-
Head & Neck Jan 2023It was the purpose of this study to evaluate the role of the serratus anterior free flap (SAFF) with its long thoracic nerve (LTN) as composite flap for dynamic facial... (Review)
Review
It was the purpose of this study to evaluate the role of the serratus anterior free flap (SAFF) with its long thoracic nerve (LTN) as composite flap for dynamic facial reanimation. A total of 10 studies, published between 2004 and 2021, met inclusion criteria. Clinical data of 48 patients were used for the systematic review and analysis. One to three slips were used, mainly as one-stage procedures (n = 39; 81.3%), to create different force vectors. Single or double innervated muscle transfers were utilized in 32 (66.7%) and 16 (33.3%) cases with additionally harvested skin paddles in 4 (8.3%) patients. The LTN was mostly anastomosed to the ipsilateral masseteric nerve (45.8%; n = 22) or to remaining facial nerve branches (37.5%; n = 18), while cross-facial-nerve-grafting was rarely used (16.7%; n = 8). The SAFF as composite flap with different force vectors proved to be a good candidate for immediate dynamic facial reanimation after any midface defects.
Topics: Humans; Free Tissue Flaps; Facial Nerve; Plastic Surgery Procedures; Nerve Transfer; Face; Facial Paralysis
PubMed: 36263461
DOI: 10.1002/hed.27219 -
Medicine Dec 2023Accomplish a thorough review on the existing biomechanical and clinical studies about coronal plane fractures of the distal femur.
BACKGROUND
Accomplish a thorough review on the existing biomechanical and clinical studies about coronal plane fractures of the distal femur.
METHODS
We performed an electronic search of PubMed/MEDLINE database from April to June, 2023. The terms for the database search included "Hoffa fractures," OR "Busch-Hoffa fractures" OR "coronal plane fractures of the distal femur."
RESULTS
The search identified 277 potentially eligible studies. After application of inclusion and exclusion criteria, 113 articles were analyzed in terms of the most important topics related to coronal plane fractures of the distal femur.
CONCLUSION
Lateral coronal plane fractures of the distal femur are more frequent than medial, present a more vertical fracture line, and usually concentrate on the weight bearing zone of the condyle. The Letenneur system is the most used classification method for this fracture pattern. Posterior-to-anterior fixation using isolated lag screws (for osteochondral fragments-Letenneur type 2) or associated with a posterior buttressing plate (when the fracture pattern is amenable for plate fixation-Letenneur types 1 and 3) is biomechanically more efficient than anterior-to-posterior fixation. Anterior-to-posterior fixation using lag screws complemented or not by a plate remains a widely used treatment option due to the surgeons' familiarity with the anterior approaches and lower risk of iatrogenic neurovascular injuries. There is no consensus in the literature regarding diameter and number of screws for fixation of coronal plane fractures of the distal femur.
Topics: Humans; Femoral Fractures; Hoffa Fracture; Fracture Fixation, Internal; Bone Screws; Femur; Bone Plates
PubMed: 38050206
DOI: 10.1097/MD.0000000000036161 -
Asian Spine Journal Dec 2023Laparoscopic anterior lumbar interbody fusion (L-ALIF), which employs laparoscopic cameras to facilitate a less invasive approach, originally gained traction during the...
Laparoscopic anterior lumbar interbody fusion (L-ALIF), which employs laparoscopic cameras to facilitate a less invasive approach, originally gained traction during the 1990s but has subsequently fallen out of favor. As the envelope for endoscopic approaches continues to be pushed, a recurrence of interest in laparoscopic and/or endoscopic anterior approaches seems possible. Therefore, evaluating the current evidence base in regard to this approach is of much clinical relevance. To this end, a systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following keywords: "(laparoscopic OR endoscopic) AND (anterior AND lumbar)." Out of the 441 articles retrieved, 22 were selected for quantitative analysis. The primary outcome of interest was the radiographic fusion rate. The secondary outcome was the incidence of perioperative complications. Meta-analysis was performed using RStudio's "metafor" package. Of the 1,079 included patients (mean age, 41.8±2.9 years), 481 were males (44.6%). The most common indication for L-ALIF surgery was degenerative disk disease (reported by 18 studies, 81.8%). The mean follow-up duration was 18.8±11.2 months (range, 6-43 months). The pooled fusion rate was 78.9% (95% confidence interval [CI], 68.9-90.4). Complications occurred in 19.2% (95% CI, 13.4-27.4) of L-ALIF cases. Additionally, 7.2% (95% CI, 4.6-11.4) of patients required conversion from L-ALIF to open surgery. Although L-ALIF does not appear to be supported by studies available in the literature, it is important to consider the context from which these results have been obtained. Even if these results are taken at face value, the failure of endoscopy to have a role in the ALIF approach does not mean that it should not be incorporated in posterior approaches.
