PubMed Health⌕ Search

Biomedical subjects

J Monner

Publications and source records attributed to J Monner.

9 recordsLinked to original sources
PubMed2004

Forehead flag flap.

We present a modification of the Okada and Maruyama's flap for forehead reconstruction, based solely on the supratrochlear vessels. The flap is raised extra-periosteally but in the area of the pedicle the periosteum is included in the flap to protect the vessels. The flap is advanced and rotated to cover full thickness defects on the contralateral hemi-forehead, like a flag on its flagpole. We have treated six patients with large malignant tumours of the forehead which required excision including the periosteum. The flap survived in all cases and no necrosis was observed in any. The main advantage of this flap is that it is relatively straightforward to raise, being a good solution in selected cases (elderly patients). The main disadvantages of this flap are that the supraorbital nerve is sacrificed and some distortion of the eyebrows occurs.

Aged↗
PubMed2004

Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps.

Soft tissue heel defects reconstruction represents a challenge for plastic surgeons because of the poor availability of regional tissue to perform the reconstruction. We divide the heel on the anterior or weight-bearing heel and the posterior or non-weight-bearing heel. Our preferences are the fasciocutaneous instep flap for anterior heel defects and the reverse sural flap for posterior heel defects. We have performed 11 reconstructions of the heel. The complications were total necrosis of 1 instep flap in a previously irradiated patient and 1 case of partial tip necrosis in a reverse sural flap. Functional recovery has been very satisfactory for both procedures. Regional island flaps are for us the first therapeutic option because the skin is similar to the lost one and less time consuming than a free-flap reconstruction.

Heel↗
PubMed2000

Is the reversed fourth dorsal metacarpal flap reliable?

We have carried out a study to determine if a flap based on vessels in the fourth metacarpal space could be used safely. We studied ten fresh cadaver specimens and used the flap in nine patients. In the anatomical study, we confirmed the presence of a suitable artery in nine out of the ten hands, arising from a piercing artery at the metacarpal bases, running distally under the fascia. The pivot point is located at the metacarpal heads, where the artery anastomoses to palmar branches and dorsal digital branches. In the clinical setting, the flap was reliable in eight patients. There was one case of flap necrosis. The flap seems to be reliable but several technical points are stressed to avoid complications.

Cadaver↗
PubMed1999

Primary amyloidosis presenting as extensor tenosynovitis.

Primary amyloidosis is a systemic disease. Amyloid arthropathy is an invalidating and uncommon form of presentation, but tenosynovitis is even rarer as the first sign of the disease. We report herein a case of unilateral amyloid deposit in the synovium of the extensor tendons of the hand, which was the first manifestation of a primary amyloidosis.

Aged↗
PubMed1998

Reconstruction of pharyngostomes with a modified deltopectoral flap combining endoscopy and tissue expansion.

The problem of pharyngostomic closure is difficult to solve, as evidenced by the large number of techniques described. The authors present the reconstruction of pharyngostomes by using Bakamjian's deltopectoral flap modified by the use of endoscopically introduced expanders for those patients in whom other techniques of choice (such as vascularized free flaps) have failed or are inapplicable either because of previous radiotherapy or because of local conditions. Bakamjian's deltopectoral flap, previously expanded with an expander coated with a partial-thickness skin graft and introduced endoscopically, allowed the authors to lift the flap in one operation to close the pharyngostome. This method provides the two walls of the pharynx (the skin graft as the inner aspect and the skin flap as the outer aspect), and the donor deltopectoral area is covered and epithelialized due to the skin graft. Thus by means of endoscopic expansion we use a nonaggressive technique to increase the surface area of the donor site and to increase its vascularization (delay phenomenon). Because the expander was coated with the graft, the authors were able to cover the anterior wall of the pharyngostome and the donor site in one surgical step.

Aged↗
PubMed1998

Transconjunctival herniation of orbital fat.

The authors present 3 patients with subconjunctival fat prolapse treated at their oculoplastic unit. Albeit rare, orbital fat is a well-recognized entity, and is described in the literature as being associated with trauma and surgery. The 3 patients reported herein, however, presented with no history of trauma or surgery. This condition is produced by herniation of the intraconal fat between the conjunctiva and the sclera, presumably due to dehiscence of the Tenon's capsule. Differential diagnosis should be made with lacrimal gland ptosis, lacrimal gland tumors, and lymphoid tumors.

Adipose Tissue↗
PubMed1997

Tissue expansion with endoscopy.

Tissue expansion is a time-honored technique in plastic surgery. However, while it is possible to rectify quite severe problems, the technique is not free of complications (e.g., extrusion) and, moreover, it can be a lengthy procedure, often taking months. Endoscopy is increasingly being used in plastic surgery and has the advantage that large areas can be dissected using only small incisions. However, in endoscopic plastic surgery the main problem is the lack of an optical cavity. This means that special retractors are needed to keep skin and fat tissue lifted. This paper describes a technique for the placement of tissue expanders during endoscopy. Incisions are not made in the area that is to be expanded and, thus, there is no risk of extrusion and tissue expanders can be fully inflated intraoperatively. A further advantage is that the procedure reduces patient discomfort to a minimum.

Adult↗
PubMed1997

Carpal tunnel release with short incision.

A new approach for carpal tunnel release is presented. By means of a specially designed guide, it is possible to completely section the carpal ligament with a short incision without damaging the carpal contents. When the retinaculum has been sectioned and the guide removed by means of three Senn-Miller retractors, one proximally and two laterally, the median nerve is seen perfectly. We performed an anatomic study to determine where the incision should be made to avoid injuring the vascular arch, the cutaneous palmar branch of the median nerve, and the ulnar nerve. We present the results obtained in 112 patients followed up for 1 year. Complaints about tenderness of the scar disappeared, and by the end of the study, patients had regained 126 percent of their preoperative grip strength. All patients were able to use their hands shortly after the operation, and after 3 weeks, all of them returned to work. We think that by using this approach we combine the advantages of the "endoscopic" technique (minimal scar, no tenderness, and early recovery) with those of the classic open technique (exploration of the carpal contents).

Adult↗