1/35. Z-plasty closure of the donor defect of the radial forearm free flap.The radial forearm is a popular free flap site for reconstruction of head and neck defects, because of its abundant, pliable, skin component and an available, extended, vascular pedicle. In addition, vascularized composite flaps, including a segment of radius, can be designed for skeletal stabilization. The donor-site defect can involve various complications, including loss of skin graft, unsatisfactory appearance, numbness, and radial fracture. Recent advances in reducing donor-site defect problems have included the use of rotation skin flaps, local muscle rotation, and soft-tissue expansion; however, each of these has its own limitations. Two cases are presented in which radial forearm donor site defects, measuring less than 4 cm x6 cm, were primarily closed successfully with z-plasties based on the longitudinal skin incision. Each patient has regained preoperative mobility, and prompt primary healing was achieved without complications.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
2/35. Reconstruction of the horizontal rami of the mandible following avulsion in childhood.A 7-year-old boy was involved in a road traffic accident in October 1971, and apparently had been dragged along face downwards with resultant avulsion of the entire horizontal mandibular rami, and most of the mandibular alveolar soft tissue and teeth. Repair by metal implants was attempted but these proved unsatisfactory, and soft tissue replacement for the missing alveolus was carried out by flap raised from arm. Rib grafting was carried out on three occasions at almost yearly intervals, but each time, probably owing to vascular insufficiency, non-union (or more correctly non-replacement) occurred in the left canine region. To "import" a new blood supply, and free some of the scar tissue, a compound muscle/bone/skin flap bearing the clavicle and sternomastoid muscle was transposed to the mandibular bed. This form of grafting was used extensively in world war i to repair facial gunshot wounds, and the transposed blood supply enabled success in the pre-antibiotic period. Bony union is now satisfactory 5 years after injuries and dentures have been recently fitted; speech is normal, the child's facial contours acceptable, and mastication has been satisfactory during this period.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
3/35. Nine-year follow-up of successful placement of endosseous implants in a mandibular bone graft.Facial trauma injuries secondary to gunshot wounds present a unique challenge. These wounds are avulsive and typically involve the destruction of soft tissue with bone loss. A technique in bone transplantation is that of particulate cancellous bone and marrow. Initial form and stability can be provided by a titanium mesh tray or reconstruction plates while the graft undergoes maturation and consolidation. dental implants can then be placed in this grafted site to provide stabilization for a functional and comfortable prosthesis and for the support of the peri-oral soft tissues.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
4/35. Vertical distraction of a free vascularized fibula flap in a reconstructed hemimandible: case report.The authors report a case of vertical distraction osteogenesis of a free revascularized fibula flap used to reconstruct an hemimandible lost as a result of a gunshot injury. The reconstruction procedure and the distraction protocol are described; clinical and radiological results are presented. The vertical discrepancy between the fibula and the native right hemimandible was corrected.- - - - - - - - - - ranking = 90.901045534145keywords = injury (Clic here for more details about this article) |
5/35. Degloving injury to mental protuberance: a case report.Sporting injuries are increasing in frequency with the increase in leisure time. This report describes a case of degloving of the mental protuberance. Ideally this injury should be treated as soon as possible by repositioning the displaced tissue and closure. Immediate assistance was not sought until superimposed infection caused pain and swelling. Because the wound was infected, treatment was aimed at obtaining healing by secondary intention.- - - - - - - - - - ranking = 454.50522767073keywords = injury (Clic here for more details about this article) |
6/35. lingual nerve injury after use of a cuffed oropharyngeal airway.The cuffed oropharyngeal airway is a modified Guedel airway and is recommended for anaesthesia in spontaneously breathing patients. To our knowledge this is the first report of transient unilateral lingual nerve palsy after the use of a cuffed oropharyngeal airway to maintain anaesthesia during arthroscopy of an ankle. The aetiology of lingual nerve damage is multifactorial. The possible mechanisms involved include anterior displacement of the mandible during insertion of the cuffed oropharyngeal airway (as in the jaw thrust manoeuvre), compression of the nerve against the mandible, or stretching of the nerve over the hyoglossus by the cuff of the cuffed oropharyngeal airway. We recommend gentle airway manipulation with the use of the cuffed oropharyngeal airway, avoidance of excessive cuff inflation and early recognition of such a complication if it occurs.- - - - - - - - - - ranking = 363.60418213658keywords = injury (Clic here for more details about this article) |
7/35. Spontaneous bone regeneration of the mandible in an elderly patient: a case report and review of the literature.Spontaneous bone regeneration is an unexpected phenomenon that may take place in large mandibular defects secondary to trauma and tumor resection. One explanation for this unusual healing course is that it may be derived from the mechanism of fracture healing. A review of the literature presents several factors that may influence this process, such as the presence of periosteum and bony fragments, mandibular stabilization, soft tissue protection, the presence of infection, and a young age. Previous reports of spontaneous mandibular regeneration have all taken place in relatively young patients (5-35 years old). This paper reports a case of spontaneous bone regeneration in a 58-year-old woman who sustained an injury to her mandible from an explosive blast, and presents some explanations on how such an event could take place.- - - - - - - - - - ranking = 91.901045534145keywords = injury, soft (Clic here for more details about this article) |
8/35. Ewing's sarcoma of the mandible in a young patient: case report.Ewing's sarcoma, a malignant tumor, rarely occurs in children younger than 5 years of age. Although it may appear in any bone, it is more common in the axial skeleton, rarely involving the jaws (1 to 2% incidence, mostly in the mandible). The most common symptoms are pain and swelling in the affected area. history of trauma often is reported. The case of a 4-year, 10-month-old Caucasian male with a rapidly expanding mass on the right side of his face following an injury to his mandible is reported.- - - - - - - - - - ranking = 90.901045534145keywords = injury (Clic here for more details about this article) |
9/35. Acute spinal cord injury in pregnancy: an illustrative case and literature review.Acute trauma is not all that uncommon in pregnancy. It accounts for 15% of non-obstetric maternal deaths. Moreover, about 15% of acute spinal cord injuries involve young women of childbearing age (Gilson et al., 1995). Most of the existing literature on spinal cord injury in pregnancy is concerned with the management of patients with pre-existing lesions; very few articles deal with acute injuries. We report the management of a case of acute spinal cord injury in the third trimester of pregnancy and review the major clinical issues associated with such cases.- - - - - - - - - - ranking = 545.40627320487keywords = injury (Clic here for more details about this article) |
10/35. Primary post-traumatic mandibular reconstruction in infancy: a 10-year follow-up.Ballistic trauma to the craniofacial skeleton combines the challenges of complex bone injury and loss with severe soft tissue injury and violation of the naso-orbital or oropharyngeal cavities. The authors report a patient who experienced a unique ballistic injury at 28 months of age that resulted in loss of the mandibular ramus and condyle. A segmental injury to the facial nerve was also identified. Primary costochondral grafting and delayed interpositional nerve grafting was undertaken. After 10 years, the patient has nearly 40 mm of opening, with only slight deviation to the injured side. Her facial nerve regeneration provides complete orbicularis oculi function, oral competence, and only slight facial asymmetry. This traumatic reconstruction differs from that of patients with hemifacial microsomia or post-traumatic/arthritic ankylosis in that the joint space itself was spared. Thus, the costochondral graft benefits from the remaining articular disk and upper disk space and is able to rotate and translate. Function and growth are adequately re-established, even in this young pediatric patient.- - - - - - - - - - ranking = 364.60418213658keywords = injury, soft (Clic here for more details about this article) |
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