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  • 1
    Online Resource
    Online Resource
    Sonoelastography in the Diagnosis of Carpal Tunnel Syndrome : A Systematic Review of Diagnostic Values Compared With the Normative Population
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Annals of Plastic Surgery Vol. 86, No. 3S ( 2021-3), p. S299-S311
    Details
    In: Annals of Plastic Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 86, No. 3S ( 2021-3), p. S299-S311
    Abstract: Sonoelastography (SEL) is widely used for assessing tissue stiffness and pathophysiology. It has also been used to diagnose carpal tunnel syndrome (CTS). However, the current criteria to diagnose CTS in SEL are diverse. The aim of this study was to systematically review the literature and assess the diagnostic value of SEL for CTS. Methods A literature review was performed using MEDLINE (PubMed), EMBASE, and the Cochrane Collaboration Library for primary research articles using the keywords sonoelastography and carpal tunnel syndrome. Data related to diagnostic and cutoff value were extracted. Bias assessment was performed. Results A total of 121 publications were reviewed. Nineteen primary case series met the inclusion criteria and were selected for full analysis. Different diagnostic approaches were identified, with units/expressions including kilopascals, conduct velocity, and strain ratio. The kilopascals and conduct velocity were measured using shear wave elastography, whereas strain ratio was calculated by relative compression quantification. A mean shear modulus cutoff value from 38.25 to 86 kPa and an acoustic radiation force impulse cutoff value of 3.0 to 3.23 m/s were used to diagnose CTS. Eight articles reported strain ratio between the median nerve and nearby tissues with diverse results due to different reference points. The other 3 additional diagnostic values were reported. Conclusions Sonoelastography is a useful noninvasive and promising modality to diagnose CTS. It may reflect both the condition of soft tissue scarring and quantitative values for CTS and median nerve stiffness. A diversity of examination values was found in different modalities. A high level of evidence was absent.
    Type of Medium: Online Resource
    ISSN: 1536-3708 , 0148-7043
    URL: Article
    DOI: 10.1097/SAP.0000000000002686
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2063013-X
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  • 2
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    Preliminary Prospective Preoperative and Postoperative Evaluation of Median Nerve Stiffness by Using Sonoelastography
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Annals of Plastic Surgery Vol. 91, No. 2 ( 2023-8), p. 265-269
    Details
    In: Annals of Plastic Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 91, No. 2 ( 2023-8), p. 265-269
    Abstract: Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. No previous studies have compared preoperative and follow-up sonoelastography results or investigated the correlation of median nerve stiffness with the subjective/objective outcomes. Therefore, the aim of this study was to compare the preoperative and postoperative elastography after carpal tunnel release and find the correlation with associated subjective/objective outcomes. From May 2017 to March 2020, 32 patients (6 males, 26 females; 34 hands) with carpal tunnel syndrome were enrolled in this prospective study. Demographic data, QuickDASH score (Chinese version), Boston Carpal Tunnel Questionnaire (Chinese version), nerve conduction velocity/electromyography, and median nerve stiffness by sonoelastography were recorded. Comparisons of preoperative and average sonoelastography findings 1.5 years postoperatively showed a significant decrease in stiffness presented by velocity (Vs) (preoperative Vs, 4.63 ± 1.27 m/s, vs postoperative Vs, 3.39 ± 0.59 m/s; P 〈 0.001). Changes in subjective functional outcomes also showed the same significant trend. Based on the neurophysiologic study, the improvement of nerve conduction study and elastography have the significant correlation. The same trend of preoperative and postoperative changes in median nerve stiffness and subjective questionnaires/objective neurophysiologic studies may imply that sonoelastography can be used to assess the response to surgery in patients with carpal tunnel syndrome.
