, respectively. The study showed good to excellent reliability in measurements. The 2nd metacarpal was consistently the longest, and the general length pattern was 3rd > 4th > 5th > 1st metacarpal in both genders. Men generally had larger metacarpal dimensions than women, except for intramedullary diameter, which showed minimal sex-related differences. Notably, the medullary cavity's narrowest part was at the 4th metacarpal, and the thumb had the widest intramedullary diameter. Conclusion This study provides valuable anatomical reference data for metacarpals in an Indian population, aiding in optimizing surgical techniques for metacarpal fractures. The 2nd metacarpal consistently stood out as the longest, and men generally had larger metacarpal dimensions than women. These insights into anatomical variations can inform clinical decisions and stimulate further research in this field. However, a larger and more diverse sample would enhance the study's representativeness.
{"title":"Indian Hand Anthropometry: Computer Tomography-Based Morphometric Analysis of Metacarpal","authors":"Maryada Venkateshwar Reddy, Mithun Pai G., Morum Mahendra Kumar, Anil K. Bhat, Adarsh Annapareddy, M. Thatte","doi":"10.1055/s-0044-1787688","DOIUrl":"https://doi.org/10.1055/s-0044-1787688","url":null,"abstract":"Abstract Introduction Metacarpal fractures are common and have various treatment options, but understanding their morphometry is crucial for optimizing fixation techniques and reducing complications. Accurate assessment of metacarpal anatomy is challenging in conventional radiographs but feasible with computed tomography (CT) scans, which offer precise views. This study aimed to provide accurate anatomical data on metacarpals within an Indian population using CT scans and to compare the results with existing literature. The findings have implications for surgical procedures, including plating, pinning, and intramedullary screw fixation. Materials and Methods This retrospective analysis utilized CT scans of 100 hands, including 50 males and 50 females, from two hospitals in India. Inclusion criteria included complete metacarpal visualization with a slice thickness of 0.6 mm, while exclusion criteria involved trauma, deformity, or underlying pathologies. Various parameters of all metacarpals were measured using RadiAnt DICOM Viewer 2021.1, providing accurate anteroposterior and lateral views. Results Male and female cohorts had mean ages of 38.58 ± 12.02 and 43.60 ± 13.61 years, respectively. The study showed good to excellent reliability in measurements. The 2nd metacarpal was consistently the longest, and the general length pattern was 3rd > 4th > 5th > 1st metacarpal in both genders. Men generally had larger metacarpal dimensions than women, except for intramedullary diameter, which showed minimal sex-related differences. Notably, the medullary cavity's narrowest part was at the 4th metacarpal, and the thumb had the widest intramedullary diameter. Conclusion This study provides valuable anatomical reference data for metacarpals in an Indian population, aiding in optimizing surgical techniques for metacarpal fractures. The 2nd metacarpal consistently stood out as the longest, and men generally had larger metacarpal dimensions than women. These insights into anatomical variations can inform clinical decisions and stimulate further research in this field. However, a larger and more diverse sample would enhance the study's representativeness.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354012","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}
Junya Oshima, Yoichiro Shibuya, Kaoru Sasaki, M. Sekido
Abstract Background: Perifascial areolar tissue (PAT) transplant is a technique in which a sheet of connective tissue on the fascia is harvested and transplanted to the wound bed. PAT engraftment fails when the exposed area of tendons, bones, or artificial materials is large. On the other hand, combination of tissue transplant and basic fibroblast growth factor (bFGF) improves the survival rate of the transplanted tissue. Methods: A wound model was created in which the artificial material was exposed on rats' backs. All the rats underwent PAT transplant, but the rats were divided into two groups according to the PAT processing method beforehand. In one group, the PAT was immersed in water for injection before transplant (bFGF[–] group), and in the other group, the PAT was immersed in bFGF product (bFGF[+] group). Specimens were collected 7 days after surgery to assess the histologic thickness of the PAT and the gene expression in the PAT. Results: The thickness of the PAT in the tissue slices was significantly higher in the bFGF(+) group than in the bFGF(–) group. Expressions of CD34 and COL3A1 were significantly higher in the bFGF(+) group than in the bFGF(–) group. Conclusion: The results of this study indicate that adding bFGF to the PAT transplant may promote PAT engraftment and wound healing by increasing angiogenesis and may increase granulation formation, which may result in a stronger covering that prevents the prosthesis from being exposed.
