Foot and ankle reconstruction is a battlefield of function and form. Every subunit has its own demands — the dorsum needs thin, pliable coverage; the heel demands durable, glabrous-like skin. In this landmark PRS 2010 paper, Hollenbeck et al. applied the subunit principle to 165 free flaps, giving surgeons a blueprint for tailored, long-term reconstruction success.
Summary:This episode breaks down the seven distinct subunits of the foot and ankle, each with unique reconstructive goals. We discuss the data behind flap outcomes, limb salvage (89% at 5 years), and complication rates, including the common pitfalls like flap debulking and late ulceration — especially in the heel subunit.
We’ll explore how subunit-based flap planning improves durability, shoe-fit, and overall limb function — plus, how specific flaps like the radial forearm, ALT, and latissimus dorsi perform across zones.
Key Takeaways:
7 subunits = 7 reconstructive goals.
Heel (Subunit 5) = highest instability risk.
Mean ambulation: 3.1 months.
Limb salvage: 89% at 5 years.
Subunit mapping improves both form and function.
Citation:
Hollenbeck ST, Woo S, Komatsu I, et al. Longitudinal Outcomes and Application of the Subunit Principle to 165 Foot and Ankle Free Tissue Transfers. Plast Reconstr Surg. 2010;125(3):924–934. DOI: 10.1097/PRS.0b013e3181cc9630
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Orbital floor fractures are among the most common midfacial injuries—and understanding when and how to operate is key for every resident. In this episode, we break down the anatomy, evaluation, and evidence-based management of orbital blowout fractures, based on Gart & Gosain’s Plastic and Reconstructive Surgery 2014 review.
We cover:
Mechanisms — buckling vs. hydraulic theory, and why both matter.
Clinical findings — diplopia, enophthalmos, oculocardiac reflex.
Timing of repair — urgent (<48 hrs) indications vs. delayed (within 2 weeks).
Surgical approaches — transconjunctival vs. subtarsal vs. subciliary.
Implant materials — bone grafts, porous polyethylene, titanium mesh, and resorbables.
Pediatric nuances — trapdoor fractures, oculocardiac reflex, and growth considerations.
🔑 Key Takeaways:
Early repair (<48 hrs) improves outcomes in entrapment and oculocardiac reflex.
Enophthalmos >2 mm or >50% floor involvement = strong indication for repair.
Transconjunctival approach offers lowest visible scarring; avoid subciliary ectropion.
In children, consider resorbable materials to avoid growth restriction.
📚 Reference:
Gart MS, Gosain AK. Orbital Floor Fractures. Plast Reconstr Surg. 2014;134(6):1345–1355. DOI: 10.1097/PRS.0000000000000719
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Mandible fractures are the most common indication for surgical repair of facial fractures, and their management continues to evolve with modern plating systems and imaging.
In this episode of Plastics in Practice, we break down the key anatomy, causes, diagnostic pearls, and surgical strategies you need to know for the boards and the operating room.
We start with the anatomy of the mandible — from condyle to symphysis — and review the opposing muscle forces that make fracture management so challenging . Then we dive into epidemiology: in the U.S., interpersonal violence dominates, while motor vehicle collisions are more common worldwide .
From there, we walk through preoperative evaluation and imaging, emphasizing the role of CT over panoramic radiographs for detecting posterior fractures. We also cover timing of repair, antibiotic prophylaxis, and surgical principles: restoring occlusion, rigid vs. functional fixation, and key approaches to angle, symphysis, bilateral, condylar, comminuted, and edentulous fractures.
Mandible fractures occur most often in men 25–34, usually from assaults or MVCs.
CT is the gold standard for imaging.
Early repair is ideal, but delays >72h don’t significantly raise infection risk.
Antibiotics are recommended, but evidence for type/duration remains weak.
Surgical principle: restore occlusion + stable fixation, tailored to fracture site.
📚 References:Morrow BT, Samson TD, Schubert W, Mackay DR. Evidence-Based Medicine: Mandible Fractures. Plast Reconstr Surg. 2014;134(6):1381–1390. doi:10.1097/PRS.0000000000000717
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Frontal sinus fractures are among the most challenging maxillofacial injuries — rare but high-stakes, with potential for meningitis, brain abscess, and lifelong sinus complications if mismanaged. In this episode of Plastics in Practice, we break down the stepwise algorithm for diagnosis and management of frontal sinus trauma.
