Musculocutaneous neurotization to restore elbow flexion in brachial plexus paralysis.

Brachial plexus injuries may result in devastating paralysis, especially if they involve all the roots. The upper roots are often traumatized, and therefore elbow flexion is usually lost. The prognosis of these injuries is grave if root avulsions are present and the paralysis includes the hand as well.

Knee dislocations and their management. A report of 16 cases.

We retrospectively studied the outcome of 16 knee dislocations. 11 patients had surgical treatment, 4 were managed nonoperatively and 1 patient died. In the elderly the outcome was poor, regardless of the type of treatment.

Complete versus incomplete nonviable amputations of the thumb. Comparison of the survival rate and functional results.

81 patients with 84 complete (55) or incomplete (29) nonviable amputations of the thumb were studied to compare the survival rate and functional results between the two groups. 3 of these patients had bilateral thumb amputations. Of the 55 completely amputated thumbs, 43 survived (78 percent), while of the 29 incomplete nonviable amputations, 25 were salvaged (86 percent).

Osteonecrosis of the femoral head in immunosuppressed patients: hip salvaging with implantation of a vascularised fibular graft.

Osteonecrosis frequently occurs in patients being treated with steroids for conditions such as systemic lupus erythematosus and other collagen diseases and in renal transplant recipients. It remains an unsolved problem and can cause more disability than the underlying disease, particularly in young patients. In a series of eight young patients who received continuous corticosteroids and immunosuppressive agents, we attempted hip salvage in ten joints by implantation of a vascularised fibular graft into the necrotic femoral head.

Distal phalanx microsurgical replantation.

Replantation of a completely amputated part of the distal phalanx, which has a very small vessel size, has been reported by several authors with a varying rate of success. Drainage through venous anastomosis is not always possible. In 12 completely amputated fingers, at the level of, or more distal to, the distal interphalangeal joint, we attempted microsurgical replantation with a successful outcome in ten cases.