https://www.selleckchem.com/products/pfk158.html The spiral rotational advancement flap is a single-stage technique that has been described for the closure of nasal ala defects and in nipple reconstruction. Herein we present our experience using the spiral flap for closure of moderately sized defects of the scalp vertex in children. Compared to other scalp reconstructive approaches, such as a simple rotational flap or primary linear closure, the spiral flap design offers improved cosmesis through recreation of the natural whorl pattern within the hair-bearing scalp. Scar camouflage is especially important in the pediatric population, as increased skin elasticity and continued cranial growth impart a high risk of scar widening in children. The electronic patient database at a single, urban, academic, tertiary pediatric otolaryngology and facial plastic surgery practice was queried to identify children who had undergone scalp reconstruction. The medical records of three children who had undergone spiral rotational advancement flap closure by a single surgoach has the added advantage of simulating the natural hair whorl in a cosmetically sensitive region and may serve as an effective alternative to linear reconstruction methods. The technique described can be added to the armamentarium of the pediatric plastic surgeon. To calculate the minimal clinically important difference (MCID) of the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Computer Adaptive Test (UE CAT) and Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH) for ligament reconstruction tendon interposition (LRTI) patients. Adult patients treated with LRTI for trapeziometacarpal OA by fellowship-trained hand surgeons between December 2014 and February 2018 at an academic tertiary institution were included. Outcomes were prospectively collected at each visit by tablet computer, including the QuickDASH, PROMIS UE, Pain Interference, Depression, and Anxiety CATs. In