We’ll walk through the embryology and anatomy that make these fractures unique, the critical role of the frontonasal duct, and how to decide between preservation, obliteration, or cranialization. You’ll learn the management principles for anterior vs posterior wall fractures, when to use a galeal frontalis flap, and how to recognize and prevent long-term complications such as mucopyocele formation.
Key Takeaways:
Diagnosis: Forehead lacerations and glabellar hematomas are red flags; always evaluate with CT scans.
Anterior wall fractures: Non-displaced can be observed; displaced require reduction and fixation.
Posterior wall fractures: CSF leak, duct injury, or dural tear dictate sinus obliteration or cranialization.
Frontonasal duct injury: Always mandates obliteration with grafts or flap coverage.
Complications: Chronic infection, meningitis, contour deformities — long-term follow-up is essential.
References:
Yavuzer R, Sari A, Kelly CP, Tuncer S, Latifoglu O, Celebi MC, Jackson IT. Management of Frontal Sinus Fractures. Plast Reconstr Surg. 2005;115(6):79e–93e. doi:10.1097/01.PRS.0000161988.06847.6A
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Zygoma fractures are among the most common midfacial injuries, directly impacting both function and aesthetics. For plastic surgery residents, mastering the anatomy, evaluation, and surgical management of these fractures is essential.
In this episode of Plastics in Practice, we break down the essentials of zygoma fractures. From the quadripod anatomy of the zygomaticomaxillary complex to the clinical signs of malar flattening, trismus, and infraorbital nerve paresthesia, we review how to approach diagnosis and treatment. We cover preoperative imaging and timing, operative approaches from transconjunctival to coronal, and fixation strategies tailored to fracture severity. Key complications, including enophthalmos, infraorbital nerve dysfunction, and lid malposition, are highlighted with strategies for prevention and management.
Takeaways:
Anatomy: Zygoma as a quadripod with five fixation points .
Evaluation: Pain, diplopia, malar flattening, sensory changes .
Timing: Ideally within 1–2 weeks; earlier for children .
Approaches: Gingivobuccal sulcus, transconjunctival, coronal .
Complications: Retrobulbar hematoma, enophthalmos, nerve injury .
References:
Ellstrom CL, Evans GRD. Zygoma Fractures. Plast Reconstr Surg. 2013;132(6):1649–1657. doi:10.1097/PRS.0b013e3182a80819
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Middle and distal leg defects can be among the most challenging reconstructive problems in plastic surgery. But what if you could avoid microsurgery and still achieve reliable “like-with-like” coverage?
In this episode, we break down the principles, technique, and outcomes of perforator propeller flaps for lower extremity reconstruction. Drawing from the landmark PRS Global Open article by Mendieta et al. (2018), we discuss their series of 28 patients in Nicaragua and how local propeller flaps performed in small-to-medium defects of the mid and distal leg. These flaps preserve the major vascular axes, avoid the morbidity of muscle sacrifice, and eliminate the need for microsurgical anastomosis.
Key technical pearls include the two-centimeter pedicle dissection rule, use of handheld Doppler for flap planning, and ensuring tension-free inset. We’ll also cover complication rates (14% in this series, mostly partial necrosis), predictors of success, and when skin grafts for donor site closure may be necessary.
Takeaways:
Preserve the main arteries and muscle—propeller flaps provide “like-with-like” coverage.
Most are based on a single perforator (posterior tibial in 50% of cases).
Up to 180° rotation is possible with careful dissection.
Donor site can be closed primarily in most cases (85.7%).
Complication rates are acceptable and comparable to free flaps.
References:Mendieta M, Cabrera R, Siu A, et al. Perforator Propeller Flaps for the Coverage of Middle and Distal Leg Soft-tissue Defects. Plast Reconstr Surg Glob Open. 2018;6:e1759. doi:10.1097/GOX.0000000000001759
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When faced with high-energy lower extremity trauma, the question of salvage versus amputation is one of the toughest decisions in reconstructive surgery. This episode breaks down the evidence and provides practical pearls for plastic surgery residents and trainees.
