The results of this study suggest that complex orbital fractures can be reconstructed with an even higher degree of accuracy with selective laser-melted PSIs than with PBTM.

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Our previous preclinical study demonstrated that both visible diffuse reflectance and autofluorescence spectroscopy, each of which yields a different set of physiological information, can predict skin flap viability with high accuracy in a MacFarlane rat dorsal skin flap model. In this report, we further evaluated our technique for the early detection and differentiation of venous occlusion and arterial occlusion in a rat groin flap model. We performed both diffuse reflectance and autofluorescence measurements on the skin flap model and statistically differentiated between flaps with and without occlusions as well as between flaps with venous occlusion and those with arterial occlusion based on these non-invasive optical measurements. Our preliminary results suggested that visible diffuse reflectance and autofluorescence spectroscopy can be potentially used clinically to detect both venous and arterial occlusion and differentiate one from the other accurately at an early time point.

BackgroundComplex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner.MethodsA retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study.ResultsWe present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from 4×9 cm (36 cm2) to 15×30 cm (450 cm2) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was 102° (range, 45° to 140°).ConclusionsIn our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.

As a technically demanding skill, microsurgery is taught in the lab, in the form of a course of variable length (depending on the centre). Microsurgical training courses usually use a mixture of non-living and live animal simulation models. In the literature, a plethora of microsurgical training models have been described, ranging from low to high fidelity models. Given the high costs associated with live animal models, cheaper alternatives are coming into vogue. In this paper we describe the use of the chicken aorta as a simple and cost effective low fidelity microsurgical simulation model for training.