Popliteal pterygium syndrome is a rare congenital disorder that consists of popliteal webs and craniofacial, genitourinary and extremity anomalies. Only moderate successful surgical excision of the fibrotic band within the popliteal web has been reported because the nerves and vessels in the affected site are short and displaced into the web and they are attached to adjacent tissues. We performed hamstring tenotomy on the ischial tuberosity, tenotomy of the flexor hallucis longus and Z-lengthening of the Achilles tendon on the ankle in our patient, and this was followed by gradual correction using an Ilizarov external fixator. Full extension of the knee joint was achieved at the ninth postoperative week. However, some recurrence of flexion contracture was noted at two years follow-up. Gradual soft tissue lengthening with an Ilizarov external fixator can be one of the optimal procedures when excision of a fibrous band and Z-plasty are not possible due to severe adhesion of the nerves and vessels into a fibrotic band. However, a cautious approach is recommended when considering the high risk of recurrence.
Child ; Contracture/*congenital/*surgery ; External Fixators ; Humans ; *Ilizarov Technique ; Knee Joint/*abnormalities/*surgery ; Male ; Tenotomy

PURPOSE: Reconstruction of postburn scar contractures is one of difficult tasks in burn plastic surgery. A linear scar contracture is usually repaired by using skin grafts, traditional or modified Z-plasty. However, the scar itself remains even if the contracture is released. Therefore, it should be suggested to reduce scars at the time of release of scar contractures. For this purpose, we have designed the Y-V flap method. This paper is presents our clinical experiences for reconstruction of postburn linear scar contractures and scar reduction by newly designed the Y-V flap. METHODS: We had 3 cases of postburn scar contractures with depressed deformities in extremities, buttock using the newly designed the Y-V flaps. The Y-V flap is made by the V shaped flap at a right angle to the scar band and it is advanced to Y incision site of opposite edge of the scar band, and this flap can correct the linear contracted scar band with moderate scar reductiontion. RESULTS: 2 cases of the postburn scar contractures were treated using the Y-V flaps. 1 case of scar contractures of extremities was reconstructed using Y-V flap and multiple Z-plasties. After postoperative follow up, relatively satisfactory results were obtained in all cases. CONCLUSION: We have had successful reconstruction of postburn scar contractures with depressed deformities by newly designed Y-V flap. The design of Y-V flap and its reliability have been introduced. The Y-V flap can be used effectively for the correction of linear scar contractures with depressed contour deformities and scar reduction.
Burns ; Buttocks ; Cicatrix* ; Congenital Abnormalities ; Contracture* ; Extremities* ; Follow-Up Studies ; Skin ; Surgery, Plastic ; Transplants

BACKGROUND: Camptodactyly refers to permanent flexion contracture at the proximal interphalangeal joint. Most cases are limited to fifth-finger involvement. Although common, the treatment of camptodactyly is controversial. Many published studies have emphasized conservative treatment, while others have described surgical procedures. The problem with this deformity is that it presents in several forms, which means that there is no single model for effective treatment. The aim of this paper is to present the difficulties encountered with this condition and the management thereof on an individual basis. METHODS: This is a case series of 14 patients (nine males, five females) who underwent surgical treatment. The results were classified using the method from Mayo Clinic as excellent, good, fair, and poor. RESULTS: Fourteen patients with 15 fingers underwent surgery, and the results achieved were as follows: excellent, 0; good, 1; fair, 6; poor, 8. The treatment of camptodactyly still remains controversial, and hence proper planning individualized to each patient is needed to achieve the maximal improvement with realistic goals. CONCLUSIONS: Although we performed individualised surgery, our careful follow-up was not able to identify any method as superior over another with respect to gain in extension and loss of flexion. We therefore propose that the extensor mechanism should not be disturbed during surgery to treat camptodactyly cases.
Ankylosis ; Congenital Abnormalities ; Contracture ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Plastics* ; Surgery, Plastic*

PURPOSE: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. METHODS: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. RESULTS: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. CONCLUSION: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.
Adolescent ; Ambulatory Care Facilities ; Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Eyelids ; Forehead ; Humans ; Nevus ; Parents ; Skin ; Surgery, Plastic ; Transplants

The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*

There is one problematic part of the facialplasty procedure that has been addressed with relative infrequency in the plastic surgery literature. Hypertrophic scar, deformed tragus and "pixie ear" deformity, the problems associated with the design and closure of the periauricular incisions, are still recognized. Prevention of these undesirable results of facialplasty is the surgical challenge about which this article is concerned. In facelift, pretragal incision leaves long scar formation on preauricular area and retrotragal incision occasionally makes the unnatural tragus. Since the marginal tragal incision consists of several short segments, it can prevent tragal deformity caused by scar contracture and preserve shape of the tragus. Putting 2 anchoring key sutures on just above the ear and at the mastoid area minimizes the tension on the incision line and minimizes postoperative ear deformity. We experienced 42 face lifting procedures in patients with aging face during the last 6 years(from Dec 1999 to May. 2005). Complications were hematoma in four cases(9.5%) and focal wound dehiscence in two cases(4.8%). The patients with the complications completely recovered 3 months later.
Aging ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Ear ; Hematoma ; Humans ; Mastoid ; Rhytidoplasty* ; Surgery, Plastic ; Sutures ; Wounds and Injuries

Inverse Duane's retraction syndrome is very uncommon. Congenital cases are even more unusual. A 6-year-old girl with convergent squint along with severe restriction on abduction is described. On attempted abduction, a narrowing of the palpebral fissure, upshoot and retraction of the eyeball were observed. Brain and orbit MRI demonstrated no intracranial or intraorbital mass, fracture, or entrapment of the medial rectus. Forced duction test was strongly positive. The primary lesion was found to be a tight medial rectus with shortening and soft tissue contracture. Surgical tenotomy of the medial rectus led to successful postoperative motility, but some limitation at full adduction and abduction persisted. This is a case reported with congenital medial rectus shortening, suggesting that this condition may be one of the etiologies of the rare inverse Duane's retraction syndrome.
Case Report ; Child ; Contracture/physiopathology ; Contracture/etiology ; Duane Retraction Syndrome/surgery ; Duane Retraction Syndrome/physiopathology ; Duane Retraction Syndrome/congenital* ; Duane Retraction Syndrome/complications ; Eye Movements ; Female ; Human ; Oculomotor Muscles/surgery ; Oculomotor Muscles/physiopathology