Loss of key-pinch sensation after median nerve injury poses significant functional detriment. Nerve transfers are utilized to improve function and size matching donor recipient nerves is important optimize success. This anthropometric study investigates the anatomy superficial branch radial (SBRN) thumb index finger explores sensory transfers, a necessary but not heavily discussed facet for hand. Anatomic dissection SBRN in 15 cadaver hands was performed assess variability diameter branching...

Introduction Staged, tissue expander-based implant reconstruction continues to be the most common mode of breast after mastectomy and has evolved significantly for past 60 years. Prepectoral acellular dermal matrix (ADM)-assisted is gaining popularity with complication rates similar total submuscular ADM-assisted partially reconstruction. Ours among first reports comparing postoperative pain early functional outcomes between 2-stage prepectoral partial Methods Patients reconstructed a...

Infection is the most significant complication in implant-based breast reconstruction, potentially leading to reconstructive failure. We hypothesized that implementation of an evidence-based protocol marked by preoperative decolonization and sterility optimization would result a decline postoperative infection rates.Informed literature review, we developed evidence-based, perioperative prevention implemented 2015. Surgical outcomes were compared between patients who had undergone...

Abstract Numerous methods for surgical correction of sagittal synostosis have been described in the literature, yielding similar outcomes. At authors’ institution, approaches to correct this condition evolved over past few decades, including Π, H-type craniectomies (Renier), endoscopic suturectomy, and our current technique, FLAG procedure. Our aim is review evolution these techniques at institution compare patient A retrospective was performed on consecutive patients undergoing...

Post-traumatic lower extremity bone loss in the setting of high-energy trauma can occur acutely as a result an open fracture and surgical debridement, or secondarily nonunion infection. Several techniques have been described literature for management these bony defects, including non-vascularized grafts, vascularized grafts distraction osteogenesis. Herein, authors review role post-traumatic extremity.

A 59-year-old male, with a history of angiogram via the left radial artery during workup for multi-trauma, presented to hand clinic 14-day progressive critical ischemia in thumb and index finger, along dry gangrene distal fingertip. Radial occlusion was confirmed on imaging. The patient underwent thrombectomy, arterial reconstruction vein graft, amputation Postoperatively, perfusion finger restored, resulting resolution associated pain hypersensitivity. This case demonstrates delayed...

This study is part of a mixed methods evaluation large urban medical center transitional care practice (NMG-TC). The NMG-TC provides integrated physical and behavioral health for high need patients referred from the hospital emergency department or inpatient units who lack usual source primary care. was designed internal quality improvement sought to evaluate staff perceptions successful transitions their medically socially complex patients, alternatively, obstacles most likely negatively...

Effective medical record documentation is imperative for both patient care and reimbursement provided. The purpose of this study was to compare coding/billing patterns plastic surgery consultations before after implementation a standardized protocol.Standardized hand, facial trauma, general consult note templates were created. Following institutional approval, records reviewed all from January October 2019. Template notes universally implemented in July Medical coding performed by certified...

Despite multiple surgical modalities available for the management of Morton's neuroma, complications remain common. Targeted muscle reinnervation (TMR) has yet to be explored as an option prevention recurrence neuroma. The purpose present investigation was determine consistency relevant foot neurovascular and anatomy demonstrate feasibility TMR neuroma.The 5 fresh-tissue donor cadaver feet studied, including course location medial lateral plantar nerves (MPNs LPNs), motor branches abductor...

A 62-year-old woman presented with wrist pain secondary to a distal radius fracture malunion 4 months after fall onto an outstretched hand. She was not ideal candidate for osteotomy and bone graft because of the degree displacement osteoporosis, so nonoperative treatment unsuccessful, she offered total arthroplasty (TWA) or arthrodesis opted TWA.At 14-month follow-up, patient reported significant improvement in her function. The current generation TWA implants may allow use management...

PURPOSE: Infection is the most significant complication in implant based breast reconstruction, potentially leading to reconstructive failure. We hypothesized that implementation of an evidence-based protocol marked by preoperative decolonization and sterility optimization would result a decline post-operative infection rates. METHODS: Informed literature review, we developed evidence-based, peri-operative prevention protocol, implemented 2015. Surgical outcomes were compared between...

PURPOSE: Near-infrared spectroscopy (NIRS) monitoring devices are a widely used adjunct to serial physical exams for microsurgical flap monitoring. Currently available two wavelength NIRS do not directly measure tissue ischemia but use the relative amount of oxidized hemoglobin deoxyhemoglobin calculate blood oxygen saturation (StO2). Although clinically improve early detection compromise, StO2 readings have significant artifactual variation requiring vigilant clinician interpretation avoid...

Introduction: Craniosynostosis occurs in approximately 1 2000 live births with sagittal synostosis representing the most common type. Many methods for surgical correction have been described similar outcomes. At our institution, numerous ways to correct this abnormality evolved over years –pi, H-type craniectomies (Renier), endoscopic suturectomy, and current technique FLAG procedure. Our aim is compare outcomes between procedure types. Methods: A retrospective review was performed on...