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PubMed1987

1987 Volvo award in clinical sciences. The perception of back pain and the role of psychophysical tests of lifting capacity.

In order to study the predictive value of pre-employment screening tests, a volunteer population of 1,741 men and 1,150 women was questioned about their experience of low-back pain (LBP) and their perception of physical exertion at work. They undertook a battery of tests, including psychophysical assessments of lifting capacity, and they were followed up by postal questionnaire after 1 year. The response rate was 88.7%. The psychophysical tests have proved to be simple and inexpensive to administer; in good hands, they are repeatable. Although psychophysical lifting capacity was less in those with previous LBP, the psychophysical strength tests were poor predictors of future LBP. But when the previous history of LBP was known, then the test results significantly enhanced the prediction.

Adult↗
PubMed1988

Isokinetic trunk and lifting strength measurements: variability as an indicator of effort.

This study examines the hypothesis that force/distance curve variability distinguishes submaximal from maximal efforts in isokinetic trunk and lifting strength tests. Thirty normal subjects were tested on the Cybex Trunk Extension/Flexion (TEF) and Liftask (LT) machines during maximal (100%) and submaximal (50%) efforts. Considering each test separately, visual assessments of curve variability were indeterminate of degree of effort in 28% of TEF and 34% of LT tests. Measurement models of curve variability were more clearly discriminating. When a given subject's test curves were considered together, scaled visual assessments identified the degree of effort in 91% of TEF and 86% of LT results. The measurement models were accurate 90-92% of TEF and 79-92% of LT results. Clinical judgment is required in evaluating effort during tests of isokinetic trunk and lifting strength.

Adult↗
PubMed1992

Self-reported back pain in fork-lift truck and freight-container tractor drivers exposed to whole-body vibration.

To study the long-term health effect of whole-body vibration, a questionnaire on symptoms of ill health was mailed to 242 drivers and a reference group of 210 workers from six harbor companies (response 81%). Vehicles driven were fork-lift trucks and freight-container tractors. Vibration level during a representative working period (vector sum of the frequency weighted acceleration in the x-, y-, and z-directions) was 0.8 m/sec2 for the fork-lift trucks and 1.0 m/sec2 for the freight-container tractors. Only the results concerning self-reported symptoms of the back are described. Of the young (less than 35 years), short-term-exposed drivers, 68% reported that they had back pain regularly vs. only 25% of the reference group of comparable age. With increasing age, the difference in the prevalence of self-reported regular back pain between the drivers and the reference group disappeared. Driving during the 5 years preceding the onset of symptoms seemed to increase the risk of back pain, whereas earlier exposure did not.

Adult↗
PubMed1994

Provisional and definitive prostheses following sinus lift and augmentation procedures.

Sinus lift and augmentation procedures with simultaneous insertion of cylindrical root form implants can be used to treat the atrophic posterior maxilla. The long-term use of a second stage provisional prosthesis is emphasized. The recommended metal-reinforced acrylic resin provisional restoration allows treatment and/or removal of a failing implant and progressive loading before fabrication of the definitive prosthesis. Modifications in prosthesis fabrication after sinus lift surgery and augmentation procedures are discussed.

Bicuspid↗
PubMed1982

Control of manual lifting hazards: II. Job redesign.

Job content and workplace components can be altered to assure that lifting stresses remain within the acceptable limits defined for the industrial population-at-large. The plan for redesign advocates (1) maintaining the weight handled within the recommended limits; (2) modifying the workplace to enhance postural stability and to avoid handling weights and excessive physical loading; and (3) increasing available job time by reducing frequency of lifts and/or introducing appropriate rest periods. Limits recommended by the National Institute for Occupational Safety and Health on acceptable loads are reviewed.

Accidents, Occupational↗
PubMed1990

A muscular endurance training program for symmetrical and asymmetrical manual lifting tasks.

The purpose of this study was to test whether the endurance limits of new employees engaged in symmetrical and asymmetrical manual lifting tasks can be significantly increased through a physical training program. Each subject participating in the training program performed a total of 16 sessions. A control group performed two sessions separated by a 4-week interval. The results of this study showed that endurance time increased by 248% for the symmetrical and 46% for the asymmetrical lifting tasks. Furthermore, the frequency of handling increased by 44% and 34% for these tasks, respectively. The control group showed no improvement in terms of endurance time and frequency of handling. The implementation of a physical training program as a tool to control overexertion injuries in industrial settings is outlined.