PubMed: 38105638
DOI: 10.31616/asj.2023.0135 -
Frontiers in Surgery 2023Odontoid fractures account for 15%-20% of cervical injuries. Although the operation methods vary in different types, the superiority of overall outcomes of the anterior... (Review)
Review
BACKGROUND
Odontoid fractures account for 15%-20% of cervical injuries. Although the operation methods vary in different types, the superiority of overall outcomes of the anterior approach (AA) and posterior approach (PA) in treating odontoid fractures still remains controversial. Thus, a meta-analysis was performed comparing AA and PA for these fractures.
METHODS
The relevant studies were searched in PubMed/MEDLINE, Cochrane Library, EMBASE, China Biological Medicine (CBM), and Wanfang Database from the onset of conception to June 2022. Prospective or retrospective comparative studies on AA and PA for odontoid fractures were screened, referring to fusion rates (primary outcomes), complications, and postoperative mortality rates. A meta-analysis of the primary outcomes and a systematic review of other outcomes were performed; the procedure was conducted with Review Manager 5.3.
RESULTS
Twelve articles comrising 452 patients were included, and all publications were retrospective cohort studies. The average postoperative fusion rate was 77.5 ± 17.9% and 91.4 ± 13.5% in AA and PA, respectively, with statistical significance [OR = 0.42 (0.22, 0.80), = 0.009]. Subgroup analysis showed a difference in fusion rates between AA and PA in the elderly group [OR = 0.16 (0.05, 0.49), = 0.001]. Five articles referred to postoperative mortality, and the mortality rates of AA (5.0%) and PA (2.3%) showed no statistical difference ( = 0.148). Nine studies referred to complications, with a rate of 9.7%. The incidence of complications in AA and PA groups was comparable ( = 0.338), and the incidence of nonfusion and complications was irrelevant. The prevalent cause of death was myocardial infarction. The time and segmental movement retention of AA were possibly superior to those of PA.
CONCLUSION
AA may be superior in regard to operation time and motion retention. There was no difference in complications and mortality rates between the two approaches. The posterior approach would be preferred in consideration of the fusion rate.
PubMed: 37377671
DOI: 10.3389/fsurg.2023.1125665 -
International Journal of Clinical... 2016The objective of this systematic review is to analyze the various treatment modalities and sequelae of intruded anterior primary teeth. (Review)
Review
OBJECTIVE
The objective of this systematic review is to analyze the various treatment modalities and sequelae of intruded anterior primary teeth.
MATERIALS AND METHODS
Electronic search in PubMed, Cochrane, and Science Direct databases was done. Hand search was performed using the reference list of chosen articles from electronic search. Three reviewers analyzed the articles independently, assessed the quality of the studies, and derived data.
RESULTS
Ten case series were identified from the electronic and hand search. No randomized control studies were available. In the observational studies treatment of intruded primary teeth ranged from conservative management, which includes waiting for spontaneous re-eruption as well as repositioning to invasive procedure, such as extraction.
CONCLUSION
Spontaneous eruption is a treatment option of intruded primary teeth in absence of damage to a permanent tooth. Surgical repositioning of intruded primary teeth has also shown as a viable alternative treatment modality. Extraction to be performed if complications develop.
HOW TO CITE THIS ARTICLE
Gurunathan D, Murugan M, Somasundaram S. Management and Sequelae of Intruded Anterior Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent 2016;9(3):240-250.
PubMed: 27843257
DOI: 10.5005/jp-journals-10005-1371 -
Eye (London, England) Jan 2021Ultrasound biomicroscopy (UBM) is the only available option for noninvasive, high-resolution imaging of the intricate iridociliary complex, and for anterior segment... (Review)
Review
Ultrasound biomicroscopy (UBM) is the only available option for noninvasive, high-resolution imaging of the intricate iridociliary complex, and for anterior segment imaging with corneal haze or opacity. While these unique features render UBM essential for specific types of trauma, congenital anomalies, and anterior segment tumors, UBM imaging has found clinical utility in a broad spectrum of diseases for structural assessments not limited to the anterior intraocular anatomy, but also for eyelid and orbit anatomy. This imaging tool has a very specific niche in the pediatric population where anterior segment disease can be accompanied by corneal opacity or clouding, and anomalies posterior to the iris may be present. Pediatric patients present additional diagnostic challenges. They are often unable to offer detailed histories or fully cooperate with examination, thus amplifying the need for high-resolution imaging. This purpose of this systematic review is to identify and synthesize the body of literature involving use of UBM to describe, evaluate, diagnose, or optimize treatment of pediatric ocular disease. The collated peer-reviewed research details the utility of this imaging modality, clarifies the structures and diseases most relevant for this tool, and describes quantitative and qualitative features of UBM imaging among pediatric subjects. This summary will include information about the specific applications available to enhance clinical care for pediatric eye disease.
