Subject(s)
Breast Neoplasms/radiotherapy , Carcinoma, Lobular/radiotherapy , Hemangiosarcoma/diagnosis , Hemangiosarcoma/etiology , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Lobular/pathology , Carcinoma, Lobular/surgery , Female , Hemangiosarcoma/surgery , Humans , Lymph Node Excision , Magnetic Resonance Imaging , Time FactorsABSTRACT
BACKGROUND: Fractures of the proximal phalanges of the fingers are common injuries in children and adolescents. The majority can be treated by closed reduction and splinting, and complications are rare. The purpose of the prospective study was to document the results of functional-conservative treatment of extra-articular physeal fractures using either a functional forearm cast or the Lucerne Cast (LuCa). METHODS: Clinical and radiographic results of 13 pediatric patients having 13 extra-articular physeal fractures (e.g., juxta-epiphyseal fractures, Salter-Harris type I or II physeal fractures) of the proximal phalanges were recorded through a minimum follow-up of 6 months. Intra-articular physeal fractures (Salter-Harris type III or IV), fractures involving the proximal interphalangeal joint (PIPJ), pathological fractures, open fractures, and concomitant injuries of the tendons were excluded. RESULTS: Fracture consolidation was achieved in all cases within 4 weeks. No palmar apex angulations, no rotational deformities, and no PIPJ extension lags could be observed. All patients achieved full total active range of motion within 3 months. CONCLUSIONS: Well-reduced extra-articular physeal fractures of the proximal phalanges can be effectively treated using functional-conservative casts. Although children may need a functional forearm cast, a LuCa is adequate in compliant adolescents.Level of Evidence The level of evidence for the study is Level II (therapeutic studies).
Subject(s)
Casts, Surgical , Finger Phalanges/injuries , Fractures, Bone/therapy , Adolescent , Child , Female , Follow-Up Studies , Fractures, Bone/diagnostic imaging , Humans , Male , Prospective Studies , Radiography , Range of Motion, Articular , Treatment OutcomeABSTRACT
OBJECTIVE: This study aims to review our experience in the surgical management of microstomia following facial burns. PATIENTS AND METHODS: For this retrospective study, we searched our burn patients' database for oral commissuroplasties with local mucosal flaps and reviewed the 18 patients suffering from microstomia after facial burns who had been operatively treated between 1995 and March 2007. Fifteen of the patients were primarily treated for severe facial burns in our burns unit, three were referred to our outpatients clinic for secondary reconstruction. Reconstruction of the oral commissures was performed according to one of the following methods: (1) triangular scar excision and mucosal Y-V advancement (n=10), (2) scar excision and wound closure with full-thickness or split-skin graft (n=4) and (3) division of the contracture and closure of the resulting defect with two rhomboid mucosal flaps per side (n=4). RESULTS: All patients showed acceptable aesthetic results and a good functional outcome. Apart from minor wound-healing disturbances, which neither required surgery nor worsened the result, no complications were observed. Patient satisfaction was high. CONCLUSION: Commissuroplasty is an early functional post-burn corrective procedure that often must be performed prior to completion of scar maturation. Mucosal advancement flaps are a viable procedure for the treatment of microstomia after facial burns, resulting in good aesthetic and functional outcome. Direct scar excision and skin grafting, although unavoidable in cases of extensive perioral scarring, frequently produces inferior results.