    Type of Medium: Online Resource
    ISSN: 1536-3708 , 0148-7043
    URL: Article
    DOI: 10.1097/SAP.0000000000003601
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
    Online Resource
    Online Resource
    The position of ‘shunt restriction’ along an arterialized vein affects venous congestion and flap perfusion of an arterialized venous flap
    Elsevier BV ; 2016
    In:  Journal of Plastic, Reconstructive & Aesthetic Surgery Vol. 69, No. 10 ( 2016-10), p. 1389-1396
    Details
    In: Journal of Plastic, Reconstructive & Aesthetic Surgery, Elsevier BV, Vol. 69, No. 10 ( 2016-10), p. 1389-1396
    Type of Medium: Online Resource
    ISSN: 1748-6815
    URL: Article
    DOI: 10.1016/j.bjps.2016.05.013
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2016
    detail.hit.zdb_id: 2214150-9
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  • 4
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    Online Resource
    Replantation of a Degloved Hand With Added Arteriovenous Anastomoses: Report of Two Cases
    Elsevier BV ; 2009
    In:  The Journal of Hand Surgery Vol. 34, No. 10 ( 2009-12), p. 1864-1867
    Details
    In: The Journal of Hand Surgery, Elsevier BV, Vol. 34, No. 10 ( 2009-12), p. 1864-1867
    Type of Medium: Online Resource
    ISSN: 0363-5023
    URL: Article
    DOI: 10.1016/j.jhsa.2009.07.021
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 2023397-8
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  • 5
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    Vascularized Toe Proximal Interphalangeal Joint Transfer in Posttraumatic Fingers: Analysis of Prognostic Factors for Suboptimal Outcomes
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 11, No. 10 ( 2023-10-04), p. e5314-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 10 ( 2023-10-04), p. e5314-
    Abstract: Posttraumatic finger osteoarthritis of the proximal interphalangeal joint (PIPJ) is a difficult problem. Over the past decade, we have reported several methods for improving the outcomes of vascularized toe joint transfer (VJT). In this study, we focused on determining poor prognostic factors which lead to a suboptimal outcome. Methods: A consecutive series of patients with posttraumatic osteoarthritis of the PIPJ who received VJT between January 2008 and January 2021 were enrolled in this study. The senior surgeon (Y.-T.L.) performed the surgery in all cases. In this retrospective study, we reexamine the initial trauma-related soft tissue and bony structure injuries of the recipient finger, to assess the baseline tissue quality before VJT. The injuries were classified into five major categories according to their anatomic region. The functional outcome parameters (including range of motion, percentage of use, and extensor lag of the transferred PIPJ) were collected. Univariate and multivariate linear regression analyses were performed using the generalized estimated equation model to identify the correlation between the injury category involved and functional outcome. Results: A total of 59 digits were enrolled. Our results revealed that the fingers with previous vascular injury that received revascularization procedures had relatively suboptimal functional outcomes. These fingers had a significantly lower percentage of use both before (β = −0.222, P  = 0.006) and after (β = −0.177, P  = 0.006) receiving secondary procedures to improve functional outcome. Conclusions: Patients with prior revascularization surgery were associated with a poor functional outcome after VJT.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000005314
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2723993-7
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  • 6
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    Comparison of the clinical outcomes between vascularized bone graft and the Masquelet technique for the reconstruction of Gustilo type III open tibial fractures
    Springer Science and Business Media LLC ; 2022
    In:  BMC Musculoskeletal Disorders Vol. 23, No. 1 ( 2022-12-01)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-12-01)
    Abstract: Gustilo type III tibial fractures commonly involve extensive soft tissue and bony defects, requiring complex reconstructive operations. Although several methods have been proposed, no research has elucidated the efficacies and differences between vascular bone graft (VBG) and the Masquelet technique (MT) to date. We aimed to evaluate and compare the clinical effectiveness of VBG and the MT for the reconstruction of Gustilo type III tibial fractures. Methods This retrospective cohort study enrolled patients who underwent reconstruction for Gustilo type III tibial fractures using VBG or the MT in a single center from January 2000 to December 2020. The patients’ demographics, injury characteristics, and surgical interventions were documented for analysis. The clinical outcomes including union status, time to union, postoperative infections, and the causes of union failure were compared between the two groups. Results We enrolled 44 patients: 27 patients underwent VBG, and 17 underwent MT. The average union time was 20.5 ± 15.4 and 15.1 ± 9.0 months in the VBG and MT groups, respectively (p = 0.232). The postoperative deep infection rates were 70.4% and 47.1% in the VBG and MT groups (p = 0.122), respectively. Though not statistically significant, the VBG group had a shorter union time than did the MT group when the bone defect length was  〉  60 mm (21.0 ± 17.0 versus 23.8 ± 9.4 months, p = 0.729), while the MT group had a shorter union time than did the VBG group when the bone defect was length  〈  60 mm (17.2 ± 5.6 versus 10.7 ± 4.7 months, p = 0.067). Conclusions VBG and MT are both promising reconstruction methods for Gustilo type III tibial fractures. VBG appears to have more potential in reconstructing larger bone defects, while MT may play an important role in smaller bone defects, severe surgical site infections, and osteomyelitis. Therefore, flexible treatment strategies are required for good outcomes in Gustilo type III open tibial fractures.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-022-06010-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041355-5
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  • 7
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    Online Resource
    Lambda (λ) repair: a novel repair technique for chronic Boutonnière deformity
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Plastic & Reconstructive Surgery Vol. Publish Ahead of Print ( 2023-05-31)
    Details
    In: Plastic & Reconstructive Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. Publish Ahead of Print ( 2023-05-31)
