Calf restoration with asymmetric fat injection in polio sequelae

Background: Many things cause leg asymmetry and sequelae seen after poliomyelitis infections are still a cause of leg deformities. In this study, lipofilling and liposuction combinations are performed on patients with poliomyelitis sequelae. Volume deficiency is not the only leg problem with polio sequelae, leg length is also a problem. For this reason, the length deficiency must be addressed in order to achieve the desired symmetry. The aim of this study is correcting limb asymmetry by a method addressing both limb length deficiency by heel raise and volume deficiency by injection of fat based on corrected limb length

Functional Sharing of the Upper Orbicularis Oris Muscle for the Reconstruction of the Lower Lip

The lip reconstruction is a very controversial topic in plastic surgery and many flaps have been described for this purpose. Despite all of the interventions, some patients still have problems such as drooling and gingival show that decrease their quality of life. In this study, the authors report a patient whose lower lip was resected totally for squamous cell carcinoma. His lip was reconstructed with radial forearm flap and the patient was referred to our clinic with the aforementioned complaints. A portion of the orbicularis oris muscle of the upper lip was designed as a bipedicled flap, and it was transposed to the lower lip to make the initial flap functional. After the operation, the sphincteric function of the lip was better, and the problems as drooling and gingival show were absent. In conclusion, this flap can be a good option to make the initial nonfunctional flaps (such as radial forearm flap), functional in the aspect of lower lip reconstruction. It has a function, and it is concordant with the principle of reconstructing like with like. The native muscle tissue of the upper lip can be transferred partially to maintain physiologic oral competency

Arthrocentesis, Arthroscopic Assessment and Surgical Interventions

Temporomandibular joint disorders (TMJD) are not rare in the general population and the patients not responding to conservative therapies are candidates for surgery. Among surgical interventions, arthrocentesis, arthroscopic interventions and anatomic restoration via arthrotomy are the most popular methods. Any surgical intervention should aim to restore the TMJ, which is anatomically very complex and delicate. It should not be forgotten that the treatment of TMJD must be multidisciplinary and the preoperative conservative therapies should be continued postoperatively. Turk J Phys Med Rehab 2010;56 Suppl 1:29-33

Sensory recovery of the reverse homodigital island flap in fingertip reconstruction: a review of 66 cases

Objectives: The location of the fingertip entitles it to have significant cosmetic and functional values, but also places it at high risk for injury. During repair, finger length and function should be maintained, and stiffness and neuroma should be avoided. Various flaps have been described for reconstruction of distal finger defects with bone, tendon, or joint exposures, including reverse flow homodigital island flap. In this study, we present our experience of reverse flow homodigital island flap in terms of sensory recovery

Use of Turn-in Skin Flaps for Nasal Lining Reconstruction

BACKGROUND Reconstruction of the nasal lining is the most difficult part of complex nasal reconstruction because the mucosa has a unique texture and fineness. Many techniques, ranging from skin grafts to local flaps, have been applied for the reconstruction of the mucosa. In some cases, even free flaps have been used

High pressure paint gun injury of the index finger: a case report

Injuries to the hand secondary to high pressure paint guns are considered to be true hand emergencies. These rare injuries may have serious outcomes, and a critical step in their management is extensive debridement performed within the first six hours following injury. For this reason, their diagnosis should not be delayed, and the hand surgeon should be informed immediately to initiate appropriate treatment. In this report, the authors describe a patient who was injured with a chemical paint gun, and whose injury was not diagnosed in the emergency department. The patient subsequently developed tenosynovitis. His treatment is reported herein

A Rare Complication of Composite Dual Mesh: Migration and Enterocutaneous Fistula Formation

Introduction. Mesh is commonly employed for abdominal hernia repair because it ensures a low recurrence rate. However, enterocutaneous fistula due to mesh migration can occur as a very rare, late complication, for which diagnosis is very difficult. Presentation of Case. Here we report the case of an enterocutaneous fistula due to late mesh migration in a mentally retarded, diabetic, 35-year-old male after umbilical hernia repair with composite dual mesh in 2010. Discussion. Mesh is a foreign substance, because of that some of the complications including hematoma, seroma, foreign body reaction, organ damage, infection, mesh rejection, and fistula formation may occur after implantation of the mesh. In the literature, most cases of mesh-associated enterocutaneous fistula due to migration involved polypropylene meshes. Conclusion. This case serves as a reminder of migration of composite dual meshes

Key and Keyhole Model for Dorsal Onlay Cartilage Grafts in Correcting Nasal Deformities

Background The shaping of the cartilage and keeping it in place is very significant for patients who need nasal reconstruction with costal grafts at traumatic or secondary rhinoplasties. In this study, a template is prepared during the surgery that shows the dorsal defect in a 3-dimensional manner and acts as a guide while shaping the cartilage

Cosmetic closure of pilonidal sinus defects with bilateral transpositional adipofascial flaps

The optimal treatment of the pilonidal sinus has not currently been defined. This study described the use of a modified bilateral transpositional adipofascial flap technique that effectively serves to flatten the deep natal cleft while keeping the scar limited to the intergluteal fold for good cosmesis. Between June 2007 and September 2011, 83 patients (61 men, 22 women) were included in the study. Duration of pilonidal sinus symptoms ranged from 1-15 (median 5) years; 15 patients had recurrent disease. Before the operation, perforating branches of the four pairs of lateral sacral arteries were identified with a Doppler audioscope. After complete excision of the sinus cavity and adequate undermining of the skin, bilateral adipofascial flaps were raised in order to realise a Yin-Yang pattern, with the lateral sacral artery perforators at the base of each flap. Complementary flaps were then transposed into the defect and inset to completely obliterate dead space. Skin was closed primarily in two layers. The median (range) defect size after total excision of the sinus cavity was 38 (19-60) cm(2). All flaps survived. There was no wound infection or dehiscense. Median (range) follow-up was 26 (6-52) months. No recurrences were observed. Extensive scarring or asymmetry in the gluteal prominences was not observed. Transient paraesthesia over the flap donor region occurred in 14 cases (16%) and resolved completely within 6 months. The bilateral adipofascial transpositional flap method is an alternative to previously described treatment options in pilonidal sinus surgery. It is a safe, reliable, and easily applicable method, which provides cosmetically acceptable coverage of pilonidal sinus defects of moderate size