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Introduction This article aims to expand the microsurgical treatment options for extremity degloving injuries with perforator artery repairs of the specific degloved angiosomes in upper and lower extremity. Methods Fourteen perforator arteries were repaired in seven patients. Four of them had circumferential degloving and 3 of them have non circumferential degloving injury. All had repair of the perforator arteries of the specific degloved segments. Four patients had additional vein repairs but none of the patients had AV shunts. Results All perforators provided adequate arterial supply to their specific angiosomes with some necrotic areas in neighboring angiosomes. Conclusions Perforator artery repair within the degloved tissues provides a direct arterial supply successfully even if one could not find an intact venous plexus.

In addition to soft tissue and bone tissue injuries as a result of high-energy trauma against the lower extremities, serious tissue losses may occur following tumor surgeries. For the reconstruction of this region, there are various options. The preferred methods of reconstruction vary with respect to the experience and knowledge of the surgeon. In this case, the mega prosthesis used following a tibia tumor resection by virtue of local flaps is discussed. [Hand Microsurg 2016; 5(2.000): 92-95]

Background There are many variables that influence nose tip harmony. Even in a rhinoplasty that appears successful in profile, one may see nostril asymmetries, alar retractions, or irregularities in the soft triangle, and patients express their dissatisfaction with these simple deformities. Objectives In this study, we define the ratio of caudal and cephalic excess of the lower lateral cartilage. We evaluate whether it is possible to eliminate nostril asymmetries and alar retractions by means of supporting the facet polygon with the help of a lower lateral cartilage auto-rim flap, a technique we have developed in our rhinoplasties. Methods The auto-rim flap was used successively on 498 primary rhinoplasty patients on whom the same surgeon operated between May 2013 and June 2015, performing marginal incisions. Results Of the 498 patients in the series, only 1 of the first 10 required a revision due to tip asymmetry related to the auto-rim flap. A minimal nostril asymmetry that did not require intervention occurred in 10 patients. In none of the patients could an increased alar retraction be seen postoperatively. All patients exhibited alar cartilage in the anatomically correct position. Conclusions With the auto-rim flap technique, a part of the caudal excess of the alar cartilage remains as a flap in the facet region; therefore, there is no need in the cephalic region to perform more of an excision than what is strictly necessary. Level of Evidence 4![Graphic][1] Therapeutic [1]: /embed/inline-graphic-1.gif

Overlapping fifth toe is a congenital deformity and is characterized by an external rotation of the toe so that it overrides the adjacent fourth toe. Treatment of this condition aims to permanently reposition the fifth toe and includes conservative and surgical techniques. Here we present a case of severe overlapping fifth toe deformity treated with a combination of Z-plasty and a unilobed transposition skin flap technique over a limited surgical area, associated with low morbidity.

Keles, Musa K/0000-0003-1915-079X WOS: 000326421800009 PubMed: 24214785 BACKGROUND: We aimed to present the primary experience of one surgeon with a new surgical technique performed on the first 13 cases and to evaluate outcomes following an extraoral endoscopic approach to subcondylar fractures. METHODS: Fifteen subcondylar fractures in 13 patients, who were treated at Ondokuz Mayis University Hospital between January 2010 and June 2011, were included in this study. Patients were operated on using either endoscopic or open approach. RESULTS: Rigid plate fixation was completed endoscopically using extraoral approach in nine fractures, while six fractures were plated by conversion to a full-open approach. In all six fractures that could not be fixed endoscopically, the proximal fragments were medially displaced, whereas seven of nine fractures that were successfully fixed endoscopically were laterally displaced. CONCLUSION: An extraoral endoscopic approach for subcondylar fractures is feasible and can be carried out with decreased morbidity. This approach is recommended for those with limited experience in endoscopy to treat low laterally displaced subcondylar fractures as their initial cases.

Objectives: Treatments of long peripheral nerve defects are limited and a means to construct a vascularized nerve graft substitute has been sought. Material and Methods: An in vivo chamber bioreactor was designed with the White New Zealand rabbit's superficial inferior epigastric pedicle (SIEP) and using autologous Schwann cell (ASC) suspension, a tissue volume containing rich vascularization and a dense presence of Schwann cells was constructed. This construct was comparatively tried on 3 cm of a sciatic nerve defect. Results: A vascularized build with rich blood supply and an abundance of Schwann cells was engineered and utilized for nerve regeneration and transmission, axonal passage being displayed. Conclusion: According to the literature review, this is the first achievement of engineering a nerve graft substitute containing vascularized Schwann cells. Therefore, it is believed this study has yielded significant preliminary results, providing a basis for future studies. [Hand Microsurg 2016; 5(2.000): 62-69]