We walk through the landmark LEAP study and subsequent meta-analyses comparing functional outcomes between limb salvage and early amputation. We also review flap timing (Godina’s “within 72 hours” principle), the evolving role of negative pressure wound therapy, and flap selection strategies based on leg thirds. Importantly, we highlight cost-utility data and long-term functional results that shape how we counsel patients.
Key Takeaways:
Injury severity scores should not be the sole factor in amputation decisions.
Early flap coverage (<72 hrs) reduces infection risk, but negative pressure therapy can buy safe time.
Limb salvage success rates approach 95% in modern free tissue transfer.
Salvage and amputation yield similar long-term function, but salvage often carries higher complication and rehospitalization rates.
Cost-utility analysis favors salvage for Gustilo IIIB/C fractures, especially in younger patients.
References:
Medina ND, Kovach SJ, Levin LS. An Evidence-Based Approach to Lower Extremity Acute Trauma. Plast Reconstr Surg. 2011;127(2):926-931. doi:10.1097/PRS.0b013e3182046a16
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Lower extremity reconstruction is one of the most challenging areas of plastic surgery, where surgeons must decide between limb salvage and primary amputation. This episode breaks down the principles from the PRS CME article by Reddy and Stevenson, giving residents and fellows a clear roadmap for evaluation, decision-making, and flap selection.
We start with preoperative assessment: patient comorbidities (diabetes, vascular disease, smoking), vascular status, and fracture stabilization. From there, we cover the spectrum of reconstructive options—secondary intention healing, skin grafting, local flaps, free flaps, and VAC therapy.
Key discussion includes:
Limb salvage vs. amputation: Absolute vs. relative indications, scoring systems, and functional outcomes.
Flap selection by anatomic thirds: Gastrocnemius and tibialis anterior for proximal third; soleus for middle third; reverse sural fasciocutaneous flap for distal third.
Free tissue transfer pearls: When to use latissimus, rectus, gracilis, or osteocutaneous fibula flaps.
Foot reconstruction: Weight-bearing vs. non-weight-bearing surfaces, plantar flaps, and toe fillet options.
VAC therapy: Benefits, pitfalls, and when to use it.
Complications: Hematoma, infection, flap failure, and osteomyelitis.
By the end, you’ll have a structured way to approach lower extremity wounds, anticipate complications, and make evidence-based decisions for limb salvage.
References:
Reddy V, Stevenson TR. Lower extremity reconstruction. Plast Reconstr Surg. 2008;121(4):1–7. doi:10.1097/01.prs.0000305928.98611.87
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Major upper extremity amputation is one of the most devastating injuries a patient can face. Unlike lower extremity amputations where prosthetics may restore function, the upper limb remains uniquely challenging. That’s why every effort should be made to replant the amputated extremity. But replantation is only the beginning — secondary reconstructive surgery is often required to optimize function.
In this episode, we review the landmark study on secondary reconstructive surgery after major upper extremity replantation. With a survival rate of 89% in 45 patients, the average number of secondary procedures was three per patient. These procedures varied predictably based on the level of injury:
Upper arm → Most often required soft-tissue coverage and tendon transfers.
Proximal forearm/elbow → Free functioning muscle transfers (FFMT) were most common to restore flexion/extension.
Distal forearm/wrist → Tenolysis dominated, followed by tendon transfers and arthrodesis.
Timing also mattered: soft-tissue coverage occurred early (within weeks), while tenolysis and tendon transfers typically occurred 1–2 years post-replant. The treatment algorithm highlights how zone of injury and level of amputation guide predictable reconstructive needs.
Key Takeaways:
Average 3 secondary procedures per successful replant.
Procedure type depends on level of amputation.
Soft-tissue coverage is early; tendon work often delayed.
FFMT is crucial for proximal-level functional restoration.
Functional recovery is challenging but achievable with staged strategy.
