> ## Content Index > Fetch the complete content index at: https://www.theplasticsfella.com/llms.txt > Use this file to discover other available public pages before exploring further. # thePlasticsPaper - July 24th - URL: https://www.theplasticsfella.com/july-24th/ - Published: 2022-07-24T11:09:57.000Z - Updated: 2022-07-24T14:22:54.000Z - Description: Curated evidence-based Plastic Surgery, direct to your inbox. It's hard to keep up-to-date. thePlasticsPaper sends you 1 email per week - just the highlights! - Author: PlasticsFella - Tags: thePlasticsPaper, #announcement #### In this week's edition 1. **✍️ Letter from P'Fella** Plastic Surgery is now the most competitive speciality. 2. **🤓 Study on Sunday + Quiz** Hypertelorism and the wide-eyed patient 3. **🤯 Ask the Expert** Don't miss these important signs on Wrist X-Rays 4. **🎭 Upcoming Events** 18 upcoming events for you. 5. **🐣 Tweets of the Week** Memes, virals & threads. 6. **🚀 New Features** Improved navigation, live updates, new search. 7. **📝 Articles of the Week** 3 must-reads, 1 deep-dive for thePlasticsPro **Fun Fact:** thePlasticsFella community spent 71 hours reading content on this platform last week. Good effort ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Letter-from-PFella-3.png) ## **Plastic Surgery is officially the most competitive speciality.** The has always been that question, "is plastic surgery actually competitive?". Now, thanks for the work of [this guy on Twitter](https://twitter.com/jbcarmody/status/1549052276685283328?s=20&t=%5F7ZU7LeEvN13kXdTxVbcyg&ref=theplasticsfella.com); we finally have the answer. And the answer is yes. ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/FX9W1b3X0AEbQ8h.jpeg) Credit: @jbcarmody This is a pretty interesting graph. Essentially it shows that plastic surgery has the highest number of applicants per position in the 2022 match. Man, that's tough. But is this a new concept? Not really. There was a pretty interesting [publication](https://www.sciencedirect.com/science/article/abs/pii/S0022480422002050?ref=theplasticsfella.com) back in 2020 which provided some more details on the application process. "For matched 2020 applicants, integrated plastic surgery had the highest USMLE Step 1 score (249), highest USMLE Step 2 score (tied at 256), and second highest number of abstracts/presentations/publications (19.1)" **So what can you do about it?** Find a mentor, work hard and, of course, do some [interview prep](https://www.theplasticsfella.com/interview/) (sorry, shameless plug). --- ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Study-on-SUnday.png) \- ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Definition-of-Hyperterlorism-1.png) #### Hypertelorism Hypertelorism is a measurement from the dacryon. This is the junction between the maxillary, frontal and lacrimal bones. It is a **radiological**, not a clinical measurement. The average adult interorbital distance can range from 20-30mm. Tessier provides a classification for this. It can be syndromic or non-syndromic: - **Syndromic**: Apert's, Craniofrontonasal dysplasia, Crouzens, Edwards - **Non-syndromic**: Sincipital encephaloceles, facial clefts, midline tumours [Answer this week's question](https://quiz.theplasticsfella.com/?ref=theplasticsfella.com) ## --- ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Upcoming-Events.png) #### 1. [RSTN](https://t.co/oEUzbfsFCl?ref=theplasticsfella.com) \- Life of an academic plastic surgeon, July 26th 2. Pulvertaft Webinar - DRUJ & ulnar head replacement, July 26th. 3. [ISAPS World Congress](https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiHkYPAlpP1AhUBiFwKHTR8B1gQFnoECAIQAQ&url=https%3A%2F%2Fwww.isapsistanbul2022.com%2F&usg=AOvVaw1KHPezm4hISqyTxqmknhFY) \- Istanbul, July 2022 4. [ICCPCA Cleft Congress](https://cleft2022.com/iccpca-webinar/?ref=theplasticsfella.com) \- Edinburgh, July 2022 5. PULM: Pediatric Upper Limb & Microsurgery, August 2022 6. [Yorkshire FRCS(Plast) Course-](http://www.bapras.org.uk/professionals/training-and-education/courses-meetings-and-events/the-yorkshire-frcs%28plast%29-course?ref=theplasticsfella.com) August 12th 7. [AO Hand Trauma Blended Course](http://www.bapras.org.uk/professionals/training-and-education/courses-meetings-and-events/ao-trauma-blended-course---management-of-fractures-of-the-hand?ref=theplasticsfella.com) \- September 26th 8. [ASSH Annual Meeting](https://www.assh.org/annualmeeting/s/?ref=theplasticsfella.com) \- Boston, September 2022. 9. [Head And Neck Siag Day ](http://www.bapras.org.uk/professionals/training-and-education/courses-meetings-and-events/head-and-neck-siag-day?ref=theplasticsfella.com)\- Hull, September 30th 10. [BAAPS Annual Conference 2022](https://baaps.org.uk/about/events/1477/baaps%5Fannual%5Fconference%5F2022?ref=theplasticsfella.com) \- London, September. 11. [European Society of Craniofacial Surgery](https://escfs2022.com/?ref=theplasticsfella.com) \- September. 