Background: Optimal management of pediatric mandible fractures demands that the practitioner balance reduction and fixation with preservation growth potential function. The ideal synthesis these goals has not yet been defined. authors catalogue their experience at a major teaching hospital reference to demographics, injury type, treatment, outcomes inform future injuries. Methods: Demographics, management, presenting over 10 years trauma center were assessed. Cephalometric analysis was...

Background: Various surgical techniques exist for lower extremity reconstruction, but limited high-quality data to inform treatment strategies. Using multi-institutional and rigorous matching, the authors evaluated effectiveness cost of three common reconstructive modalities. Methods: All adult subjects with wounds who received bilayer wound matrix, local tissue rearrangement, or free flap reconstruction were retrospectively reviewed (from 2010 2017). Cohorts’ comorbidities characteristics...

Background: Little is known about the efficacy of newer skin substitute scaffolds to reconstruct complex lower extremity wounds. The investigators present a multihospital experience reconstructive surgeons utilizing collagen-GAG bilayer wound matrix in soft-tissue reconstruction with goals (1) characterize suitable patient population, (2) categorize failures optimize selection, and (3) determine factors affecting success. Methods: Subjects underwent collagen-GAG–based from May 2010 June...

Objectives The objectives of this study were (1) to evaluate dog bite–related injuries and associated medical documentation (2) compare these results with a bites from the same institution 10 years prior. Methods Data retrospectively collected pediatric emergency department July 2007 2011 for patients treated bites. These data then compared Results A total 1017 bite (average, 254.25 bites/year), which represents 25% increase Comparing 1997 cohorts, patient demographics, rate among children...

Learning Objectives: After studying this article, the participant should be able to: 1. Understand age-related changes to face and neck pertinent anatomy discuss important aspects of fat graft harvesting, processing, infiltration. 2. Recognize key differences between common techniques for processing infiltration develop a plan patients based on site-specific facial anatomical zones. 3. Appreciate utility grafting as an adjunct other rejuvenating procedures such lift blepharoplasty list...

Success with bone morphogenetic protein-2 (BMP-2) has been widely reported in the osseous reconstruction of large calvarial defects. These efforts have required enormous doses BMP-2 and are not sufficiently refined to facilitate detail-oriented repair for intricate craniofacial structures. We previously shown that inkjet-based bioprinting technologies allow precisely customized low-dose protein patterns induce spatially regulated osteogenesis. Here, we investigate importance direct contact...

Background: Repair of complex cranial defects is hindered by a paucity appropriate donor tissue. Bone morphogenetic protein 2 (BMP2) and transforming growth factor beta 1 (TGFβ1) have been shown separately to induce bone formation through physiologically distinct mechanisms potentially improve surgical outcome for defect repair obviating the need We hypothesize that combination BMP2 TGFβ1 would calvarial healing augmenting physiologic osteogenic mechanisms. Methods/Results: Coronal...

Velopharyngeal insufficiency affects as many one in three patients after cleft palate repair. Correction using a posterior pharyngeal flap (PPF) has been shown to improve clinical speech symptomatology; however, PPFs can be complicated by hyponasality and obstructive sleep apnea. The goal of this study was assess if outcomes revert clinically indicated PPF takedown.The cleft-craniofacial database the Children's Hospital Pittsburgh at University Medical Center retrospectively queried identify...

Introduction: Soft-tissue reconstruction of the scalp has traditionally been challenging in oncologic patients. Invasive tumors can compromise calvarium, necessitating alloplastic cranioplasty. Titanium mesh is most common material, but concerns soft-tissue coverage have introduced hesitancy utilization. The authors aim to identify prognostic factors associated with free-flap failure context underlying titanium oncology Methods: A retrospective review (2010–2018) was conducted at a single...

Panniculectomy and abdominoplasty are uptrending procedures to address excess skin after weight loss which affects patient-reported quality of life. The authors aimed identify factors associated with low preoperative life, quantify the benefit these procedures, evaluate benefits across grades obesity.Patients seeking panniculectomy between 2018 2019 a completed BODY-Q questionnaire were identified. Stratification by life in tertiles for each domain allowed identification characteristics...