Topics: Anterior Eye Segment; Child; Corneal Opacity; Eye Diseases; Humans; Iris; Microscopy, Acoustic; Ophthalmology
PubMed: 32963311
DOI: 10.1038/s41433-020-01184-4 -
JPRAS Open Jun 2022Ulnar nerve injuries, especially high (proximal forearm) injuries, result in poor functional recovery. Peripheral nerve transfers have recently become a popular... (Review)
Review
BACKGROUND
Ulnar nerve injuries, especially high (proximal forearm) injuries, result in poor functional recovery. Peripheral nerve transfers have recently become a popular technique to augment nerve repairs and reduce the reinnervation distance before distal motor endplates irreversibly degenerate, leading to incomplete recovery.
OBJECTIVES
To systematically review and analyse the recent literature regarding anterior interosseous nerve (AIN) to ulnar nerve transfers, including demographics, indications, outcomes, and complications.
METHODS
A search was performed using PubMed, MEDLINE, EMBASE, CINAHL, Scopus, and Cochrane databases using the keywords ulnar nerve, ulnar nerve injury, ulnar motor nerve, anterior interosseous nerve, anterior interosseous, AIN, nerve transfer, and end-to-side using a 3-component search along with the Boolean operators 'AND' and 'OR'.
RESULTS
A total of 341 studies were retrieved using the search criteria. Sixteen studies met the inclusion criteria including 12 retrospective case series, 3 retrospective cohort studies, and a single randomised control trial. Nine studies involved supercharged end-to-side transfer (SETS), 6 involved end-to-end transfer (ETE), and only 1 study compared results between SETS and ETE transfers. A total of 269 patients underwent nerve transfers. In the ETE subgroup, the average time to nerve transfer was 7 months, with a mean follow-up period of 24.5 months. Post-procedure, 100% (37/37) patients recovered intrinsic function of BMRC ≥1, and the average recovery time was 3.6 months. A total of 85% of patients recovered intrinsic function of BMRC ≥3. In the SETS group, the average time to nerve transfer was 2.5 months. The average follow-up in this cohort was 13.2 months. About 93% (145/156) recovered the intrinsic function of BMRC ≥1, and the average time to recovery was 7 months. About 75% of patients recovered the intrinsic function of BMRC ≥3 in their first dorsal interossei.
CONCLUSION
AIN to ulnar nerve transfer carries low morbidity, and there is low quality evidence to suggest recovery of intrinsic muscle function compared with conventional primary repair techniques. The supercharged end-to-side transfer (SETS) seems to be more favourable compared with end-to-side transfer. Outcome measurements are highly variable amongst studies, making standardisation difficult. Results of further trials are highly anticipated in this exciting field of peripheral nerve surgery.
PubMed: 35498818
DOI: 10.1016/j.jpra.2022.02.007 -
Global Spine Journal Oct 2018Systematic review. (Review)
Review
STUDY DESIGN
Systematic review.
OBJECTIVES
Diagnosis of pseudarthrosis after anterior cervical fusion is difficult, and often depends on the surgeon's subjective assessment because recommended radiographic criteria are lacking. This review evaluated the available evidence for confirming fusion after anterior cervical surgery.
METHODS
Articles describing assessment of anterior cervical fusion were retrieved from MEDLINE and SCOPUS. The assessment methods and fusion rates at 1 and 2 years were evaluated to identify reliable radiographical criteria.
RESULTS
Ten fusion criteria were described. The 4 most common were presence of bridging trabecular bone between the endplates, absence of a radiolucent gap between the graft and endplate, absence of or minimal motion between adjacent vertebral bodies on flexion-extension radiographs, and absence of or minimal motion between the spinous processes on flexion-extension radiographs. The mean fusion rates were 90.2% at 1 year and 94.7% at 2 years. The fusion rate at 2 years had significant independence ( = .048).
CONCLUSIONS
The most common fusion criteria, bridging trabecular bone between the endplates and absence of a radiolucent gap between the graft and endplate, are subjective. We recommend using <1 mm of motion between spinous processes on extension and flexion to confirm fusion.
