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Percutaneous treatment of trigger finger 34 fingers followed 0.5-2 years

We performed percutaneous A1 pulley release on 34 trigger fingers in 30 patients with an angiocath needle. Complete release was achieved in all fingers. There were no complications and no recurrences during mean 0.5 (1-2) years follow-up.

Osteocutaneous posterior interosseous flap for reconstruction of the metacarpal bone and soft-tissue defects in the hand.

&NA; A vascularized bone segment of the ulna together with a posterior interosseous fasciocutaneous flap is harvested, including a cuff of the extensor pollicis longus muscle. The authors treated five male patients with metacarpal bone and soft‐tissue defects of the hand using a distally based island osteocutaneous posterior interosseous flap. Their ages at the time of surgery ranged from 15 to 37 years (mean, 24 years). The bone defects were in the first metacarpal in three cases, the fourth metacarpal in one, and the fifth metacarpal in one. The length of the donated ulna ranged from 3 to 7 cm (mean, 5 cm). The follow‐up period ranged from 5 to 92 months (mean, 39 months). All flaps survived completely. The posterior interosseous flap provides thin skin of good texture, together with vascularized bone, for a one‐stage reconstruction of the metacarpal bone and soft‐tissue defects in the hand. (Plast. Reconstr. Surg. 109: 982, 2002.)

Temporomandibular joint reconstruction with free microvascular transfer of the metatarsophalangeal joint: A case report

Free microvascular transfer of the second metatarsophalangeal joint was performed for the treatment of temporomandibular joint ankylosis in a 15‐year‐old male patient. The result is excellent in one‐year follow‐up. The technique seems to be a good alternative to the problem in selected patients.

A new flap from the dorsum of the first intermetacarpal area : The first dorsal intermetacarpal flap

&NA; Soft‐tissue reconstruction of the hand still remains a challenge for plastic and reconstructive surgeons. Several flaps have been described to cover soft‐tissue defects of the digits and the hand. In the first web region, there are some communications between the intermediate artery arising from the dorsal branch of the radial artery and the volar arteries of the thumb and the index finger. Depending on these communications, a new distally based flap is raised from the first dorsal intermetacarpal area. This flap has been used to cover various defects of the thumb in four patients and the distal radial side of the palmar area in one patient. Donor sites have been closed primarily except in one patient. There were no complications, and the results show that this flap is useful to cover soft‐tissue defects of the thumb and proximal phalanx of the index finger as well as the radial side of the palmar and dorsal surfaces of the hand. (Plast. Reconstr. Surg. 100: 914, 1997.)

An unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology.

Medicinal plant extracts are commonly used worldwide. Their use relies mostly on historical and anecdotal evidence and might be so hazardous. Phytophotodermatitis is a well-known entity that is caused by the sequential exposure to certain species of plants containing furocoumarins and then to sunlight. In this article, superficial burn lesions caused by fig leaf decoction that was applied to a patients both upper extremity as a remedy for a dermatitis of unknown etiology is reported. Direct sun exposure is an essential component of phytophotodermatitis. All reported cases to date have in common that patients are exposed to direct sunlight or to artificial UVA lights (like solarium) of varying durations. In our case neither direct sun exposure, other than inevitable indoor UVA influence, nor blister formation was present. The etiologic factors, symptoms, signs, course, and treatment alternatives for phytophotodermatitis are also reviewed briefly.

Custom subatmospheric dressing for fingertip injuries.

Fingertip injuries are difficult to treat. Although the best way is to cover the wound with flap or graft without finger shortening, coverage of the wound with flap or graft cannot be suitable in each case. For some cases, secondary wound healing can be an alternative treatment. In the secondary healing process, to promote the granulation tissue and to reduce wound-healing time, subatmospheric dressing (vacuum dressing) can be a useful method. In this study, a new custom-made subatmospheric dressing method designed for fingertip injuries has been described.

Using a plastic sheet to prevent the risk of contamination of the burn wound during the shower

The shower technique for hydrotherapy was used in the treatment of the burn patients in our burn center. Before showering, the shower trolley (stretcher) was draped with a sterilized disposable plastic sheet to decrease the potential for seeding surface bacteria to open burn wounds. The patients were washed on the draped shower trolley. Samples for culture were taken from the surface of the shower trolley (stretcher) before it was draped with the sterilized disposable plastic sheet following the treatment of a patient. The samples were taken once a week for the first 6 months and only once a month for the last 42 months. At the period of 48 months (4 years), a total of 67 samples were obtained. Results of cultures of all the samples were negative. No patients were contaminated from the surface of the shower trolley during the shower. The use of the sterilized disposable plastic sheet proved to be a most effective procedure to decrease the risk of contamination between patients during the shower.

A new autogenous graft choice in pelvic reconstructions: free vascularized rib (a case report).

Primary or secondary bone tumours are not uncommon in pelvic girdle. In some cases, after radical resection, there is a big bony defect where the prosthesis is not applicable; arthrodesis is the only choice for good functional results. In this instance, the major problem is to achieve the fusion. In this case report, we focused on easy harvesting and minimal time consumption with free vascularized rib graft to achieve the fusion between the resected segments. Two year follow up showed fusion with good functional result.

Outcomes of elderly burn patients requiring hospitalization

Abstract Background: The elderly population is more likely to be affected by accidents, such as burns, compared to younger populations because of their diminished host defense. There is limited data about the outcomes of elderly burn patients requiring hospitalization. Methods: In this retrospective study, we assessed the epidemiology and outcomes of burn injuries in elderly patients (>60 years old) admitted to a burn unit of a tertiary medical center based on patient characteristics, type and extent of burns, treatment, hospital stay and mortality rates. Results: Forty-eight elderly burn patients among 870 burn patients during the study period were evaluated. Fire was the most common cause of burns (77.1%). Most of the burns involved more than 20% of total body surface area. Twenty-six (54.2%) patients died during hospitalization. Although burn surface area slightly and non-significantly increased in patients over 75 years, there was a significantly increased mortality rate in these patients. Multivariate linear regression analysis revealed burn area and age as independent associates of mortality. Conclusion: Our data show a high mortality rate in elderly burn patients. Extensive burns and increased age seem to increase the mortality risk.

Treatment of recurrent temporomandibular joint dislocation.

Temporomandibular joint dislocation is defined as the movement of condyle out of the fossa and the advancement of the posterior surface of the condyle in front of the articular eminence. If this condition becomes chronic, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. In this study, a retrospective analysis is presented examining 73 patients and 83 joints that were treated with hook-shaped miniplates and miniscrews fixed to otolog bone grafts. Records were obtained from archives of the Uludag University Medical Faculty, Plastic, Reconstructive and Aesthetic Surgery Department. The duration of postoperative follow-up was 3–30 months. In one case, the miniplate was fractured, and in two cases, abscesses existed. This study aims to emphasize that using miniplates and otolog bone grafts is more cost effective.