手术矫治Poland 综合征

目的探讨手术矫治Poland 综合征的方法. 方法 1990年5月～2002年5月,对3例年龄分别为3、12和16岁的女性Poland综合征患儿进行了胸壁成形术矫治,患儿均有胸大肌缺如、胸小肌发育不良及肋软骨缺损等畸形.其中1例行自身肋软骨移植、右侧背阔肌移位术,另2例行自身肋软骨移植、涤纶布片修补术. 结果术后分别随访1、7和10年,结果显示患儿胸壁外观恢复满意,患侧上肢及胸背部功能正常,生长发育无异常. 结论 Poland综合征是一组涉及多部位的先天畸形,应根据病变的程度和范围制定手术治疗计划,方可取得较满意的效果.     

柔软固体硅橡胶假体修复Poland综合征胸壁畸形

目的 探索Poland综合征胸壁畸形修复的方法。方法 按照Poland综合征不同个体胸壁畸形的形态定制柔软固体硅橡胶假体，柔软度接近人的胸大肌。手术经畸形胸壁外侧6cm长切口，在畸形区域紧贴肋骨表面分离，将定制假体置入分离出的腔隙内。结果 自2000年10月，7例男性Poland综合征胸壁畸形患者，年龄18～45岁，采用了柔软固体硅橡胶假体置入术，术后随访3～17个月，均获得了较为满意的胸部外观，对称性和柔软度，其中2例术后有积液，经抽吸后消失。结论 采用柔软固体硅橡胶假体修复男性Poland综合征胸壁畸形可获得与健侧接近的柔软度和外形，具有方法简便、手术创伤小的优点。     

Poland’s综合征24例临床分析

目的　总结 2 4例Poland’s综合征的临床表现及治疗方法。方法　对 2 4例病例进行回性研究。对并指畸形行并指分离术 ;对胸部畸形行自身软组织填充或 和硅凝胶乳房假体、硅胶块植入 ,或扩张器植入。结果　 9例行并指分离术者 ,手外形及功能改善 ;14例行胸部畸形矫正术者 ,术后胸部两侧基本对称或外形改善 ;10例胸部畸形末行手术矫正。结论　根据Poland’s综合征患者的年龄及畸形特点、程度 ,分期手术及应用不同的手术方法 ,儿童患者宜先行手部畸形矫正 ,成年患者宜选用能提供足够组织量的肌瓣或皮瓣 ,恢复胸部对称 ,对女性患者应重视乳房的再造及对称     

Poland综合征胸壁畸形的外科治疗（附三例报告）

Poled综合征是一种少见的先天性前胸壁及上肢畸形,又称胸大肌缺损并指综合征.2003年7月至2007年8月,我们行胸壁重建手术矫治Poland综合征胸壁畸形3例,疗效满意,现报告如下.     

部分同侧背阔肌肌瓣修复Poland综合征胸壁畸形

Poland综合征是并不少见的先天畸形 ,发病原因尚不清楚 ,典型征候群包括同侧胸壁及上肢畸形。 2 0 0 0年 9月～2 0 0 2年 5月 ,我们应用同侧部分背阔肌肌瓣修复男性Poland胸廓畸形 2例 ,效果较满意。1　临床资料本组 2例 ,均为男性 ,年龄分别为 19及 2 5岁 ,均表现为右侧部分胸大肌缺失。2　手术方法用美蓝在体表标出需修复的胸大肌范围和背阔肌的切取范围。在患侧胸壁距腋窝底 2cm处起行长 18cmS状切口 ,达深筋膜浅面 ,在此层向腋窝、脊柱及髂嵴方向分离至背阔肌外侧约 2 3处 ,切断背阔肌的起点 ,从其下层向腋窝方向分离 ,找到背阔肌在…     

Poland综合征临床特点与治疗

目的 根据Poland综合征的临床特点,探讨其治疗策略.方法 对15例患者进行回顾性研究,将Poland综合征胸部畸形分为4类:轻度,女性;重度,女性;轻度,男性;重度,男性.分别行自身软组织填充或(和)硅凝胶乳房假体置入术.结果 随访6个月至4年,全部患者胸部外形对称,肌瓣全部成活,无假体包膜挛缩、移位,手术效果满意.结论 Poland综合征临床表现多样,分类方法能够简单而有效指导临床进行个性化治疗,疗效满意.背阔肌肌瓣带蒂或游离移植填充,女性患者结合乳房假体置入,是矫正重度Poland综合征胸部畸形的首选方法.     

