Giovanni Risitano

A FREE VEIN GRAFT CAP INFLUENCES NEUROMA FORMATION AFTER NERVE TRANSECTION

Neuroma formation is a major problem in nerve surgery and consensus about its prevention has not been reached. It has been suggested that vein covering can reduce neuroma formation in transected nerves. In this article, the Authors propose an easy and novel method of covering by nerve stump capping with a free vein graft.

Solitary asymptomatic nodule of the great toe

Subungual exostosis is a benign osteocartilaginous tumor of the ungual apparatus, particularly of the toes. It affects both sexes equally, more frequently in the second and third decades of life. We describe a 6‐year‐old girl who came to our attention because of the enlargement of a pinkish nodule in the distal part of the nail bed of the first toe, progressively elevating the nail plate. History, X‐ray imaging and histopathologic examination led us to confirm our clinical suspicion, excluding any other possible cause of the subungual mass. The peculiar features of this clinical entity, and the possibility of effective treatment by practical surgical techniques, are discussed.

Isolated fracture of the capitate with rotation of the proximal fragment. Case report

A case of capitate fracture in a 28-year-old man, with a 180-degree rotation (volar dislocation) of the proximal fragment is reported. Due to a late diagnosis, the patient presented 2 weeks after trauma. Open reduction and internal fixation with Kirschner wires provided good bone alignment, uneventful healing and a good range of wrist motion was achieved. The authors remind the reader the possibility of capitate fracture, a rare but troublesome event among wrist traumas, requiring a prompt diagnosis and treatment to relief important wrist pain and to restore function. Moreover, in consideration of important vascular complications, producing non-union and arthritis, the emerging role of imaging in detecting even minor signs of bone necrosis, leading to correct surgical indications, has to be taken into account.

An anterior-lateral thigh perforator flap on a recipient brachial-radial vein graft for complex wound reconstruction: A case report

A case of challenging microsurgical reconstruction of a difficult defect in a radiated upper limb is reported. A difficult wound, with tendon and bone exposition, developed on the dorsum of the forearm in a 76‐year‐old patient; she had been radiated since almost 50 years and her left hand had also been revascularized twice with venous grafts between the humeral artery and the superficial palmar arch. After failure of a local flap, an anterior‐lateral thigh perforator flap was successfully transferred with end‐to‐side anastomoses on the arterialized venous graft. Up to date follow‐up shows a good outcome. The Authors discuss the case and review the indications for microsurgical reconstruction in difficult wounds after radiation and ischemic limb conditions.