Evaluation of Different Fixation Methods Combinations After L-Shaped Osteotomy Reduction Malarplasty: An In Vitro Biomechanical Study.

BACKGROUND: This in vitro study compared the stability of different fixation method combinations for the zygomatic complex after simulated L-shaped osteotomy reduction malarplasty, a common facial contouring surgery in East Asia with high postoperative complications due to poor fixation methods. MATERIALS AND METHODS: The study used 108 zygoma replicas with various fixation methods combinations in the zygomatic body (L-shaped plate with short wing on zygoma and on the maxilla, two bicortical screws, one bicortical screw with L-shaped plate, square plate, and rectangular plate) and zygomatic arch (Mortise-Tenon structure, 3-hole plate, and Mortise-Tenon structure plus short screw). The failure force under incremental load was applied through the Instron tensile machine to a well-stabilized model using a rubber band simulating the masseter muscle and recorded the increasing force digitally. ANOVA test was used for comparison between recorded values (P < 0.05). RESULTS: The results showed that the most stable combination was a six-hole rectangular plate and a Mortise-Tenon structure plus one short screw (358.55 ± 51.64 N/mm2). The results also indicated that the placement vector of the fixation methods around the L-shaped osteotomy and the use of the two-bridge fixation method were important factors in enhancing the stability of the zygomatic complex. CONCLUSION: The study suggested that surgeons should choose appropriate fixation methods based on these factors to reduce postoperative complications and improve surgical outcomes. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Flying squirrels, hidden treasures.

In the rain forests of Hainan, China, two species of squirrel create grooves on the surface of smooth nuts so that they can wedge them in the forks between branches.

Flying squirrels use a mortise-tenon structure to fix nuts on understory twigs.

Squirrels of temperate zones commonly store nuts or seeds under leaf litter, in hollow logs, or even in holes in the ground; however, in the humid rainforests of Jianfengling in Hainan, South China, we show that some flying squirrels cache elliptical or oblate nuts by hanging them securely in vegetation. These small flying squirrels were identified as Hylopetes phayrei electilis (G. M. Allen, 1925) and Hylopetes alboniger (Hodgson, 1870), in video clips captured of their behavior around focal nuts. Squirrels chewed grooves encircling ellipsoid nuts or distributed on the bottoms of oblate nuts, and then used these grooves to fix nuts tightly between small twigs 0.1-0.6 cm in diameter that were connected at angles of 25-40°. The grooves carved on the nuts (concave structure) connected with Y-shaped twigs (convex structure) and thus firmly affixed the nuts to the plant in a way similar to a mortise-tenon joint used in architecture and carpentry. Cache sites were on small plants located 10-25 m away from the closest potentially nut-producing tree, a behavior that likely reduces the discovery and consumption of the nuts by other animals. The adaptive squirrel behavior that shapes and fits nuts between twigs seems to be directed at providing more secure storage that increases food supply during dry periods in a humid tropical rainforest. In addition to providing such benefits for the squirrels, we suggest that this behavior also impacts the distribution of tree species in the forest.

The rainy forests of South China are home to Cyclobalanopsis trees whose smooth, elliptical nuts are favoured by many animal species. While doing fieldwork in the Jianfengling nature reserve in the southern province of Hainan, China, researchers came across an unusual sight: many of these nuts had been wedged into the Y-shaped forks between diverging twigs. A closer inspection revealed that a carefully crafted groove on the surface of the nuts helped them to stay wedged and secured between the branches. Which creature was responsible for such a feat? To investigate, Xu et al. set up motion-triggered, infra-red cameras near some of the hoarding sites. They discovered that the culprits were Hylopetes phayrei electilis and Hylopetes alboniger, two small species of flying squirrel that tend to store Cyclobalanopsis nuts to prepare for the dry, cool season. The footage showed that the squirrels first chewed the nuts before inserting them tightly between the branches. In fact, this process appeared to require much care ­ and, potentially, cognitive involvement ­ with the squirrels testing and adjusting their grooves many times until a perfect fit was achieved. Caching sites were usually found 10 to 25 meters away from the nearest Cyclobalanopsis tree, which probably helps to protect the hoards from other animals on the hunt for nuts. Squirrels from temperate regions typically prepare for winter by hiding food in the ground, between logs or inside hollow trees; in humid, tropical forests, however, such caching sites may promote mould, decomposition or germination. In these conditions, securely hanging nuts between branches may prove to be a more suitable strategy. By choosing caching sites that are away from the mother tree, squirrels may also inadvertently help Cyclobalanopsis to expand their range, with forgotten nuts becoming dislodged and sprouting in new locations across the reserve. Overall, these findings shed new light on animal adaptation and cognition, as well as on the forces that help to shape forest ecology.