Spring-mediated cranioplasty (SMC) is an increasingly utilized technique to treat patients with nonsyndromic sagittal craniosynostosis, but variables impacting outcomes are incompletely understood. The purpose of this study was determine most predictive following SMC, primarily changes in cephalic index (CI).Patients craniosynostosis undergoing SMC at our institution between 2014 and 2021 were included. Cephalic measured from patient computed tomography scans, x-rays, or by caliper-based...

Abstract Purpose We examined differences in long-term morphometric outcomes of spring-mediated cranioplasty (SMC) for various forms isolated nonsyndromic sagittal craniosynostosis. Methods A retrospective review was performed children who underwent SMC from 2011 to 2020 at the Children’s Hospital Philadelphia. Cephalic indices (CI), Whitaker grades, parietal bone thickness, and degree suture fusion were assessed. Frontal bossing vertex-nasion-opisthocranion (VNO) angles compared a normal...

The purpose of this study was to assess long-term outcomes tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) resolve upper airway obstruction in patients with Robin sequence (RS). A retrospective cohort performed subjects presenting a tertiary care pediatric center who underwent either primary MDO or TLA for the treatment RS between 2004 2020. N=59 met inclusion criteria (n=34 MDO, n=25 TLA), there were no significant differences preoperative patient characteristics...

The literature provides no guidelines for antibiotic use in palatoplasty. authors sought to ascertain practice patterns; review a large, single-surgeon experience, and propose primary palatoplasty.A six-question survey was e-mailed all surgeons of the American Cleft Palate-Craniofacial Association. A retrospective study also conducted senior author's 10-year palatoplasty series, two groups were studied. Group 1 received antibiotics. 2 preoperative and/or postoperative antibiotics.Three...

The pediatric craniofacial skeleton fractures in patterns distinct from those typical adults; this has implications pertinent to management that may go unrecognized. authors reviewed multilevel presenting their institution, surmising they would display an oblique trajectory of fracture patterns, and be at increased risk growing skull (GSFs), compared with adults.A retrospective review was performed patients between 2004 2010. Demographics, cause injury, associated injuries, management,...

Background: Although many metrics for neurodevelopment in children with nonsyndromic craniosynostosis have been analyzed, few directly examined early language acquisition and speech development. The authors characterized development craniosynostosis. Methods: authors’ institutional database was queried from 2000 to 2014. Patients an identified syndrome were excluded. Specific data elements included age, gender, velopharyngeal adequacy by means of the Pittsburgh Weighted Speech Scale,...

Background: Total extraperitoneal laparoscopically assisted harvest of the deep inferior epigastric vessels permits a decrease in myofascial dissection artery perforator flap breast reconstruction. The authors present reliable technique that further decreases donor-site morbidity autologous Methods: conducted retrospective cohort study female subjects presenting to senior surgeon (S.K.K.) from March 2018 2019 for reconstruction after newly diagnosed cancer. operative is summarized as...

Background: Carpometacarpal arthroplasty provides well-documented pain relief with preservation of thenar function in basal joint arthritis treatment. Nevertheless, some patients continue to have following surgery. The authors hypothesize that unrecognized midcarpal (capitolunate) is a contributor persistent after carpometacarpal arthroplasty. prevalence unknown. This article establishes the radiographic arthritis. Methods: Patients were identified from search using International...

Abstract Spring-mediated cranial vault expansion (SMC) has become a primary treatment modality at our institution to correct scaphocephalic head shape in the setting of isolated sagittal craniosynostosis (CS). cranioplasty is associated with minimal procedural morbidity and reliable clinical efficacy, although long-term outcomes are not well elucidated. Herein we describe institutional experience lessons learned SMC. We hypothesize that SMC performed young infants offers durable correction...

Craniofacial trauma is difficult to repair and presents a significant burden the healthcare system. The inflammatory response following bone critical initiate healing, serving recruit progenitor cells promote angiogenesis. A role for inflammation in graft-induced regeneration has been suggested, but still not well understood. current study assessed impact of Toll-like receptor (TLR4) signaling on calvarial presence morselized components. Calvarial defects wild-type global TLR4(-/-) knockout...