12. [BAPRAS Celtic Meeting](https://t.co/NfAnON0U4t?ref=theplasticsfella.com) \- Dunblane, Scotland, September 13. [BAAPS 2022](http://www.bapras.org.uk/professionals/training-and-education/courses-meetings-and-events/baaps-2022-the-art-of-aesthetic-plastic-surgery?ref=theplasticsfella.com): London, Step 27th 14. [Skills For Junior Plastic](http://www.bapras.org.uk/professionals/training-and-education/courses-meetings-and-events/surgical-skills-for-aspiring-junior-plastic-surgeons?ref=theplasticsfella.com)s - Alexandra Hospital, 8th Oct 15. [Plastic Surgery, The Meeting](https://www.plasticsurgerythemeeting.com/?ref=theplasticsfella.com) \- Boston, October 2022. 16. [Aec 5.1 Limb Reconstruction](http://www.bapras.org.uk/professionals/training-and-education/bapras-events/aec-5-1-limb-reconstruction?ref=theplasticsfella.com) \- October 26th, 2022. 17. [AEC Limb Reconstruction](http://www.bapras.org.uk/professionals/training-and-education/bapras-events/aec-5-1-limb-reconstruction?ref=theplasticsfella.com) \- Virtual, October 2022 18. [B](https://twitter.com/hashtag/BAPRAS2022?src=hashtag%5Fclick&ref=theplasticsfella.com)APRAS 2022 Congress - November 2022. [Submit your Event](https://beta.theplasticsfella.com/?ref=theplasticsfella.com) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Tweet-sof-the-Werek.png) > If you never seen what a capsular contracture looks like 👇🏽👇🏽 [pic.twitter.com/rXuQVwrFK8](https://t.co/rXuQVwrFK8?ref=theplasticsfella.com) > > — Abdullah Al Qurashi (@QurashiAbdula) [July 22, 2022](https://twitter.com/QurashiAbdula/status/1550532041875275779?ref%5Fsrc=twsrc%5Etfw&ref=theplasticsfella.com) > Love is all we need😂😂😂 [pic.twitter.com/FoDNYdRYRI](https://t.co/FoDNYdRYRI?ref=theplasticsfella.com) > > — Tansu YEĞEN (@TansuYegen) [July 22, 2022](https://twitter.com/TansuYegen/status/1550344162339323905?ref%5Fsrc=twsrc%5Etfw&ref=theplasticsfella.com) > Reddish skin discoloration in the median nerve distribution after carpal tunnel glucocorticoid injection (vasomotor disturbance) [#medtwitter](https://twitter.com/hashtag/medtwitter?src=hash&ref%5Fsrc=twsrc%5Etfw&ref=theplasticsfella.com) [pic.twitter.com/jUeE3CyvUp](https://t.co/jUeE3CyvUp?ref=theplasticsfella.com) > > — Avraham Z. Cooper, MD (@AvrahamCooperMD) [July 22, 2022](https://twitter.com/AvrahamCooperMD/status/1550286780292792322?ref%5Fsrc=twsrc%5Etfw&ref=theplasticsfella.com) --- ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/ask-the-expert.png) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Untitled-design-1.png) #### Radiological signs on Wrist X-Ray **Expert: Karan Choudhry, Orthopaedic Hand Trauma Specialist.** There are 3 important radiological signs to look for when assessing wrist-Xrays. **1\. Gilula’s lines:** proximal and distal carpal rows form 3 arcs. A carpal fracture will disrupt the greater arc and a carpal dislocation with a lesser arc injury. **2\. Signet ring:** A ring-like appearance over the distal portion of the scaphoid because of flexion. The distal pole of the scaphoid overlaps on the waist. It is indicative of scapholunate and lunotriquetral ligament injury. **3\. Terry Thomas sign:** Indicative of a Scapholunate ligament injury on PA view. It may or may not be a result of the initial propagation of the radial styloid fracture. It resembles the teeth gap of the British comedian Terry Thomas. [Follow the Expert on Twitter](https://twitter.com/KaranChoudhry6?ref=theplasticsfella.com) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/New-Features.png) **Improved user experience** P'Fella wanted to make it easier for you to find your educational tools and also stay up-to-date with the new topics. Now, you can quickly find your library, flashcards and interview stations in the top bar. You will also see real-time updates every time a topic is created. p.s you will probably also like the new search function :) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/IMPROVED-NAVIGATION.png) ### --- ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/07/Articles-of-the-Week.png) #### 3 Top Picks 1. **[Tips for Treating Dupuytrens ](https://journals.lww.com/prsgo/Fulltext/2022/01000/Treatment%5FOptions%5Ffor%5FDupuytren%5Fs%5FDisease%5F%5FTips.59.aspx?utm%5Fsource=dlvr.it&utm%5Fmedium=twitter)** Denkler et al.Treatment Options for Dupuytren’s Disease: Tips and Tricks, Plastic and Reconstructive Surgery - Global Open: January 2022 2. [**CDB for Arthritis**](https://pubmed.ncbi.nlm.nih.gov/35637038/?ref=theplasticsfella.com) Heineman et al. A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis. J Hand Surg Am. 2022 Jul;47(7):611-620 3. [**Carpal Tunnel in CRPS patients**](https://journals.lww.com/plasreconsurg/Fulltext/2022/07000/Outcomes%5Fof%5FCarpal%5FTunnel%5FRelease%5Fin%5FComplex.21.aspx?utm%5Fsource=dlvr.it&utm%5Fmedium=twitter) del Piñal et al. Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients, Plastic and Reconstructive Surgery: July 2022 - Volume 150 - Issue 1 - p 93-101 ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/06/Deep-3.png) #### Karapandazic Flap - Original The Karapandzic flap was described in 1974 after a 5-year case series of lip defect reconstruction. This journal club critiques the methods, results and conclusions of this landmark paper. [Journal Club](https://www.theplasticsfella.com/karapandzic-flaps-original-publication/) ---