RESUMEN
BACKGROUND: The literature describing the best clinical practice for proximal-distal autograft orientation, otherwise known as nerve graft polarity, is inconsistent. With existing disparities in the peripheral nerve literature, the clinical question remains whether reversing nerve autograft polarity bears an advantage for nerve regeneration. METHODS: A comprehensive review of the literature using Embase and PubMed databases (1940-June 2015) was performed to retrieve all original articles on the effects of nerve autograft polarity on nerve regeneration and functional recovery following primary repair of peripheral nerve defects. RESULTS: The initial database search yielded 318 titles. Duplicate exclusion, title review and full text review yielded six articles which directly compared nerve autograft polarity. Histological, morphometric, electrophysiological, and behavioral outcomes were reviewed. All retained articles were animal studies, of which none demonstrated significant differences in outcomes between the normal and reversed polarity groups. A reversed graft may ensure that regenerating nerve fibers are not lost at branching points, however this may not translate into improved function. CONCLUSION: There is insufficient data to suggest that nerve autograft polarity has an impact on nerve regeneration and functional outcomes.
Asunto(s)
Autoinjertos/cirugía , Regeneración Nerviosa , Traumatismos de los Nervios Periféricos/cirugía , Trasplante Autólogo/métodos , Humanos , Regeneración Nerviosa/fisiología , Procedimientos de Cirugía Plástica/métodos , Recuperación de la Función , Resultado del TratamientoRESUMEN
Anteromedial (perineal) dislocation of the hip is rare. The authors describe the case of a 13-year-old girl whose femoral head was dislocated into the vagina as a result of a motor vehicle accident. The hip could not be reduced by traction but was pushed through the vagina with moderate ease. When the patient was placed in the lithotomy position, the hip redislocated and further reduction was required. The vagina and soft tissues were repaired and the hip joint was irrigated and closed over a drain. Antibiotics were given for 10 days. The girl recovered completely.