摘要:

The treatment of facial asymmetries presents an aesthetic component of great importance. To correct facial contour defects, there are many therapeutic possibilities available, such as autologous tissue grafts and inorganic implants. The arrival of microsurgical techniques has improved the outlook for facial contour restoration. Among the tissues used are groin, escapular, and omentum flaps. This article introduces our experience with the latissimus dorsi free flap for the restoration of facial contour defects. Our experience is based on 7 patients affected with hemifacial microsomia and Romberg's disease. Operative planning, surgical procedure, and results are described.The use of the latissimus dorsi free flap is our procedure of choice for its greater adaptability in conforming to the shape of the defect, its long vascular pedicle, the abundance of available tissue, and minimal tendency to ptotic changes. At present we recommend this technique for replacement of soft tissue in severe defects of the face.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A retrospective study of 48 patients with ring avulsion injuries was performed. Patients were grouped according to severity of damage. Revascularization with interposition grafts was performed in all patients where indicated. In contrast to the experience of others, even class III lesions (total avulsion) were salvaged.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Nonunion occurs in less than 1% of phalangeal fractures. Despite this rarity we have accumulated a series of 14 proximal and middle phalangeal delayed unions, nonunions, and malunions. All patients but 1 were initially treated by a physician other than the senior author. All patients developed loss of active motion following their primary treatment. Secondary treatment was by open reduction and internal fixation with Kirschner wires. The mean and median total active motion before secondary treatment were 130 and 90 degrees, respectively. Following secondary treatment, the total active motion increased significantly(p< 0.05) to a mean of 215 degrees and a median of 255 degrees. We recommend secondary treatment of delayed union, nonunion, and malunion of phalanges of the hand. Open reduction and internal fixation followed by early (two to three weeks) active motion leads to a significant improvement in finger function.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The increasing incidence of illicit intravenous drug abuse has reached epidemic proportions in western society. Although the accompanying infectious complications such as hepatitis and acquired immunodeficiency syndrome receive the most notoriety, injection injuries are causing an increasing number of problems. A retrospective review of patients requiring admission for acute or chronic drug injection injuries of the upper extremities was made at the Detroit Receiving Hospital from 1980 through 1985. The demographical, historical, physical, microbiological, and follow-up data were analyzed. The majority of the injuries involved subcutaneous injections into the hand with accompanying inflammatory or infectious complications. The bacteriological data revealed unique characteristics and did not reflect patterns expected from inoculation of normal skin flora. A treatment regimen based on the data is proposed.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The understanding of human dermal lymphatic anatomy has rested for nearly 120 years on the original work of Sappey. Subsequently, others have added significantly to our knowledge with anatomic studies. Copious lymphoscintigraphical data have accumulated in recent years in the evaluation of cutaneous melanomas. These data suggest that the old anatomic picture of lymphatic anatomy is functionally inaccurate. Analysis of these cumulative data reveals an extensive network of feeding lymphatic connections to major nodal basins far more expansive than previously recognized. These nodal basins overlap to a significant extent, rendering drainage prediction based on location nearly impossible. Therapeutic implications are remarkable.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Ultrasound mammography is presented as a safe, simple, and reliable method of assessing prosthesis and prosthesis-related complications in the augmented breast. The ability to distinguish between silicone gel, muscle, hematoma, and fluid collections has made ultrasound mammography especially valuable in diagnosing capsular rupture, implant rupture, or periprosthetic hematoma in subpectoral breast augmentations. Examples are given and discussed.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The congenital facial melanocytic lesion Ota's nevus is reviewed, and an effective cosmetic treatment—sequential dry ice application and epidermal peeling combined with argon laser—is discussed. It is emphasized that Ota's nevus is not simply a dermal lesion and that patients should receive careful ophthalmological follow-up.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Basal cell carcinoma in children is rare. Its occurrence has been described in association with nevoid basal cell carcinoma syndrome, preexisting organoid nevus, and xeroderma pigmentosum. We present a case of solitary basal cell carcinoma in a 13-year-old boy with nonactive damaged skin or a genetically transmitted syndrome. The contribution of this case is to alert the physician to the possibility of basal cell carcinoma in children so that appropriate treatment may be initiated immediately and any delay avoided.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We report the case of a monomorphic adenoma of the parotid in a neonate. Although solid tumors of the parotid are rare in the pediatric population, these lesions may develop in utero and present at any time after birth. A solid mass in the parotid must be considered malignant until proved otherwise regardless of the age of the patient.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Dermal cylindroma is a benign neoplasm of the eccrine sweat glands, which presents in the head and neck area in 91% of cases. In its most florid presentation, the entire scalp can be involved, leading to the descriptive label turban tumor. We present the case of a 30-year-old woman with dermal cylindroma extensively involving her forehead and scalp and whose family was affected in three consecutive generations. She underwent total scalp and forehead excision with coverage by split-thickness skin grafts from the thigh. Seven years later, because of progressive external ear involvement, auricular resurfacing was performed. Her scalp and forehead have remained tumor free in the eight-year follow-up period and the auricles at one year. Total excision has led to a cosmetic and functional improvement, and the possibility of malignant degeneration is theoretically decreased.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID