The extended peroneal artery perforator flap for lower extremity reconstruction.

The peroneal artery perforator flap and its modifications have been widely used for coverage of soft tissue defects of ankle and foot in the past decade. In this article, we report on a series of upper knee, ankle, and foot reconstructions with a proximally or distally based extended peroneal artery perforator (EPAP) flap supplied by distinct perforating branches off the proximal or distal peroneal artery. Total pedicle length obtained ranged from 6 to 12 cm. Twelve patients with soft tissue defects of the lower extremity underwent reconstruction using the EPAP flap. The flaps were designed with the sizes from 10 x 6 cm to 25 x 15 cm. All 12 flaps survived completely without complications. Our experience demonstrates that the EPAP flap is reliable and versatile and can provide a large amount of soft tissue for coverage of defects in the leg anywhere from knee to forefoot obviating the need for free tissue transplantation.

The aesthetic correction of the ptotic breast by the procedure of nipple-areola transposition - a contemporary translation and commentary.

'No vertical scar' techniques of breast shaping have received increasing attention during the last decade and are sometimes viewed as 'new' methods. In this article, we provide a comprehensive introduction to the roots of this procedure. Raymond Passot has to be credited with the original design of 'no vertical scar' methods. We provide a contemporary translation of his original article written in French in 1925. The historical context of this new procedure was researched using original sources that were in French and German languages. The evolution of the procedure and its reception by Passot's contemporaries up to 1932 are examined, which give insight into the concepts of blood supply to the breast, shaping techniques and the aetiopathology of breast deformities in the pre-World War II era, which were successfully developed by the Austrian-German school of thought, resulting in the birth of modern breast shaping surgery based on Passot's 'no vertical scar' procedure. The lasting truths discovered in that era were frequently reinvented in the subsequent decades in English without crediting the original authors.

Nonorthodontic orthognathic surgery.

Orthognathic surgery for occlusal improvement commonly requires preoperative and postoperative orthodontic treatments to fine-tune intercuspation. This report focuses on the feasibility, treatment goals, and outcomes of orthognathic surgery in a series of patients with congenital dentofacial anomalies who were considered ineligible for or noncompliant with orthodontic treatment. Despite suboptimal occlusal outcomes, the orthognathic procedures resulted in tangible benefits for the patients. We conclude that surgical treatment without concomitant orthodontics is a viable option in selected patients.

A case of latissimus dorsi pedicle arising from the lateral thoracic vessels.

The thoracodorsal system represents a versatile, yet reliable system for the harvest of tissues for microsurgical transplantation. Also, the donor vessel anatomy is generally thought to be highly predictable in terms of topography and branching patterns. In this article we describe for the first time the occurrence of a branching pattern during a clinical harvest of the latissimus dorsi muscle flap, previously encountered only in cadaver dissections. We compare our intraoperative findings with published anatomical investigations and discuss the implications of this particular variation of the blood supply to the latissimus dorsi muscle for clinical practice.