摘要 背景：筋膜周围组织（PAT）移植是一种采集筋膜上的结缔组织片移植到伤口床的技术。当肌腱、骨骼或人工材料的暴露面积较大时，PAT 移植就会失败。另一方面，组织移植与碱性成纤维细胞生长因子（bFGF）的结合可提高移植组织的存活率。方法：创建一个伤口模型，将人工材料暴露在大鼠背部。所有大鼠都接受了 PAT 移植，但事先根据 PAT 的处理方法将大鼠分为两组。一组在移植前将 PAT 浸入水中进行注射（bFGF[-]组），另一组将 PAT 浸入 bFGF 产品中（bFGF[+]组）。术后 7 天采集标本，评估 PAT 的组织学厚度和 PAT 中的基因表达。结果bFGF(+)组组织切片中的PAT厚度明显高于bFGF(-)组。bFGF(+) 组 CD34 和 COL3A1 的表达明显高于 bFGF(-) 组。结论本研究结果表明，在 PAT 移植中添加 bFGF 可通过增加血管生成促进 PAT 移植和伤口愈合，并可增加肉芽形成，从而形成更坚固的覆盖层，防止假体外露。
{"title":"Effect of Basic Fibroblast Growth Factor in Perifascial Areolar Tissue Transplant","authors":"Junya Oshima, Yoichiro Shibuya, Kaoru Sasaki, M. Sekido","doi":"10.1055/s-0044-1787561","DOIUrl":"https://doi.org/10.1055/s-0044-1787561","url":null,"abstract":"Abstract Background: Perifascial areolar tissue (PAT) transplant is a technique in which a sheet of connective tissue on the fascia is harvested and transplanted to the wound bed. PAT engraftment fails when the exposed area of tendons, bones, or artificial materials is large. On the other hand, combination of tissue transplant and basic fibroblast growth factor (bFGF) improves the survival rate of the transplanted tissue. Methods: A wound model was created in which the artificial material was exposed on rats' backs. All the rats underwent PAT transplant, but the rats were divided into two groups according to the PAT processing method beforehand. In one group, the PAT was immersed in water for injection before transplant (bFGF[–] group), and in the other group, the PAT was immersed in bFGF product (bFGF[+] group). Specimens were collected 7 days after surgery to assess the histologic thickness of the PAT and the gene expression in the PAT. Results: The thickness of the PAT in the tissue slices was significantly higher in the bFGF(+) group than in the bFGF(–) group. Expressions of CD34 and COL3A1 were significantly higher in the bFGF(+) group than in the bFGF(–) group. Conclusion: The results of this study indicate that adding bFGF to the PAT transplant may promote PAT engraftment and wound healing by increasing angiogenesis and may increase granulation formation, which may result in a stronger covering that prevents the prosthesis from being exposed.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354013","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}
Amarnath V. Munoli, Sarika Mayekar, P. Mukati, M. Jagannathan
Abstract Introduction Fractures of the condylar region of the mandible, although fairly common, also generate the most debate regarding management—both closed and open treatment options have been recommended and shown to yield good results. We present our experience with a minimal access retromandibular approach to fractures of the vertical mandible. Materials and Methods This is a retrospective study of all patients who underwent open reduction and internal fixation for fractures of the vertical mandible (condyle, subcondylar region, ramus) using a retromandibular approach at a tertiary care hospital in a metropolitan city in India between January 2022 and July 2023. All fractures were approached using a standard technique through a retromandibular incision and a transparotid route. The proximal segment was mobilized, reduced, and fixed to the ramus with two 2-mm miniplates—one along the posterior border and the other along the sigmoid notch border. Postoperative guiding elastics were placed for 2 weeks without any rigid maxillomandibular fixation. Patients were followed at weekly intervals for 1 month followed by monthly visits for 6 months. At each visit, mouth opening, occlusion, and facial nerve function were assessed. Scar quality was assessed by both examiner and patient using the Patient and Observer Scar Assessment Scale (POSAS) scoring system. Results A total of 25 subcondylar fractures in 20 patients were fixed using the retromandibular approach. Nineteen were male and 1 was female. The etiology of trauma was road accident (8), fall from train (2), fall from height (5) and assault (5). Fifteen patients had unilateral fractures while 5 had bilateral fractures. All patients had concomitant fractures of the mandibular arch which were also fixed. The interval between trauma and surgery ranged from 5 to 28 days. All patients had premature molar contact on the side of fracture with anterior open bite. Mouth opening ranged from 1.5 to 2.5 cm. All the fractures could be fixed using the retromandibular approach. None of the patients developed any facial nerve dysfunction or salivary leak. The occlusion was restored to pretrauma status in all patients and was stable at 6 months' follow-up. Mouth opening ranged from 3.5 to 4 cm. The POSAS observer score ranged from 09 to 19 with a mean score of 12.7. The POSAS patient score ranged from 17 to 28 with a mean score of 20.3 revealing that all patients were extremely happy with the scar. Conclusion The minimal access retromandibular approach to the vertical mandible is a versatile technique enabling accurate reduction and fixation of fractures of the vertical segment of the mandible with good long-term functional and cosmetic results.
