BACKGROUND Dorsal augmentation of the nose for aesthetic and reconstructive purposes is an important issue in rhinoplasty surgery. This study aimed to compare the two methods of dice cartilage wrapping for dorsal augmentation of the nose including temporalis fascia and alloderm. METHODS In a clinical trial study, 50 patients who needed to augment the nasal dorsum, were enrolled and randomly allocated to two equal groups. In the first group, diced cartilage graft of the patient was wrapped in temporalis fascia and in the second group, a thin sheet of alloderm was used for this purpose. After one year follow up, satisfaction of patients and the expert panel were compared in two groups. Also mean increase in dorsal height was measured and compared in two groups. RESULTS The mean increase of dorsal nasal height one year after surgery in the alloderm and temporalis fascia was 3.13±0.49 and 3.42±0.33, respectively and in the fascia group was significantly higher (p=0.02). The mean of patients' satisfaction in the two groups of alloderm and temporal fascia groups was 7.48±0.92 and 8.04±0.89, respectively (p=0.03). The mean satisfaction of expert panel in the two methods was 7.56±0.81 and 7.7±0.63, respectively (p=0.5). CONCLUSION The use of temporal fascia for covering the diced cartilage in augmentation of nasal dorsum had better results than the alloderm. Patients satisfaction and mean dorsal height was higher in temporal fascia group.
BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases. AIM To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident. METHODS A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated. RESULTS A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively. Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict. CONCLUSION Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.
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