Stahl's ear is a rare congenital anomaly difficult to correct surgically. This report presents the experience of the Division of Plastic Surgery, University of São Paulo Medical School for managing this anomaly. From January 1994 to September 1999, 15 patients underwent surgery (17 ears). Ages ranged from 7 to 22 (mean 15 years). Six patients were female. Four subjects were of Oriental descent, four were Negroes, and seven were Caucasians. Deformities included two bilateral, four on the left ear, and nine on the right one. Different methods were utilized for correction depending on the elasticity of the cartilage. In the presence of an elastic cartilage, sutures only are employed, otherwise the cartilage is repositioned, as described by Sugino et al. No standard characteristics were noted regarding gender or race, however, there were more unilateral cases and more on the right ear. The results were adequately satisfactory, with the two methods enabling us to recommend these surgical techniques for correction of Stahl's ear.
Introduction: Foot infections are common among diabetic patients with peripheral neuropathy and/or peripheral arterial disease and may be the main factor that leads to major or minor lower-extremity amputation. Most deep infections in diabetic feet are preceded by an unnoticed lesion with local penetration of pathogens into deeper tissues. Knowledge of critical issues for diabetic foot management, such as ischemia, wound-healing principles, immunology and microbiology, has changed the traditional approach to the diabetic foot and has led to new advances. The application of tissue engineering, biomedicine and biotechnology with corrective and instrumental surgical techniques for the management of this disease has become an emerging field with demonstrable advantages. This study provides an updated overview of the orthopedic management for extremity salvage of the diabetic foot with deep infection. Methods: Nine patients (10 feet), 7 men and 2 women, whose mean age at hospital admission was 53 years (ranging from 34 to 72), were evaluated retrospectively after salvage therapy of the extremities. We considered the functional clinical outcome good when the patient was able to wear shoes for insensitive feet, acceptable when the patient had residual deformity requiring custom-made orthosis and poor when the patient required extremity amputation. Results: After a mean follow-up of 6 months (ranging from 4 to 14), an average of 7 surgical procedures were performed (ranging from 2 to 23), including angioplasty in 5 patients and amputation at the level of the Lisfranc joint in one patient. Outcomes were good in 9 feet and acceptable in one foot with braceable residual deformity. Conclusion: We believe that an aggressive approach and the use of new technology has numerous attributes that can help to salvage the extremities of seriously ill patients.
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