Accidents, Occupational↗
PubMed2005

Simultaneous sinus lifting and alveolar distraction of the atrophic maxillary alveolus for implant placement: a preliminary report.

This article describes a procedure for performing simultaneous sinus lifting and alveolar distraction to augment an atrophic maxillary alveolus. This technique is a 1-stage operation that is indicated when the amount of native sinus floor bone is minimal (<5 mm). The technique is contraindicated when there is <2 mm of sinus floor,when a 2-stage operation is needed (sinus lifting, alveolar distraction osteogenesis). Postoperative complications are minimal.

Adolescent↗
PubMed2005

Drill device for sinus lift.

A crestal approach for implant placement in deficient alveolar ridges is presented. The set of drills allows the surgeon to lift the membrane at the floor of the maxillary sinus with a bone disc, without the risk of tearing it. The plastic and cutting drills, respectively, are set in just below the floor of the maxillary sinus. The lifting drill is then slowly inserted from the socket, until a desirable length. Implants were hydroxyapatite coated and had a 3.75-mm diameter. This invention suggests that this is a reliable and predictable technique for the prosthetic rehabilitation of the maxillary posterior regions in the presence of anatomic restrictions for implanting.

Dental Implantation, Endosseous↗
PubMed2004

Endoscopic pretrichial brow lift: surgical indications, technique and outcomes.

PURPOSE: To present an alternative technique for rejuvenating the upper face of patients with high hairlines. METHODS: A chart review was performed to ascertain the longevity and aesthetic quality of endoscopically assisted pretrichial brow lifts. The charts of a single surgeon were reviewed (2000 to 2003). The technique was noted to be consistent, and in the majority of cases, additive to other concurrent procedures. Morbidity was defined as asymmetry, poor longevity, and patient dissatisfaction. All patients were included who had the procedure performed. No exclusions were recognized for race, age, gender, medical history, or any other patient demographic. RESULTS: Results for the clinical outcome were graded as excellent, good, fair, or poor. Subjective and objective assessments were made by using history, examination, and photos. A rating of excellent incorporates symmetry, longevity, smoothness of the brow skin, and patient satisfaction both with the recovery process and with the results. CONCLUSIONS: In properly selected cosmetic patients, the endoscopic pretrichial brow lift is an effective method for rejuvenating the upper face. A more youthful appearance is achieved with the procedure, and it is easily combined with eyelid rejuvenation. We believe that this technique is the procedure of choice for addressing brow ptosis in patients with high hairlines.

Adult↗
PubMed2006

Update on brow and forehead lifting.

PURPOSE OF REVIEW: The purpose of this review is to provide the latest findings in the constantly changing field of brow and forehead lifting. Significant articles published in the last 24 months are reviewed and discussed based on the personal experience of the senior author (F.P.). RECENT FINDINGS: Important anatomical findings have been made over the last few years which will have an impact on plastic surgery of the upper third of the face, with new ligamentous structures of the forehead and more precise landmarks of the supraorbital neurovascular bundle being described. The short-term efficacy of a new device for periosteal fixation has been evaluated and new data have been collated about the time required for forehead periosteal readhesion. SUMMARY: In the last few years there have been important anatomical findings which will allow the development of more detailed and safe techniques for forehead lift surgery. New absorbable materials are available that allow efficient mechanical fixation of the soft tissues. The senior author of this review has extensive personal experience involving more than 400 cases. In addition to commenting on recent articles, we detail the methods we have used over the last 8 years, especially regarding the fixation technique.

Cadaver↗
PubMed2002

Anatomicohistologic study of the retaining ligaments of the face and use in face lift: retaining ligament correction and SMAS plication.