    Type of Medium: Online Resource
    ISSN: 0032-1052
    URL: Article
    DOI: 10.1097/PRS.0000000000010789
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2037030-1
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  • 8
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    Neurectomy of the Nerve of Henle Associated with Periarterial Sympathectomy for Management of Intractable Raynaud’s Phenomenon
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Plastic & Reconstructive Surgery
    Details
    In: Plastic & Reconstructive Surgery, Ovid Technologies (Wolters Kluwer Health)
    Abstract: In periarterial sympathectomy for intractable Raynaud’s phenomenon, the extent of adventitiectomy as well as postoperative outcomes and hand perfusion assessment tools remain debatable. We evaluated the outcome of neurectomy of the nerve of Henle combined with ulnar tunnel release and periarterial adventitiectomy in the treatment of refractory Raynaud’s phenomenon using objective measurements and patient-reported outcomes. Methods: Nineteen patients with 20 affected hands were prospectively enrolled and underwent the proposed procedures from 2015 to 2021. Relevant data, including Michigan Hand Outcomes Questionnaire and 36-Item Short Form health questionnaire scores, were documented for analysis during a 3-year follow-up. Results: The average ingress value of the three measured fingers (index, long, and ring) on indocyanine green angiography increased after surgery ( p =0.02). The median number of ulcers decreased ( p 〈 0.001) and the median digital skin temperature increased ( p 〈 0.001). Questionnaire scores showed improvement in physical aspects, such as overall hand function ( p ≤0.001), activities of daily living ( p =0.001), work performance ( p =0.02), pain ( p 〈 0.001), physical function ( p =0.053), and general health ( p =0.048), as well as mental aspects, such as patient satisfaction ( p 〈 0.001) and mental health ( p =0.001). The average indocyanine green ingress value of the three measured fingers significantly correlated with the patient-reported outcomes, including overall hand function (r=0.46, p= 0.04), work performance (r=0.68, p= 0.001), physical function (r=0.51, p= 0.02), and patient satisfaction (r=0.35, p= 0.03). Conclusions: The proposed surgical procedures provided satisfactory outcomes, both subjectively and objectively, over a follow-up period of up to 3 years. Indocyanine green angiography may provide rapid and quantitative measurements for perioperative hand perfusion assessment.
    Type of Medium: Online Resource
    ISSN: 0032-1052
    URL: Article
    DOI: 10.1097/PRS.0000000000010902
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 9
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    Prognosis of Traumatic Ulnar Nerve Injuries : A Systematic Review
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Annals of Plastic Surgery Vol. 82, No. 1S ( 2019-1), p. S45-S52
    Details
    In: Annals of Plastic Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 82, No. 1S ( 2019-1), p. S45-S52
    Abstract: Ulnar nerve injury (UNI) is not uncommon and often results in incomplete motor recovery after the initial nerve repair and requires secondary functional reconstruction. To clarify the prognosis and predicting factor of UNI, and if it is reasonable to wait after the initial repair, a systematic literature review from PubMed computerized literature database and Google scholar was performed. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist and guidelines were followed to develop the search protocol for this literature review. Two reviewers independently assessed titles, abstracts, and full-text articles, and a third reviewer resolved any disagreements. Seventeen articles with 260 cases were found with sufficient data and enough follow-up. After multiple logistic regression, age, injury level, gap of lesion, and delayed time to surgery were significant prognostic factors in UNI. If considering only high-level injuries (injury at or above proximal forearm), age became the only predicting factor. In cases with likely poor prognosis, their motor recovery tends to be unsatisfactory, and observation for months after the initial repair might not be reasonable. Other surgical interventions such as early nerve transfer may be an option to improve the outcome.
    Type of Medium: Online Resource
    ISSN: 1536-3708 , 0148-7043
    URL: Article
    DOI: 10.1097/SAP.0000000000001727
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 10
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    Rationalizing the Vascular Anatomy for Oblique Osteotomy of the Metatarsal Head during Toe/Joint Transfers of the Metatarsophalangeal Joint
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 6, No. 10 ( 2018-10), p. e1805-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 10 ( 2018-10), p. e1805-
    Abstract: The metatarsophalangeal joint (MTPJ) of the lessor toe has been used to reconstruct the metacarpophalangeal joint. When an oblique osteotomy of the metatarsal head is performed, the orientation of the vascular pedicle is crucial to preserve the blood supply to the MTPJ. This study was conducted to identify the path of the nutrient artery to the MTPJ. Methods: We reviewed our operative records in consecutive series of 45 patients during toe or joint harvest. Retrograde dissection of the vascular pedicle was performed starting from the distal communicating artery at the first webspace toward the first dorsal metatarsal and first plantar metatarsal arteries. All the vessels related to the MTPJ were explored and ligated if the MTPJ was not included in the flap. Results: The condylar branches to the proximal phalanx and the metaphyseal branches to the second metatarsus were barely identifiable during the dissections. The articular branch running perpendicularly from the plantar artery toward the plantar surface of MTPJ was verified in all cases. The articular branches originated either from the first plantar metatarsal artery (92.1%) or from the tibial plantar digital artery (7.9%). The external diameter of the articular branches was around 0.5–1 mm. When the articular branch was included and preserved, the metatarsal heads oozed immediately after the flap was reperfused. Conclusions: The study demonstrated the constant and sizable articular branch of the MTPJ that originates from the plantar artery system. The consistency of the vascular anatomy enables oblique osteotomies of the metatarsal head to be performed without fear of injury to the pedicle.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000001805
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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