Chenicheri Balakrishnan

The effect of partial-thickness facial burns on social functioning.

The impact of partial-thickness facial burns on the behavior of adults was investigated. Burn injuries of the face often have a deleterious effect on the psychologic well-being of the patient. Even when no skin grafting is performed, there seems to be significant deterioration of the physical and emotional function of adults after they have incurred partial-thickness burns of the face.

Acute carpal tunnel syndrome from thrombosed persistent median artery

We report a case of acute carpal tunnel syndrome from thrombosis of a persistent median artery caused by blunt trauma. The sudden onset of numbness in the median nerve distribution with pain in the fingers in a young adult may provide clues to the diagnosis.

Post-traumatic osteomyelitis of the clavicle: A case report and review of literature.

Osteomyelitis of the clavicle is a rare form of infection occurring from hematogenous spread or trauma. This has been reported following head and neck surgery, and subclavian catheter placement. In traumatic cases, the management involves removal of bone fixation, debridement of the bone and coverage with a muscle flap.

Intraneural lipoma of the radial nerve presenting as Wartenberg syndrome: A case report and review of literature

The superficial branch of the radial nerve is highly vulnerable to trauma, irritation and compression due to its anatomical location. Intraneural lipomas and fibrolipomas arising from the supporting tissues of this peripheral nerve can cause compression of the adjacent nerve leading to symptoms of neuritis of the radial nerve or Wartenberg syndrome.

Fascial release of the pectoralis major: a technique used in pectoralis major muscle closure of the mediastinum in cases of mediastinitis.

Background: The authors’ goal was to demonstrate a technique of gaining added width from the right pectoralis major muscle flap through muscle fascia release, with the hope of attaining sturdier, tension-free dead space closure of the debrided mediastinum in cases of mediastinitis. Methods: The authors measured the preincisional and postincisional widths of the right pectoralis major flap following release of the fascia in nine patients who underwent mediastinal reconstruction using pectoralis major muscle flaps from 2002 to 2004 at the Detroit Medical Center. Results: The average width of the nine muscles was 16.3 ± 1.7 cm before fascia release and 22.1 ± 1.3 cm after release. The average increase in width was 5.8 ± 1.3 cm, with a 95 percent confidence interval of 4.8 to 6.8 cm. A value of p < 0.0001 indicated that this increase in width was statistically significant. After fascial release, the width of the muscles increased by an average of 26.1 percent, with a 95 percent confidence interval of 21.6 to 30.6 percent. Conclusions: The authors present a new technique that can be used to gain additional width from the right pectoralis major muscle in cases of mediastinal reconstruction using the pectoralis major muscle flap. With the added 26 percent of width obtained from the right pectoralis major muscle with fascia release, the authors contend that a sturdier and tension-free closure of the mediastinal dead space can be obtained, further expanding the indications for use of the pectoralis major muscle flap as the sole closure modality in even the most complicated cases of mediastinitis.

Closure of orocutanous fistula using a pedicled expanded deltopectoral flap

Orocutaneous fistulas are associated with considerable morbidity. Closures of these fistulas are a challenge to the reconstructing surgeon. The aim of treatment is to provide healthy tissue to repair both the oral and cutaneous defects. The use of an expanded pedicled deltopectoral flap for the closure of an orocutaneous fistula in a patient who has undergone bilateral neck dissection and radiation is reported.

Intraneural lipoma of the ulnar nerve: A case report and review of literature.

Intraneural lipomas of the peripheral nerve or its cutaneous branches are rare benign tumours. These slow-growing tumours present as asymptomatic swelling, and diagnosis is usually made at the time of exploration. In most cases, these tumours can be enucleated without damage to the nerve fibres.

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Acute carpal tunnel syndrome is the most common compression neuropathy of the upper extremity following trauma. A rare occurence of spontaneous bleeding into the carpal tunnel, presenting as acute carpal tunnel syndrome, is presented.

Self-inflicted specific pattern burns in psychiatric patients

Self-inflicted burns represent a major social and medical problem for society. Differences have been demonstrated between patients who attempt suicide and those who deliberately harm themselves without any intention of killing themselves. These self-inflicted injuries may resemble injuries that are intentionally inflicted by others and may require investigation by protective services. Little is known about these specific pattern burn injuries in psychiatric patients.

Dupuytren's contracture after burns of the upper extremity.

A case of Dupuytrens contracture in a patient with previous history of burns of the upper extremity is reported. Because this patient has no predisposition to the disease, burns of the upper extremity should be considered as a trigger to the onset of the disease.