Plastic surgeons have sought to improve nasolabial folds, jowls, jaw lines, and cervical contour with face-lifting procedures that are abundant in the literature. The retaining ligaments of the face support facial soft tissue in normal anatomic position, resisting gravitational change. As this ligamentous system attenuates, facial fat descends into the plane between the superficial and deep facial fascia, and the stigmata of facial age develop. In this study, surgical correction of the retaining ligaments and plication of the superficial musculoaponeurotic system (SMAS) to reposition the structures that have descended with gravitation are discussed. The anatomy of the facial retaining ligaments was studied in 22 half-faces of 11 fresh cadavers, and the localization, extension, and width of the ligaments were examined macroscopically and histologically. Surgical correction of the retaining ligaments and plication of the SMAS have been accomplished in 27 face-lift patients with this anatomicohistologic study taken into consideration. There was hematoma in one patient at the cheek region and a permanent dimple caused by postoperative edema in two patients, with a localization of one zygomatic and two parotidomasseteric ligaments. In one patient, hypesthesia in the mandibular nerve region was seen, which remitted at 14 weeks. There were no other complications, and with a follow-up of 24 months, excellent aesthetic results and a high level of patient satisfaction were encountered.

Adult↗
PubMed2003

A new resorbable tack fixation technique for endoscopic brow lifts.

The endoscopic brow lift is now widely accepted in aesthetic plastic surgery, and various fixation techniques have been described in the literature. New developments and technology have expanded the use of resorbable devices in different surgical specialties, including plastic surgery. The authors present a technique that offers simple, fast, and reliable forehead fixation for endoscopic brow lifts using resorbable tacks. Successful facial rejuvenation was obtained in the majority of the patients without complications, need for follow-up visits to tighten the flap fixation system, or secondary procedures to extract the fixation system.

Absorbable Implants↗
PubMed2003

The safe face lift with bony anatomic landmarks to elevate the SMAS.

The risk for facial nerve injury has been reported to be increased with the inclusion of superficial musculoaponeurotic system (SMAS) elevation as compared with a skin-only face lift. The facial nerve courses through the parotid gland. The SMAS is elevated superficial to the parotid gland. However, in elevating the SMAS anterior to the parotid gland, the facial nerve is at risk of injury where its branches emerge from the anterior edge of the parotid gland. The purpose of this study was to identify bony anatomic landmarks to predict the location of the anterior edge of the parotid gland to avoid injury to the facial nerve branches as they exit the parotid gland. The authors dissected 20 cadaver face halves to determine bony landmarks-the masseteric tuberosity and the inferior lateral orbital rim-to predict the location of the anterior parotid edge. Then they measured the anterior edge of the parotid gland in relation to the vector formed between these two bony landmarks. They identified and measured the most anterior portion of the parotid gland in relation to this vector. Then the most posterior aspect of the parotid gland in relation to this vector was measured. In the 20 dissections, the authors found the most anterior portion of the parotid gland to be 2.7 +/- 1.0 mm anterior to the vector from the inferior lateral orbital rim to the masseteric tuberosity. The most posterior part of the anterior edge of the parotid gland in relation to this vector was found to be 1.0 +/- 1.5 mm posterior to this vector. The parotid gland measured an average of 38.8 +/- 3.5 mm in width from the tragus to the anterior parotid edge. In elevating the SMAS with a face lift, the facial nerve branches can be predicted to exit the anterior edge of the parotid gland, which can be located 38.8 mm anterior to the tragus and near the vector from the inferior lateral orbital wall to the masseteric tuberosity.

Cephalometry↗
PubMed2005

Early postoperative efficacy of fibrin glue in face lifts: a prospective randomized trial.

Fibrin glue is increasingly finding use in plastic surgery at the clinical and basic science level. The authors conducted a prospective, nonblinded, randomized, controlled trial in 30 patients undergoing face lifts to examine the efficacy of fibrin glue in reducing postoperative wound drainage, hematomas, and, in particular, the degree of ecchymosis and edema at 24 hours and at 8 days. Patients were their own controls and were randomized to have the glue on one side of their face only to compare the glued and unglued sides. The patients ranged in age from 42 to 72 years (mean age, 60 years). There was one major hematoma requiring surgical evacuation. In the remaining 29 patients, the mean drainage on the glued side was 26 ml, compared with 33.5 ml on the control, unglued side. This difference was statistically significant numerically (p = 0.037) but was not thought to be surgically significant. Comparing scores among grades of hematomas, ecchymosis, and edema, there were minimal differences between the glued and unglued sides. This study suggests that fibrin glue may not be as beneficial as previously thought in reducing ecchymosis and edema in the early postoperative period after face lifts, and its future role is discussed.