📚 References:
Fufa D, Lin CH, Lin YT, Hsu CC, Chuang CC, Lin CH. Secondary Reconstructive Surgery Following Major Upper Extremity Replantation. Plast Reconstr Surg. 2014;134(4):713–720. doi:10.1097/PRS.0000000000000538
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Hand trauma with vascular compromise demands fast and accurate decision-making. In this episode of Plastics in Practice, we review two pivotal studies shaping how we triage and manage these patients: the use of pulse oximetry for objective assessment of vascular injuries and the role of IV heparin following digital replantation.
Traditional bedside exam—capillary refill, Doppler signals, pinprick—remains subjective and operator-dependent. Tarabadkar et al. (PRS, 2015) demonstrated that pulse oximetry provides reliable, objective data:
Digits with ≥95% SpO₂ had no ischemic injury.
Digits ≤84% SpO₂ all required operative repair .
This tool can reduce unnecessary transfers and streamline triage.
On the anticoagulation side, Nishijima et al. (PRS, 2019) conducted a randomized trial on unfractionated heparin after digital replantation. Their findings:
No overall survival benefit with routine heparin.
Higher risk of congestion/complications in the heparin group.
Subgroup benefit for patients ≥50 years old, with significantly higher success when given heparin .
Key Takeaways:
Pulse ox is quick, widely available, and should be part of every vascular hand trauma triage.
Cutoffs: ≥95% → safe; ≤84% → surgical intervention needed.
Routine IV heparin post-replantation is unnecessary.
Consider targeted use of heparin in older patients or high-risk vascular repairs.
Evidence-based triage + anticoagulation = better outcomes, less morbidity.
References:
Tarabadkar N, Iorio ML, Gundle K, Friedrich JB. Plast Reconstr Surg. 2015;136(6):1227-33. doi:10.1097/PRS.0000000000001777
Nishijima A, Yamamoto N, Gosho M, et al. Plast Reconstr Surg. 2019;143(6):1224e-1232e. doi:10.1097/PRS.0000000000005665
Distal fingertip amputations are among the most common hand injuries, yet whether to replant or revise remains one of the most debated questions in hand surgery.
In this episode, we break down “A Systematic Review of the Outcomes of Replantation of Distal Digital Amputation” (Sebastin & Chung, PRS 2011). Thirty studies encompassing 2,273 distal replantations give us the best available evidence on survival, function, and complications. Contrary to the long-held belief that fingertip replants offer little value, this review shows high survival rates (86%) and meaningful functional recovery. We discuss survival differences by mechanism (clean-cut vs crush), the role of venous anastomosis, and long-term outcomes such as sensation, pulp atrophy, and nail deformity.
Key Takeaways:
Survival: ~86% overall, similar between Zone I & II.
Mechanism matters: Clean cuts survive better than crush/avulsion.
Vein repair helps: Improves survival in both zones.
Function: Mean 2-point discrimination 7 mm; most regain protective sensibility even without nerve repair.
Work: 98% return to work reported.
Complications: Nail deformity (~23%) and pulp atrophy (~14%) remain common.
This paper challenges the myth that distal replants are “not worth it” — showing reproducible, good outcomes when performed by skilled microsurgeons.
References:
Sebastin SJ, Chung KC. A systematic review of the outcomes of replantation of distal digital amputation. Plast Reconstr Surg. 2011;128(3):723–737. doi:10.1097/PRS.0b013e318221dc83
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Upper limb replantation remains one of the most challenging — and rewarding — procedures in plastic and reconstructive surgery. From fingertip injuries to major limb salvage, success depends not only on microsurgical skill but also on sound decision-making, efficient technique, and anticipating complications.
In this episode, we break down the essential principles every trainee should know when faced with an amputation on call. We review absolute and relative indications, discuss how to approach very distal fingertip injuries, and highlight pearls for zone 2 replantation, thumb salvage, avulsion injuries, and multi-digit cases. We also touch on more complex scenarios, including transmetacarpal and major limb replantation, and strategies for managing ischemia, venous congestion, and postoperative anticoagulation.
Whether you’re a resident seeing your first replant in the trauma bay, or a fellow refining your operative flow, this episode offers practical guidance to help you prioritize function over length, select the right cases, and master technical details that make the difference between survival and success.
Key takeaways:
Replantation is always about restoring function, not just tissue.
