A practical correction of great toe claw deformity.

Ischemic contracture of the leg causing clawing of the toes is a known complication of compartment syndrome of the leg. Although a substantial amount of published data are available on the prevention and acute management of compartment syndrome, a relative paucity of data has been published on the optimal management of the resultant claw toe deformity. In the present case report, the operative management of a patient with left great toe clawing secondary to ischemia is described. Surgical management included lengthening of the extensor hallucis longus tendon and transfer of the extensor hallucis brevis tendon to the extensor hallucis capsularis, with percutaneous pinning of the great toe.

The Subtleties of Success in Simultaneous Augmentation-Mastopexy.

BACKGROUND: Many have challenged the safety of performing breast augmentation and mastopexy simultaneously. However, staging these procedures incurs the increased risk and inconvenience of two periods of anesthesia and recuperation. The authors set out to evaluate the occurrence of complications across the populations of patients undergoing (1) combined augmentation-mastopexy, (2) isolated augmentation, and (3) isolated mastopexy. METHODS: A retrospective analysis of one surgeon's consecutive series of each of these procedures from 2000 to 2009 was conducted. Preoperative risk factors were characterized. Sixteen different complications were examined, and those necessitating operative revision were tracked. Statistical analysis was performed looking for significant differences between the surgical groups. RESULTS: No instances of infection, tissue loss, or implant exposure occurred among the 297 patients over an average follow-up period of 15.5 months. The isolated mastopexy group did not provide sufficient data for statistical comparison. Tissue-related complications were most common in the combined procedure group. The operative revision rate for isolated augmentation was 7.97 percent compared with a combined procedure revision rate of 12.4 percent (p = 0.28). CONCLUSIONS: The majority of complications in this series comparing simultaneous augmentation-mastopexy to isolated augmentation were minor. Complications requiring operative revision were not found to be significantly different between the two groups. There was a much lower reoperation rate (12.4 percent) with the combined procedure compared with a 100 percent reoperation rate when the procedure is staged. Thus, the authors feel the combined procedure can safely be part of every plastic surgeon's practice. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.