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"I think that probably convenience is what did in the flexor mechanism allograft," Dr. Leonard Furlow explained in response to why tendon allografts in the 1960s were overshadowed by the Hunter rod, which is still routinely used for flexor tendon reconstruction today. At 83 years old, Dr. Furlow had graciously made the trip from his home in Gainesville, FL up to Charlottesville, VA for a special interview with the Department of Plastic Surgery at the University of Virginia. Furlow is perhaps better known for developing the double-opposing Z-plasty for cleft palate repair, but his interest in hand surgery led to a year in Chapel Hill, NC where he trained with the creator of the flexor mechanism allograft, Dr. Erle E. Peacock, Jr. Through innovative experimental work on flexor tendon reconstruction, Peacock had pioneered the use of fresh composite tendon allografts, which transplant the unscarred synovial space between the tendon and its sheath such that scar formation only occurs outside the sheath. Inspired by our recent research interest in this subject, we asked Dr. Furlow to reflect on his experience with the tendon allograft in the 1960s with the late Dr. Peacock. The picture he painted was of a simple, elegant, and astonishingly successful solution for flexor tendon reconstruction that suffered from a lack of practicality at the time.

An account of the history surrounding the first successful surgical repair of a cleft palate, with excerpts from the patient's narrative.

This article presents a method of muscle reconstruction in the cleft lip patient that grossly reproduces the interlacing muscle anatomy in the central portion of the upper lip and thereby addresses both the static and the functional requirements of cleft lip repair. This lip repair procedure is combined with paranasal muscle reconstruction, preoperative nasoalveolar molding, and postoperative nasal stenting to constitute a comprehensive approach to cleft lip/nose repair.

The advantages of palate repair by double opposing Z-plasty include excellent access for complete mobilization of the palatal muscles, construction of an overlapping muscle sling, and avoidance of the growth-limiting horseshoe-type scars of the hard palate that result from lateral relaxing incisions or pushback procedures. The excellent speech that results seems to justify use of the procedure. An Abbe flap designed to mimic the normal philtrum placed over an interlacing orbicularis reconstruction that is well supported superiorly can salvage a thin, scarred upper lip and improve its mobility. The lateral gingival flap provides excellent esthetic reconstruction of the cleft alveolus, secure cover over an alveolar bone graft, and ease closure of an anterior oronasal fistula.

A longitudinally folded 3 x 5 card or similar-sized stiff piece of paper can be used to release a slide stuck in a carousel without removing the carousel or its locking ring.

For fingers left shorter volarly after finger-tip amputation, a volar V-Y amputation flap designed with the V-Y portion at the middle phalanx level and using the Snow cupping technique for reconstruction of the pulp and tip has provided good sensation, padding and contour. Hypersensitivity and beaking of the nail have not been problems.

As the treatment of intraspinal protrusion of intervertebral disks becomes more common, increasing efforts are being made to find a simple and accurate but safe objective method for the diagnosis of this disorder. Without entering into a detailed discussion, it is safe to state that neither air, lipiodol, nor thorotrast has proved to be the ideal contrast medium. With air there is often insufficient contrast for clear definition of minor protrusions. With lipiodol the removal of the oil is often inadequate and at times uncomfortable for the patient. Removal of thorotrast is time-consuming and usually incomplete, so that its use is not without risk. In an effort to find a more satisfactory medium, Warren, Strain, Plati, and associates (1, 2) developed ethyl iodophenylundecylate, a mixture of isomers obtained by the addition of iodobenzene to ethyl undecylate in the presence of aluminum chloride. It contains 30.5 per cent of iodine in firm organic combination. It is called “Pantopaque.” The chemistry and th...

In an attempt to improve speech results following palate repair while allowing adequate maxillary growth, a palatoplasty using two opposing Z-plasties of the soft palate, one of the oral and one of the nasal layers, has been used in 22 infants. Eight patients had unilateral cleft lip and palate, eight had bilateral cleft lip and palate, and six had cleft palate. The Z-plasties facilitate effective dissection and redirection of the palatal muscles to produce an overlapping muscle sling and lengthen the velum without using tissue from the hard palate, which permits hard palate closure without pushback or lateral relaxing incisions. Of the 20 children old enough for speech evaluation, 18 have no velopharyngeal insufficiency. Two have very mild velopharyngeal insufficiency. None has required a pharyngeal flap.