Thumb and multi-digit injuries take priority.
Bone shortening, venous salvage, and nerve repair are central to good outcomes.
Team efficiency and thoughtful sequencing matter as much as microsurgical precision.
References:Woo SH. Practical Tips to Improve Efficiency and Success in Upper Limb Replantation. Plast Reconstr Surg. 2019;144:878e–911e. doi:10.1097/PRS.0000000000006134
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Hand and upper extremity amputations are devastating injuries — but modern microsurgery has transformed outcomes. Not every part should be replanted, and today’s decisions balance survival, function, and efficiency.
In this episode of Plastics in Practice, we dive into the current concepts of upper extremity replantation. Since the first successful thumb replantations in the 1960s, the field has shifted from “save every part” toward careful patient and injury selection, maximizing functional recovery, and minimizing unnecessary costs and transfers.
We discuss:
Clear Indications: thumb, multiple digits, mid-palm amputations, all pediatric cases.
Contraindications: severe crush, multilevel injuries, prolonged normothermic ischemia, or patients unable to rehab.
Injury Mechanism: sharp injuries have highest survival (~91%), while crush and avulsion lag behind but show improving outcomes with vein grafts.
Distal Tip Injuries: often viable candidates — vein/nerve repair may not always be necessary.
Ischemia Tolerance: digits can survive much longer than previously thought, with reports of >90 hours cold ischemia.
Special Populations: children have remarkable recovery, and age alone shouldn’t be an exclusion.
Finally, we cover evolving practices such as replantation regionalization, use of telemedicine for triage, and pearls for venous drainage strategies.
References:
Prucz RB, Friedrich JB. Upper Extremity Replantation: Current Concepts. Plast Reconstr Surg. 2014;133(2):333-342. doi:10.1097/01.prs.0000437254.93574.a8
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What if you could fix hand fractures without sedation, tourniquet pain, or costly OR time? Welcome to the era of wide-awake, local anesthesia, no tourniquet (WALANT) surgery.
In this episode, we unpack the principles, technique, and rehab pearls behind wide-awake surgical management of hand fractures. WALANT challenges long-held beliefs about epinephrine use in the finger and empowers surgeons to treat metacarpal and phalangeal fractures safely and effectively — with patients awake, engaged, and moving intraoperatively.
Key Takeaways:
Why WALANT? Lower cost, no fasting or pre-op clearance, minimal perioperative anxiety, and high patient satisfaction .
Intraoperative advantage: Surgeons can confirm fixation stability and detect tendon gapping by asking patients to actively move .
Technique pearls: Buffered lidocaine with epinephrine, periosteal blocks, and the “hole-in-one” anesthesia strategy improve comfort and hemostasis .
Fracture fixation: K-wire configurations for metacarpal, phalangeal, and mallet injuries, with intraop fluoroscopy to confirm alignment .
Rehab protocols: Early protected motion (Modified St. John Protocol) minimizes stiffness and speeds recovery .
Complications: Rare cases of finger necrosis underscore the importance of knowing contraindications and phentolamine rescue .
Whether you’re a resident learning fracture fixation or an attending rethinking anesthesia strategy, WALANT offers a powerful, patient-centered approach that’s reshaping hand surgery.
References:
Hyatt BT, Rhee PC. Wide-Awake Surgical Management of Hand Fractures: Technical Pearls and Advanced Rehabilitation. Plast Reconstr Surg. 2019;143(3):800–810. doi:10.1097/PRS.0000000000005379
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Seymour fractures are small injuries with big consequences. These pediatric distal phalanx fractures can easily be overlooked — but missing the nail-bed involvement means missing an open fracture.
In this episode of Plastics in Practice, we dive into the clinical entity first described by Seymour nearly 50 years ago: pediatric distal phalanx Salter-Harris I/II or juxta-epiphyseal fractures. We review how tendon insertions create the characteristic mallet deformity, why nail-bed lacerations matter, and how management has evolved.
Key Takeaways:
Red Flags: Subungual hematoma, nail plate subluxation, or nail fold laceration should raise suspicion for a Seymour fracture .