PubMed: 30443486
DOI: 10.1177/2192568218755141 -
Tomography (Ann Arbor, Mich.) Jul 2022The aim of this study was to investigate the features of partial anomalous left pulmonary artery (PALPA) and differences between cases with posterior versus anterior a... (Review)
Review
The aim of this study was to investigate the features of partial anomalous left pulmonary artery (PALPA) and differences between cases with posterior versus anterior a nomalous vessels in relation to the tracheobronchial tree. We hypothesized that statistical significance was dependent on the course of the anomalous vessel due to airway compression in the posterior type. This study included cases obtained from the literature ( = 33) and an institution teaching file ( = 2). Information collected: age, sex, medical history, additional anomalies, anomalous vessel course, and respiratory symptoms. Data were analyzed with independent samples -test and Fisher's exact test. PALPAs were more commonly anterior than posterior. Mean age: 5.3 years (SD = 12.4) for anterior and 6.8 years (SD = 18.5) for posterior ( = 0.77). Respiratory symptoms: 20% of anterior and 60% of posterior cases ( = 0.032). Tracheobronchial anomalies: 35% of anterior and 60% of posterior cases ( = 0.182). Non-cardiac and non-tracheobronchial anomalies: 30% of anterior and 47% of posterior cases ( = 0.511). Kabuki syndrome: 25% of anterior and 6.7% of posterior cases ( = 0.207). In conclusion, respiratory symptoms were the only significant difference between anterior and posterior PALPA types.
Topics: Abnormalities, Multiple; Child, Preschool; Heart Defects, Congenital; Humans; Pulmonary Artery; Vascular Malformations; Vestibular Diseases
PubMed: 36006061
DOI: 10.3390/tomography8040163 -
Knee Surgery, Sports Traumatology,... Feb 2023Given the paucity of literature on the re-revision of ACL, the current study was undertaken. The purpose of this systematic review was to synthesise and qualitatively... (Review)
Review
PURPOSE
Given the paucity of literature on the re-revision of ACL, the current study was undertaken. The purpose of this systematic review was to synthesise and qualitatively assess the currently available evidence in the literature regarding the re-revision of ACL reconstruction (rrACLR).
METHODS
A systematic review was conducted based on the PRISMA guidelines. The following search terms were used in the title, abstract and keywords fields: "ACL" or "anterior cruciate ligament" AND "revision" or "multiple" or "repeat". The outcome data extracted from the studies were the Lysholm score, Subjective IKDC, Marx Score, Tegner, Marx Score, KOOS score, radiological changes and the rate of return to sports. Complications, failures and/or revision surgery were also analysed.
RESULTS
The cohort consisted of 295 patients [191 (64.7%) men and 104 (35.3%) women] with a mean age of 29.9 ± 2.8 years (range 14-58 years) from 10 studies. The mean postoperative follow-up (reported in all studies except one) was 66.9 ± 44.7 months (range 13-230.4 months). Associated injuries were 103 (34.9%) medial meniscus tears, 57 (19.3%) lateral meniscus tears, 14 (4.7%) combined medial plus lateral meniscus tears, 11 (3.7%) meniscal tears (not specified), 252 (85.4%) cartilage lesions, 6 (2.0%) medial collateral ligament injury and 2 (0.7%) lateral collateral ligament injuries. In 47 (15.9%) patients an extra-articular plasty was performed for the anterolateral ligament. In all studies that reported pre- and post-operative IKDC (subjective and objective) and Lysholm score, there was a significant improvement compared to the pre-operative value (p < 0.05). At the final follow-up, laxity measured with KT-1000 was found to be 2.2 ± 0.6 mm. 31 (10.5%) out of 295 patients returned to their pre-injury activity level. A total of 19 (6.4%) re-ruptures were found, while only 4 (1.4%) complications (all minors) were reported, out of which 2 (0.7%) were superficial infections, 1 (0.3%) cyclops lesion and 1 (0.3%) flexion loss.
CONCLUSION
Multiple revisions of anterior cruciate ligament reconstruction allow acceptable clinical results and a good degree of knee stability with a low rate of subsequent new re-ruptures but the possibility of regaining pre-injury sports activity is poor; whenever possible, it is preferred to revise the ligament in one stage. This surgery remains a challenge for orthopaedic surgeons and many doubts persist regarding the ideal grafts, additional extra-articular procedures and techniques to use.
LEVEL OF EVIDENCE
IV.
STUDY REGISTRATION
PROSPERO-CRD42022352164 ( https://www.crd.york.ac.uk/prospero/ ).
Topics: Male; Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament; Knee Joint; Knee Injuries; Anterior Cruciate Ligament Reconstruction; Reoperation; Follow-Up Studies
PubMed: 36224291
DOI: 10.1007/s00167-022-07197-8