{"title":"Minimal Access Retromandibular Approach to Fractures of Vertical Segment of the Mandible: A Versatile Technique","authors":"Amarnath V. Munoli, Sarika Mayekar, P. Mukati, M. Jagannathan","doi":"10.1055/s-0044-1787659","DOIUrl":"https://doi.org/10.1055/s-0044-1787659","url":null,"abstract":"Abstract Introduction Fractures of the condylar region of the mandible, although fairly common, also generate the most debate regarding management—both closed and open treatment options have been recommended and shown to yield good results. We present our experience with a minimal access retromandibular approach to fractures of the vertical mandible. Materials and Methods This is a retrospective study of all patients who underwent open reduction and internal fixation for fractures of the vertical mandible (condyle, subcondylar region, ramus) using a retromandibular approach at a tertiary care hospital in a metropolitan city in India between January 2022 and July 2023. All fractures were approached using a standard technique through a retromandibular incision and a transparotid route. The proximal segment was mobilized, reduced, and fixed to the ramus with two 2-mm miniplates—one along the posterior border and the other along the sigmoid notch border. Postoperative guiding elastics were placed for 2 weeks without any rigid maxillomandibular fixation. Patients were followed at weekly intervals for 1 month followed by monthly visits for 6 months. At each visit, mouth opening, occlusion, and facial nerve function were assessed. Scar quality was assessed by both examiner and patient using the Patient and Observer Scar Assessment Scale (POSAS) scoring system. Results A total of 25 subcondylar fractures in 20 patients were fixed using the retromandibular approach. Nineteen were male and 1 was female. The etiology of trauma was road accident (8), fall from train (2), fall from height (5) and assault (5). Fifteen patients had unilateral fractures while 5 had bilateral fractures. All patients had concomitant fractures of the mandibular arch which were also fixed. The interval between trauma and surgery ranged from 5 to 28 days. All patients had premature molar contact on the side of fracture with anterior open bite. Mouth opening ranged from 1.5 to 2.5 cm. All the fractures could be fixed using the retromandibular approach. None of the patients developed any facial nerve dysfunction or salivary leak. The occlusion was restored to pretrauma status in all patients and was stable at 6 months' follow-up. Mouth opening ranged from 3.5 to 4 cm. The POSAS observer score ranged from 09 to 19 with a mean score of 12.7. The POSAS patient score ranged from 17 to 28 with a mean score of 20.3 revealing that all patients were extremely happy with the scar. Conclusion The minimal access retromandibular approach to the vertical mandible is a versatile technique enabling accurate reduction and fixation of fractures of the vertical segment of the mandible with good long-term functional and cosmetic results.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350670","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}
Abstract Introduction Most common type of hair loss is androgenetic alopecia. Orentreich's donor dominance theory and the definition of safe donor area are the theoretical foundation of modern hair transplantation. In safe donor area no progression of permanent hair loss occurs. Its knowledge is important to prevent loss of transplanted hair. Estimation is not tailored to every patient, also in early stages, the margins are assumed to be free from future hair loss. Our study is an attempt to find and establish a relationship between safe zone dimensions and other standard scalp dimensions, and effectively predict the complete safe zone in early stages of hair loss. Materials and Methods From July to December 2022, the first 100 patients with Norwood IV onwards of hair loss were included. Then, the distance between the vertex and the point of change in occipital hair quality and density was measured, and from this point till occipital protuberance were taken. The ratio between the two was taken. In the next 100 patients of Norwood II to IVa, the applicability of the new ratio to assess the permanent zone was used. Results Ratio method takes into account the patient's measurements, that is, permanent zone and total distance from vertex occiput. The ratio range we got is: Permanent zone: total distance from vertex to occiput: 0.43–0.53 Therefore, the permanent zone would be equal to = total distance from vertex to occiput × 0.43–0.53. With the lower limit being the occiput. Over 90% of the patients did not have significant reduction in density of transplanted hair. Conclusion The authors suggest the use of this ratio method to determine the dimensions of the permanent zone especially in patients with early grades of hair loss as per the Norwood scale. It is a simple, effective, and easily applicable concept that can ensure long-lasting results in patients undergoing hair transplants.
