RESUMEN
PURPOSE OF REVIEW: Fractures of the mandibular angle are surgically challenging with high rates of postoperative complications. Among established fixation techniques for these injuries, Champy's tension band approach with miniplate fixation has held prominence. Rigid fixation, using two plates, also remains commonly used. More recently, geometric ladder plates, which confer greater three-dimensional stability have been developed to overcome the shortcomings of conventional fixation approaches. Herein, we aim to summarize the recent evidence surrounding the use of ladder plates and offer our own opinion for optimal treatment of these fractures. RECENT FINDINGS: In high-powered studies, the rates of hardware failure, malocclusion, and malunion are lower among cohorts managed with ladder plates relative to miniplate groups. Rates of infection and paresthesia remain similar. Ladder plates have also been shown to decrease operative time in preliminary study. SUMMARY: Ladder plates show superiority to miniplate approaches across several outcomes. However, the relatively larger strut plate constructs may not be necessary for minor, uncomplicated fractures. It is our belief that reasonable outcomes may be achieved with either approach depending on surgeon experience and comfort with the given fixation technique.
Asunto(s)
Maloclusión , Fracturas Mandibulares , Humanos , Fijación Interna de Fracturas/efectos adversos , Fijación Interna de Fracturas/métodos , Placas Óseas/efectos adversos , Complicaciones Posoperatorias , Fracturas Mandibulares/cirugíaRESUMEN
We present the case of an 11-month-old girl with Mycoplasma pneumoniae-associated pneumonia who was subsequently diagnosed with a methicillin-resistant Staphylococcus aureus retropharyngeal abscess with mediastinal extension.
Asunto(s)
Absceso/microbiología , Enfermedades del Mediastino/microbiología , Staphylococcus aureus Resistente a Meticilina/fisiología , Absceso Retrofaríngeo/microbiología , Infecciones Estafilocócicas/diagnóstico , Coinfección/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Neumonía por Mycoplasma/diagnósticoRESUMEN
The paramedian forehead flap (PMFF) is a versatile flap with a robust vascular supply that is well suited for reconstruction of complex or large nasal defects. Although a 2-stage technique is most common, a single-stage procedure involving tunneling the proximal pedicle and 3-stage procedures involving tissue expansion, vascular delay, and flap tailoring after inset before pedicle division have also been described. This article describes a traditional 2-stage technique and presents the case of a patient with a posttraumatic nasal deformity reconstructed with a PMFF.
Asunto(s)
Frente/cirugía , Deformidades Adquiridas Nasales/cirugía , Rinoplastia/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Estética , Humanos , Complicaciones PosoperatoriasRESUMEN
Indocyanine green angiography is increasingly being adopted by reconstructive surgeons for use in pedicle tissue flaps and microvascular free-tissue transfer procedures. With the increasing adoption of this technology, the postoperative complication rate and the need for reoperation can be decreased, making these reconstructive procedures more predictable. The main disadvantage of this technology is its cost; with time and greater adoption of this technology, the cost will eventually decrease. Decreased postoperative complications and reduced need for revision surgery with the use of this technology will play a significant role in decreasing the overall health care costs for these complex reconstructive procedures.