Poland综合征临床特点与治疗

目的 根据Poland综合征的临床特点,探讨其治疗策略.方法 对15例患者进行回顾性研究,将Poland综合征胸部畸形分为4类:轻度,女性;重度,女性;轻度,男性;重度,男性.分别行自身软组织填充或(和)硅凝胶乳房假体置入术.结果 随访6个月至4年,全部患者胸部外形对称,肌瓣全部成活,无假体包膜挛缩、移位,手术效果满意.结论 Poland综合征临床表现多样,分类方法能够简单而有效指导临床进行个性化治疗,疗效满意.背阔肌肌瓣带蒂或游离移植填充,女性患者结合乳房假体置入,是矫正重度Poland综合征胸部畸形的首选方法.     

背阔肌肌瓣转移修复Poland综合征胸部畸形

目的 探讨背阔肌肌瓣转移矫治Poland综合征胸部畸形的方法与注意事项。方法 10例患者采用侧胸垂直切口及腋下小切口切取转移背阔肌肌瓣矫正胸壁畸形,注意腋前皱襞的重建。结果 10例背阔肌肌瓣全部成活,随访1～2年,效果良好。结论 背阔肌肌瓣具有稳定、可靠的血供保证,能提供足够的组织量,是修复Poland综合征胸部畸形的理想方法。     

Poland综合征临床特点与治疗

目的 根据Poland综合征的临床特点,探讨其治疗策略.方法 对15例患者进行回顾性研究,将Poland综合征胸部畸形分为4类:轻度,女性;重度,女性;轻度,男性;重度,男性.分别行自身软组织填充或(和)硅凝胶乳房假体置入术.结果 随访6个月至4年,全部患者胸部外形对称,肌瓣全部成活,无假体包膜挛缩、移位,手术效果满意...     

计算机辅助游离脂肪移植治疗儿童Poland综合征胸部软组织畸形的效果

目的探讨计算机辅助游离脂肪移植改善Poland综合征胸部软组织畸形的疗效。方法回顾性分析2016年1月至2021年1月南京医科大学附属儿童医院收治的Poland综合征患儿临床资料。将患儿分为计算机辅助组和对照组。对计算机辅助组进行术前胸部CT检查, 将数据传至3D slicer软件, 依据健侧胸部组织作为对照, 计算出患侧的胸部软组织镜像, 减去患侧现有组织, 所得的三维图像即可直观显示缺损的软组织。把缺损部位分为6个小区域, 先计算每个区域的体积, 再计算出总缺损量, 3D打印出模型。根据术前计算的总缺损量抽取自体脂肪组织, 依据三维模型和对应的缺损量进行脂肪移植注射。对照组患儿由术者根据经验确定术中脂肪移植量进行脂肪移植注射。随访观察患儿术后胸部情况、局部及全身并发症, 记录移植次数。术后6个月复诊, 患儿及家长进行术后满意度评分, 第三方整形外科医师通过对患儿正、侧位照片对比进行满意度评分, 并采用独立样本t检验进行统计学分析。结果计算机辅助组纳入18例患儿, 男8例, 女10例, 年龄为3～12岁, 平均8.3岁。10例进行了1次移植, 6例进行了2次移植, 2例进行了3次移植...     

Autologous rib transplantation and terylene patch for repair of chest wall defect in a girl with Poland syndrome: a case report

Poland syndrome is a constellation of anomalies including absent pectoralis muscle and rib defects, even with malformations of the upper extremity that more often affects boys than girls. This case describes a 5-year-old and 4-month-old girl diagnosed with Poland syndrome that required chest wall reconstruction. An autologous rib transplantation and terylene patch were used for repair of the chest wall defect. The girl had a satisfactory postoperative recovery. This technique was an effective method of treatment of this condition.     