{"title":"Patient-Based Ratio Method for Permanent Zone Donor Area Calculation in Hair Transplant","authors":"Sudhanshu Punia, A. Goel, Amit Gupta","doi":"10.1055/s-0044-1787655","DOIUrl":"https://doi.org/10.1055/s-0044-1787655","url":null,"abstract":"Abstract Introduction Most common type of hair loss is androgenetic alopecia. Orentreich's donor dominance theory and the definition of safe donor area are the theoretical foundation of modern hair transplantation. In safe donor area no progression of permanent hair loss occurs. Its knowledge is important to prevent loss of transplanted hair. Estimation is not tailored to every patient, also in early stages, the margins are assumed to be free from future hair loss. Our study is an attempt to find and establish a relationship between safe zone dimensions and other standard scalp dimensions, and effectively predict the complete safe zone in early stages of hair loss. Materials and Methods From July to December 2022, the first 100 patients with Norwood IV onwards of hair loss were included. Then, the distance between the vertex and the point of change in occipital hair quality and density was measured, and from this point till occipital protuberance were taken. The ratio between the two was taken. In the next 100 patients of Norwood II to IVa, the applicability of the new ratio to assess the permanent zone was used. Results Ratio method takes into account the patient's measurements, that is, permanent zone and total distance from vertex occiput. The ratio range we got is: Permanent zone: total distance from vertex to occiput: 0.43–0.53 Therefore, the permanent zone would be equal to = total distance from vertex to occiput × 0.43–0.53. With the lower limit being the occiput. Over 90% of the patients did not have significant reduction in density of transplanted hair. Conclusion The authors suggest the use of this ratio method to determine the dimensions of the permanent zone especially in patients with early grades of hair loss as per the Norwood scale. It is a simple, effective, and easily applicable concept that can ensure long-lasting results in patients undergoing hair transplants.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352542","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}
Uday Bhat, Mangesh K. Pawar, I. Katyal, Amit Peswani, S. Basu, S. Waghmare, Abhishek Uday Dhakad, Udit Dalmia
Abstract Background Augmentation rhinoplasty requires graft with substantial volume. In cases where patient is reluctant to use costal cartilage, this can be done using septum and conchal cartilage graft. Using the technique of “stacked cartilage graft” an assembly is made using septum and conchal cartilage for nasal augmentation and contour defects. Although multilayered grafts have been described before, we propose an elaborate and effective method named after our city, Mumbai, to shape these grafts and highlight economical use of conchal and septal cartilage to overcome its limited volume. It also describes its clinical and aesthetic outcome of this technique in Indian patients. Methods A retrospective study from 2005 to 2020 was done in our institute. Data was collected from medical and hospital records. Preoperative and postoperative photographs were obtained for preoperative planning and outcome analysis. Rhinoplasty Outcome Evaluation score was used for outcome analysis. Minimum follow-up was 1 year in our study. Results A total of 210 patients were included in our study. In all cases, the stacked cartilage graft technique produced a natural appearing dorsum. Complications of cartilage such as resorption, extrusion, and warping were minimum. All the patients were satisfied with their results. Conclusion Although the limited volume of conchal cartilage is criticized, in reality it can be used effectively for larger requirement with “economy of use” using our technique. The curvatures and convolutions of conchal cartilage can be effectively neutralized by using this technique to obtain a smooth surface. However, this technique requires incorporation of every bit of cartilage and meticulous stacking of the pieces to get the desired shape. Thus, the stacked cartilage grafts have excellent versatility and produce natural and long-lasting results and minimal complications.
{"title":"Versatility and Outcomes of ‘Mumbai Technique’ of Stacked Cartilage Grafts in Indian Rhinoplasty","authors":"Uday Bhat, Mangesh K. Pawar, I. Katyal, Amit Peswani, S. Basu, S. Waghmare, Abhishek Uday Dhakad, Udit Dalmia","doi":"10.1055/s-0044-1787658","DOIUrl":"https://doi.org/10.1055/s-0044-1787658","url":null,"abstract":"Abstract Background Augmentation rhinoplasty requires graft with substantial volume. In cases where patient is reluctant to use costal cartilage, this can be done using septum and conchal cartilage graft. Using the technique of “stacked cartilage graft” an assembly is made using septum and conchal cartilage for nasal augmentation and contour defects. Although multilayered grafts have been described before, we propose an elaborate and effective method named after our city, Mumbai, to shape these grafts and highlight economical use of conchal and septal cartilage to overcome its limited volume. It also describes its clinical and aesthetic outcome of this technique in Indian patients. Methods A retrospective study from 2005 to 2020 was done in our institute. Data was collected from medical and hospital records. Preoperative and postoperative photographs were obtained for preoperative planning and outcome analysis. Rhinoplasty Outcome Evaluation score was used for outcome analysis. Minimum follow-up was 1 year in our study. Results A total of 210 patients were included in our study. In all cases, the stacked cartilage graft technique produced a natural appearing dorsum. Complications of cartilage such as resorption, extrusion, and warping were minimum. All the patients were satisfied with their results. Conclusion Although the limited volume of conchal cartilage is criticized, in reality it can be used effectively for larger requirement with “economy of use” using our technique. The curvatures and convolutions of conchal cartilage can be effectively neutralized by using this technique to obtain a smooth surface. However, this technique requires incorporation of every bit of cartilage and meticulous stacking of the pieces to get the desired shape. Thus, the stacked cartilage grafts have excellent versatility and produce natural and long-lasting results and minimal complications.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352409","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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