Open Fracture Principle: Nail-bed laceration = open fracture → requires irrigation, debridement, reduction, and antibiotics .
Timing Matters: Delayed presentation (>48 hrs) significantly increases infection and osteomyelitis risk .
Surgical Algorithm: Stable fractures → splinting; unstable → pinning; always explore when nail-bed injury is suspected .
Outcomes: Early recognition and appropriate management lead to excellent functional and aesthetic results.
References:
Gibreel W, Charafeddine A, Carlsen BT, Moran SL, Bakri K. Salter-Harris Fractures of the Distal Phalanx: Treatment Algorithm and Surgical Outcomes. Plast Reconstr Surg. 2018;142(3):720–729. doi:10.1097/PRS.0000000000004645
Seymour N. Juxta-epiphysial fracture of the terminal phalanx of the finger. J Bone Joint Surg Br. 1966;48:347–349.
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Metacarpal fractures are some of the most common hand injuries encountered in plastic surgery — and knowing when to treat conservatively versus when to operate is critical. In this episode, we review evidence-based management of metacarpal fractures, focusing on nonoperative thresholds, fixation techniques, and practical surgical pearls.
Key topics include:
Nonoperative care: Angulation tolerances by digit, when splinting is enough, and why rotational deformity is never acceptable.
Operative indications: Shortening >5 mm, articular step-off >1 mm, or >25% articular involvement .
Fixation techniques: Percutaneous K-wires, plates, lag screws, intramedullary fixation, and external fixation — with pros/cons for each .
Thumb metacarpal base fractures: Why Bennett and Rolando fractures demand surgical attention.
Comparative studies: Evidence suggesting intramedullary pinning may offer superior outcomes for fifth metacarpal neck fractures .
By the end of this episode, you’ll have a framework for approaching metacarpal fractures in both hand call and exam scenarios.
References:
Wong VW, Higgins JP. Evidence-Based Medicine: Management of Metacarpal Fractures. Plast Reconstr Surg. 2017;140(1):140e–151e. doi:10.1097/PRS.0000000000003470
Hand fractures and dislocations are among the most common injuries encountered by plastic surgeons, and their management directly impacts long-term function. In this episode, we break down the essentials of diagnosis, treatment, and surgical decision-making for common fractures and dislocations of the hand, drawing on the landmark PRS review by Jones, Jupiter, and Lalonde.
We focus on the core treatment philosophy: achieving full range of motion through fracture reduction with minimal dissection and early protected movement. From non-operative methods like buddy taping to surgical strategies involving K-wires, lag screws, and plating, we highlight when to operate and when conservative management suffices.
Key topics include:
Bennett & Reverse Bennett fractures: why anatomical reduction matters.
Metacarpal shaft & neck fractures: acceptable angulation thresholds and fixation choices.
Phalangeal fractures: risks of stiffness, early motion protocols, and fixation techniques.
PIP joint dislocations: splinting, extension block pinning, and complex salvage options like volar plate arthroplasty or hemi-hamate grafting.
Ulnar collateral ligament (UCL) injuries of the thumb: how to recognize and treat Stener lesions.
This is a must-know topic for residents preparing for boards and anyone seeking practical pearls in hand trauma surgery.
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References:
Jones NF, Jupiter JB, Lalonde DH. Common fractures and dislocations of the hand. Plast Reconstr Surg. 2012;130(5):722e–736e. doi:10.1097/PRS.0b013e318267d67a
In this episode, we cover the embryology, classification, and repair of nonsyndromic cleft palate. Techniques discussed include Bardach two-flap, Furlow double-opposing Z-plasty, and radical intravelar veloplasty, with emphasis on timing (9–12 months), outcomes, and complications.
📘 Free Study Guides: → https://drive.google.com/drive/u/8/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ
Citations
van Aalst JA, Kolappa KK, Sadove M. Nonsyndromic Cleft Palate. Plast Reconstr Surg. 2008;121(1 Suppl):1–14. doi:10.1097/01.prs.0000294706.05898.f3
Salyer KE, Sng KWE, Sperry EE. Two-Flap Palatoplasty: 20-Year Experience and Evolution. Plast Reconstr Surg. 2006;118(1):193–204. doi:10.1097/01.prs.0000220875.87222.ac
Woo AS. Evidence-Based Medicine: Cleft Palate. Plast Reconstr Surg. 2017;139(1):191e–203e. doi:10.1097/PRS.0000000000002854
Furlow LT Jr. Cleft Palate Repair by Double-Opposing Z-Plasty. Plast Reconstr Surg. 1986;78(6):724–738. doi:10.1097/00006534-198678060-00012
Disclaimer
This content is for educational purposes only and is not medical advice.