Individualized implant-based reconstruction of Poland syndrome breast and soft tissue deformities

BACKGROUND: Poland syndrome encompasses a constellation of congenital chest wall, breast, and upper-extremity deformities, which present a significant reconstructive challenge for the plastic surgeon. The broad range of chest wall and breast anomalies has led to an equally broad variety of surgical solutions. Often, however, initial attempts at surgical correction fall short because of failure to identify the best reconstructive option for an individual's particular deformity. METHODS: In a retrospective series of 29 patients, we report our institution's experience with reconstructing breast and chest contour deformities associated with Poland syndrome. We also present a review of the literature. RESULTS: The breast and chest wall deformities associated with Poland syndrome can be effectively treated in an algorithmic, individualized fashion. CONCLUSIONS: We propose an algorithmic approach to the patient with a Poland syndrome chest wall and breast deformity.     

Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele

Poland syndrome is characterized by hypoplastic unilateral chest wall structures. These chest wall deformities may be associated with upper extremity anomalies. The association of Poland syndrome with either intercostal liver herniation or a spinocerebral deformity has been described, but there is no report of both findings encountered simultaneously. This is the first report of a newborn child with Poland syndrome associated with an intercostal liver segment herniation and thoracic myelomeningocele with features of an Arnold-Chiari II cerebral malformation.     

Chest Wall Reconstruction With Methacrylate Prosthesis in Poland Syndrome

Poland syndrome is a rare congenital malformation. This syndrome was described in 1841 by Alfred Poland at Guy's Hospital in London. It is characterized by hypoplasia of the breast and nipple, subcutaneous tissue shortages, lack of the costosternal portion of the pectoralis major muscle and associated alterations of the fingers on the same side. Corrective treatment of the chest and soft tissue abnormalities in Poland syndrome varies according to different authors. We report the case of a 17-year-old adolescent who underwent chest wall reconstruction with a methyl methacrylate prosthesis. This surgical procedure is recommended for large anterior chest wall defects, and it prevents paradoxical movement. Moreover it provides for individual remodeling of the defect depending on the shape of the patient's chest.     

Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

Poland''s syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF). In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.KEY WORDS: Capsular contracture, chest wall deformity, gracilis free flap, Poland''s syndrome     

Poland Syndrome: Description of an Atypical Variant

Poland syndrome comprises a unilateral absence of the large pectoral muscle, ipsilateral symbrachydactyly, and occasionally other malformations of the anterior chest wall and breast. The condition is more frequent among males, and usually occurs on the right hemithorax in the unilateral form. The syndrome is believed to be caused by a genetic disorder that reduces the embryonal circulation in the interior chest artery: the stronger the interaction, the more severe the pathology. This article analyzes an unusual pathologic case in which the 17-year-old patient lacked the large pectoral muscle on the left side, but showed no arterial alteration. This case raises questions as to the true pathogenesis of this syndrome.     

Titanium mesh prosthesis repair of symptomatic Poland syndrome in a premature infant

The authors describe a case of Poland syndrome in a ventilator-dependent premature infant with severe chest wall deformities treated during the neonatal period with a prosthetic titanium mesh. The implant significantly improved lung volume and provided stabilization of the chest wall allowing for weaning from ventilator, extubation, and discharge of the patient.     

Ascher syndrome: Review of literature and case report

A 13 year old girl presented with aesthetic deformity of upper lip since birth. She also presented with eyelid swelling on and off for 11 months. She was diagnosed to be a rare case of Ascher syndrome. Ascher syndrome commonly presents with double lip and blepharochalasis, sometimes associated with goitre. The deformity of her double upper lip was corrected by appropriate surgery. Because her blepharochalasis is in active stage now, she is under periodic follow up for appropriate intervention. This article describes the management of the patient and brief overview of the syndrome. Ascher syndrome is often missed or misdiagnosed commonly.     

Congenital Deformities of the Upper Extremity

Congenital deformities of the upper extremity are rare. They are often associated with other, more severe disorders of the cardiovascular, craniofacial, neurologic, and musculoskeletal systems. Most upper-extremity congenital anomalies are minor and cause no functional deficits, and surgical reconstruction is therefore unnecessary. If a severe cosmetic deformity is present or there is significant functional compromise, surgical treatment is indicated. The authors review the common congenital deformities of the upper extremity and offer treatment recommendations.