Adult↗
PubMed2005

Brow fixation with the Endotine Forehead device in endoscopic brow lift.

BACKGROUND: The Endotine Forehead device (Coapt Systems, Inc., Palo Alto, Calif.) is an implantable bioabsorbable fixation device designed to provide intuitive, multipoint, distributed tension and repeatable and predictable brow fixation during endoscopic and open browplasty. The purpose of this study was to evaluate early results in a series of endoscopic brow lift cases using the Endotine Forehead device. METHODS: Two versions of the Endotine device were used in this study. One was composed of polylactic acid, and the other was a smaller version consisting of 82/18 L-lactide/glycolide). In a consecutive series of endoscopic brow lift cases, preoperative and postoperative standardized photographs were taken in the Frankfort horizontal plane and three measurements were compared: midpupil to superior brow, midpupil to hairline, and lateral canthus to superior brow. RESULTS: A total of 21 patients (19 women and two men) underwent endoscopic browplasty. Photographs were obtained preoperatively and 54 to 174 days postoperatively. Brow elevation measurements were obtained postoperatively. No significant adverse events were encountered in the follow-up period. CONCLUSION: The Endotine Forehead device provides significant and reproducible brow elevation, with no significant adverse events, as measured at three points in excess of 14 weeks postoperatively.

Endoscopy↗
PubMed2007

An alternative approach to brow lift fixation: temporoparietalis fascia, galeal, and periosteal imbrication.

BACKGROUND: Brow elevation is one of the goals of surgical rejuvenation procedures. In this article, the authors evaluate the results of a frontotemporal suspension-fixation technique by means of temporoparietalis fascia/galeal/periosteal flap imbrication through an open or endoscopically assisted approach. METHODS: A total of 32 female patients aged between 44 and 72 years were operated on under local anesthesia and sedation. In 23 cases, the frontotemporal lift was associated with a cervicofacial lift through separate incisions and in 19 with an upper/lower blepharoplasty performed at the same time or subsequently. The open approach was used in 26 cases and a combined approach with endoscopic assistance and reduced temporal incisions was used in six cases. Preoperative and postoperative measurements were taken between the lower hairline of the eyebrow and the medial and lateral canthal angles. RESULTS: Lateral brow elevation ranged from 3 to 7 mm, with an average of 5 mm. A lasting result was observed during the follow-up period, with partial relapse in five cases. Complications consisted of two transient frontal paresthesias, remarkable periorbital bruising in four cases, and a transient decrease in temporal hair density in six cases (6 to 8 months). No permanent alopecia was observed. CONCLUSIONS: Brow elevation is an essential feature for a pleasing aesthetic result in the periorbital region. The best results are those achieved in association with blepharoplasty. This technique produces stable results, and the incidence of sequelae and complications is acceptable.

Adult↗
PubMed2006

Pursestring thigh lift: direct approach for a problematic deformity.

Extreme thigh lipodystrophy localized in a "saddlebag" distribution can be difficult to treat with conventional body-lift approaches. We present a case of extreme thigh lipodystrophy treated with suction lipectomy and direct excision of skin and fat. The circular defects were closed with pursestring sutures and yielded a greatly improved contour and minimal iatrogenic deformity or scarring. In properly selected patients, the pursestring thigh-lift can provide a superior esthetic result.

Adult↗
PubMed2006

Drag and lift on rotating vanes in granular beds.

We have performed systematic experiments on vane intruders of different sizes and aspect ratios that are immersed and slowly rotated in beds of monodisperse glass beads of different diameters. We find that the torque and lift force on the vane increase with bead size. The measured torque on the rotating vanes follows a scaling behavior that depends on the effective immersion depth and the effective vane diameter. The torque increases with the square of the effective immersion depth and the square of the effective vane diameter, and closely resembles the scaling behavior previously reported for the torque on rotating cylinders. We also find that the vertical lift forces have a supralinear dependence on the effective immersion depth, and qualitatively resemble the plunging forces produced when an intruder is slowly immersed into beds of glass beads.

Journal Article↗