Optimizing donor fascicle selection in Oberlin's procedure: A retrospective review of anatomical variability using intraoperative neuromonitoring.

BACKGROUND: Transfer of the fascicle carrying the flexor carpi ulnaris (FCU) branch of the ulnar nerve (UN) to the biceps/brachialis muscle branch of the musculocutaneous nerve (Oberlin's procedure), is a mainstay technique for elbow flexion restoration in patients with upper brachial plexus injury. Despite its widespread use, there are few studies regarding the anatomic location of the donor fascicle for Oberlin's procedure. Our report aims to analyze the anatomical variability of this fascicle within the UN, while obtaining quantifiable, objective data with intraoperative neuromonitoring (IONM) for donor fascicle selection. METHODS: We performed a retrospective review of patients at our institution who underwent an Oberlin's procedure from September 2019 to July 2023. We used IONM for donor fascicle selection (greatest FCU muscle and least intrinsic hand muscle activation). We prospectively obtained demographic and electrophysiological data, as well as anatomical location of donor fascicles and post-surgical morbidities. Surgeon's perception of FCU/intrinsic muscle contraction was compared to objective muscle amplitude during IONM. RESULTS: Eight patients were included, with a mean age of 30.5 years and an injury-to-surgery interval of 4 months. Donor fascicle was located anterior in two cases, posterior in two, radial in two and ulnar in two patients. Correlation between surgeon's perception and IONM findings were consistent in six (75%) cases. No long term motor or sensory deficits were registered. CONCLUSIONS: Fascicle anatomy within the UN at the proximal arm is highly variable. The use of IONM can aid in optimizing donor fascicle selection for Oberlin's procedure.

Regenerative Peripheral Nerve Interfaces (RPNIs) in Animal Models and Their Applications: A Systematic Review.

Regenerative Peripheral Nerve Interfaces (RPNIs) encompass neurotized muscle grafts employed for the purpose of amplifying peripheral nerve electrical signaling. The aim of this investigation was to undertake an analysis of the extant literature concerning animal models utilized in the context of RPNIs. A systematic review of the literature of RPNI techniques in animal models was performed in line with the PRISMA statement using the MEDLINE/PubMed and Embase databases from January 1970 to September 2023. Within the compilation of one hundred and four articles employing the RPNI technique, a subset of thirty-five were conducted using animal models across six distinct institutions. The majority (91%) of these studies were performed on murine models, while the remaining (9%) were conducted employing macaque models. The most frequently employed anatomical components in the construction of the RPNIs were the common peroneal nerve and the extensor digitorum longus (EDL) muscle. Through various histological techniques, robust neoangiogenesis and axonal regeneration were evidenced. Functionally, the RPNIs demonstrated the capability to discern, record, and amplify action potentials, a competence that exhibited commendable long-term stability. Different RPNI animal models have been replicated across different studies. Histological, neurophysiological, and functional analyses are summarized to be used in future studies.

Influencia de los congresos en la difusión de la especialidad. #CirugíaPlástica por redes sociales / Influence of meetings on dissemination of the specialty. #PlasticSurgery in social media

INTRODUCCIÓN Y OBJETIVO: La utilidad de las redes sociales como medio de difusión de la Cirugía Plástica, y específicamente en cuestiones académicas, es un área en desarrollo. Estudios recientes han demostrado el uso de la etiqueta (hashtag) #CirugiaPlastica. Sin embargo, no se ha estudiado la influencia de los congresos nacionales e internacionales en la difusión del conocimiento a través de las redes sociales, tema que nos proponemos estudiar en el presente artículo. MATERIAL Y MÉTODO: Realizamos un análisis retrospectivo de los tuits publicados en español con las palabras "CirugiaPlastica" o la etiqueta #CirugiaPlastica, comparando 5 grupos en relación a los congresos más importantes de la especialidad en español: 1. Grupo control días laborables (no coincidente con congresos de Cirugía Plástica); 2. Grupo control fin de semana (no coincidente con congresos de Cirugía Plástica); 3. Grupo Congreso Iberolatinoamericano; 4. Grupo Jornada Monográfica SECPRE (Sociedad Española de Cirugía Plástica, Reparadora y Estética); 5. Grupo Congreso AECEP (Asociación Española de Cirugía Estética Plástica). Analizamos, entre otras, las siguientes variables: identidad del autor, tema del tuit, uso de la etiqueta #CirugiaPlastica, finalidad educativa o promocional y disponibilidad de enlace a un artículo científico. RESULTADOS: Revisamos 1165 tuits. Los realizados por cirujanos plásticos, instituciones académicas y sociedades científicas supusieron un 13.44% en los grupos control frente a un 18.52% en los grupos congreso (p-valor = 0.02). La presencia de un congreso nacional o internacional no aumentó de manera significativa el número de tuits educacionales, ni el número de enlaces a artículos científicos (p-valor > 0.05). CONCLUSIONES: En el ámbito de la Cirugía Plástica, los congresos analizados no han demostrado una repercusión estadísticamente significativa en el contenido educacional de los tuits. Las redes sociales deberían ser potenciadas durante estos congresos para aumentar la difusión y conocimiento de nuestra especialidad

BACKGROUND AND OBJECTIVE: The use of social media to spread knowledge about Plastic Surgery, especially regarding academic issues, is still in its infancy. Recent studies have shown that the hashtag #PlasticSurgery has been used to spread knowledge and leadership in our specialty. However, the influence of national and international meetings in this regard has not been studied, a topic that we propose to study in this article. METHODS: A retrospective analysis of tweets published in Spanish containing the words "CirugiaPlastica" or the hashtag #CirugiaPlastica was performed, comparing 5 groups: 1. Working days control group (non-coincident with Plastic Surgery meetings); 2. Weekend control group (non-coincident with Plastic Surgery meetings); 3. Iberolatinoamericano Meeting Group; 4. SECPRE (Spanish Plastic, Reconstructive and Aesthetic Surgery Association) Monographic Meeting Group; 5. AECEP (Spanish Aesthetic Plastic Surgery Association) meeting group. The following variables were analyzed, among several others: author identity, tweet topic, hashtag #CirugiaPlastica use, educative or promotional finality and the availability of the digital link to a journal article. RESULTS: A total of 1165 tweets were analyzed. Tweets written by plastic surgeons, academic institutions and scientific societies were 13.44% in the control groups compared to 18.52% in the meeting groups (p-value = 0.02). The presence of a national or international meeting did not increase significantly the number of educational tweets nor the links to scientific articles (p-value > 0.05). CONCLUSIONS: Analyzed meetings did not show a statistically significant repercussion on the educational content of tweets. Social media should be encouraged during these meetings to spread knowledge and to increase the repercussion of our specialty