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The clinical applications of the fibula flap for reconstructing bone defects in the limbs have been widely studied. This study aims to investigate the use of the fibula flap in the treatment of bone defects resulting from trauma, infections, or oncological pathology. Additionally, the study focuses on analyzing preoperative experiences, including imaging and intraoperative aspects, to optimize preoperative planning. The study includes a retrospective analysis of adult patients who underwent surgical treatment for extensive bone defects from 2014 to 2020. Demographic data, surgical interventions, and postoperative complications were collected. Specific anatomical elements of the fibula flap, such as vascularization and dimensions, were also studied. The findings of this study provide valuable insights into the clinical applications and optimization of the fibula flap for reconstructive surgery. [ABSTRACT FROM AUTHOR]

The field of transplantation, including the specialized area of vascularized composite allotransplantation (VCA), has been transformed since the first hand transplant in 1998. The major challenge in VCA comes from the need for life-long immunosuppressive therapy due to its non-vital nature and a high rate of systemic complications. Ongoing research is focused on immunosuppressive therapeutic strategies to avoid toxicity and promote donor-specific tolerance. This includes studying the balance between tolerance and effector mechanisms in immune modulation, particularly the role of costimulatory signals in T lymphocyte activation. Costimulatory signals during T cell activation can have either stimulatory or inhibitory effects. Interfering with T cell activation through costimulation blockade strategies shows potential in avoiding rejection and prolonging the survival of transplanted organs. This review paper aims to summarize current data on the immunologic role of costimulatory blockade in the field of transplantation. It focuses on strategies that can be applied in vascularized composite allotransplantation, offering insights into novel methods for enhancing the success and safety of these procedures. [ABSTRACT FROM AUTHOR]

Glomus tumors are frequently associated with pain, tenderness and cold sensitivity. We report the diagnosis and successful surgical management of a case of a classic glomus tumor in a young woman. The clinical diagnosis was made on the basis of medical history and MRI findings. The lesion was excised via a dorsolateral subungual approach, leading to the complete resolution of symptoms. Histology confirmed the lesion to be a glomus tumor. Glomus tumors are painful subungual lesions. They produce a throbbing or lancinating local discomfort, cold-sensitivity, and severe pain following minor trauma. The diagnosis is confirmed by histology, but the clinical diagnosis is highly suggestive. Complete excision will usually relieve pain. Recurrence is common following incomplete resection. [ABSTRACT FROM AUTHOR]

Background Vein anastomosis is the most important factor determining the success in the replantation of distal phalanx amputations. It is very difficult to find the collapsed veins and to perform vein anastomosis immediately after arterial repair. We have chosen to delay the vein repair between 30 minutes and 1 hour to give time to the veins to expand to a more reasonable diameter for repair. Aim The purpose of the study was to show that the delayed venous method provides a higher rate of success in distal phalanx replantations and does not require the use of specialized techniques. Methods The delayed venous method for vein anastomosis was used for the past 2 years. This surgical procedure includes initial arterial anastomosis, delayed expansion of the vein, and subsequent vein anastomosis after 30 mins of waiting. Results The delayed method was used in eight cases. Expansion of veins up to 1 mm or more resulted in a high success rate (75%). In contrast, the success rate for distal phalanx replantation is extremely low in other techniques because of the difficulty of vein finding and anastomosis. Conclusion The delayed venous method allows easier anastomosis of the subdermal veins of the distal phalanx. Therefore, it is a useful operative technique for treatment of amputated distal phalanx amputation. [ABSTRACT FROM AUTHOR]

The article discusses the aspects of facial transplantation as a complex microsurgical and functional reconstruction available to plastic surgeons. It mentions the potential capability of facial transplantation to restore the functional and aesthetic deficits and to improve social and psychological conditions of patients. It cites several indications for transplantation including neurofibromatosis, traumatic facial injury and facial deformity after tumor resection.

The article presents the outcome of the world's experience with face transplantation. A total of 18 patients have received face transplants with promising results from 2005 to 2012. Most of the operations have been designed to restore facial defects. Patients have been warned about the potential complications of face transplantation.

Controversy exists with regard to the nomenclature, treatment and outcome of a group of well-differentiated lipomatous tumors sometimes labelled as atypical lipomatous tumors. For elimination of inadequate or excessive treatment it has been advocated that the term well-differentiated liposarcomas be retained for retroperitoneal/mediastinal tumors and atypical lipomatous tumors for the rest of the sites. The most important prognostic factor for ALT/WD liposarcoma is anatomic location, overall mortality ranging from 0% for ALT of the extremities to more than 80% for WD liposarcomas occurring in the retroperitoneum if the patients are followed up for 10-20 years. Primary treatment of ALT/WD liposarcoma is represented by a complete, preferably wide-margin surgical resection. The role of radiation therapy for atypical lipomatous tumors/well-differentiated liposarcomas is still unclear. Despite the side effects of postoperative radiation therapy it has been shown that in patients with positive surgical margins postoperative RT in doses over 64Gy, improves local control. [ABSTRACT FROM AUTHOR]

Controversy exists with regard to the nomenclature, treatment and outcome of a group of well-differentiated lipomatous tumors sometimes labelled as atypical lipomatous tumors. For elimination of inadequate or excessive treatment it has been advocated that the term well-differentiated liposarcomas be retained for retroperitoneal/mediastinal tumors and atypical lipomatous tumors for the rest of the sites. The most important prognostic factor for ALT/WD liposarcoma is anatomic location, overall mortality ranging from 0% for ALT of the extremities to more than 80% for WD liposarcomas occurring in the retroperitoneum if the patients are followed up for 10-20 years. Primary treatment of ALT/WD liposarcoma is represented by a complete, preferably wide-margin surgical resection. The role of radiation therapy for atypical lipomatous tumors/well-differentiated liposarcomas is still unclear. Despite the side effects of postoperative radiation therapy it has been shown that in patients with positive surgical margins postoperative RT in doses over 64Gy, improves local control. [ABSTRACT FROM AUTHOR]