In this episode of Plastics in Practice, we explore the anatomy, diagnosis, and surgical management of facial fractures — including frontal sinus, nasoethmoidal, orbital, zygomatic, and mandibular injuries. We review mechanisms of injury, key radiographic findings, surgical exposures, fixation strategies, and complication avoidance. Practical pearls include when to observe vs. operate, selecting fixation methods, approaches to nerve blocks, and sequencing in panfacial trauma.
Citations
1. Ricketts S, Gill HS, Fialkov JA, Matic DB, Antonyshyn OM. Facial Fractures. Plast Reconstr Surg. 2016;137(2):424e–444e. doi:10.1097/01.prs.0000475760.09451.49
2. Morrow BT, Samson TD, Schubert W, Mackay DR. Mandible Fractures. Plast Reconstr Surg. 2014;134(6):1381–1390. doi:10.1097/PRS.0000000000000717
3. Gart MS, Gosain AK. Orbital Floor Fractures. Plast Reconstr Surg. 2014;134(6):1345–1355. doi:10.1097/PRS.0000000000000719
4. Ellstrom CL, Evans GRD. Zygoma Fractures. Plast Reconstr Surg. 2013;132(6):1649–1657. doi:10.1097/PRS.0b013e3182a80819
5. Yavuzer R, et al. Management of Frontal Sinus Fractures. Plast Reconstr Surg. 2005;115(6):79e–93e. doi:10.1097/01.PRS.0000161988.06847.6A
6. Zide BM, Swift R. How to Block and Tackle the Face. Plast Reconstr Surg. 1998;101(3):840–851.
Disclaimer
“This content is for educational purposes only and is not medical advice.”
📘 Free Study Guides: → https://drive.google.com/drive/u/8/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ
This episode synthesizes key information from provided sources on adult peripheral nerve disorders and brachial plexus injuries, focusing on pathophysiology, diagnosis, treatment options, and outcomes. Peripheral nerve disorders encompass a wide spectrum, from entrapment neuropathies to severe traumatic injuries like brachial plexus avulsion. Accurate diagnosis relies on a detailed history, meticulous clinical examination, and advanced electrophysiologic and radiographic studies. Treatment goals include pain management and restoration of sensory and motor function, often involving complex surgical interventions such as direct nerve repair, nerve grafting, and nerve transfers. Recent advancements, particularly in nerve transfer techniques and the use of allografts, offer promising alternatives to traditional methods, aiming for faster and more effective recovery while minimizing donor-site morbidity. However, challenges remain, especially for extensive injuries and in the context of chronic pain.
📘 Free Study Guides: → https://drive.google.com/drive/u/8/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ
Citations
Fox IK, Mackinnon SE. Adult Peripheral Nerve Disorders: Nerve Entrapment, Repair, Transfer, and Brachial Plexus Disorders. Plast Reconstr Surg. 2011;127(5S):105e–118e. doi:10.1097/PRS.0b013e31820cf556.
Terzis JK, Kostopoulos VK. The Surgical Treatment of Brachial Plexus Injuries in Adults. Plast Reconstr Surg. 2007;119(4):73e–92e. doi:10.1097/01.prs.0000254859.51903.97.
Leckenby JI, et al. Outcomes of Avance Nerve Allografts. Plast Reconstr Surg. 2020;145(2):368e–380e. doi:10.1097/PRS.0000000000006485.
Safa B, et al. Recovery of Motor Function after Mixed and Motor Nerve Repair with Processed Nerve Allograft. PRS Global Open. 2019;7:e2163. doi:10.1097/GOX.0000000000002163.
Disclaimer
Educational only; not medical advice or a substitute for reading the full studies or clinical judgment.
