Multiple Mini Incision Technique for Sural Nerve Harvest: When to Add a Fibular Incision Based on a New Surgical Classification.

Sural nerve is the most common nerve used as a source for nerve grafting. Open harvest with longitudinal incisions produces unsightly scars, and this have led to development of less invasive techniques using endoscopes, nerve stripper, and mini-incisions. Several anatomical classifications have also been proposed due to the variations in the anatomy of the sural nerve.

Nonvascularized Double Metatarsal Transfer After Excision of Epithelioid Hemangioma of Hand: A Case Report.

Case: Epithelioid hemangioma (EH) is an uncommon, benign, locally aggressive neoplasm, and it may present as multifocal lytic lesions with soft tissue involvement in the hand. We report the midterm follow-up of a patient with recurrent EH of the hand that was reconstructed successfully, with a nonvascularized double metatarsal transfer, after tumor excision. To the best of the authors' knowledge, this is the first case report where a nonvascularized double metatarsal transfer has been used successfully after tumor resection.

Does endovascular repair of post-traumatic thoracic vascular injury of the subclavian/axillary arteries followed by brachial plexus injury improve outcome?

Traumatic injuries to the axillary artery or subclavian artery along with a brachial plexus injury are infrequent. Although the traditional management has been conservative because of robust collaterals, the functional improvement of the limb depends on the degree of brachial plexus injury and on the revascularization status. We report three cases of endovascular repair post-traumatic axillo-subclavian artery injuries followed by brachial plexus injury with good functional outcomes.

Endoscopic Anterior Transposition of Ulnar Nerve (EATUN) for Treatment of Tardy Ulnar Nerve Palsy.

Background: Tardy ulnar nerve palsy is the development of late onset ulnar nerve dysfunction and is usually treated by open anterior transposition of ulnar nerve. Open technique is done using a longitudinal incision about 6-8 inch. in length with chances of development of medial antebrachial cutaneous nerve neuromas.

Restoration of elbow flexion in adult traumatic brachial plexus injury - a quantitative analysis of results of single versus double nerve transfer.

Background: Restoration of elbow flexion is one of the key components of adult brachial plexus surgery. Nerve transfers are routinely used to attain elbow flexion.

Purpose: This study aims to quantify the recovery of elbow flexion power and to compare the outcome following single nerve transfer and double nerve transfer to branches of the musculocutaneous nerve in adult traumatic brachial plexus injury.

The Efficiency of WhatsApp in Teleconsultation of Finger Vascularity in Hand Surgery.

Teleconsultation over the smartphone is now widely used in modern medicine in the management of burns, flap cover, upper extremity trauma, and in the assessment of the feasibility of reimplantation in amputated fingers. The development of the WhatsApp application has enhanced the smartphone's efficiency remarkably to transmit images in clinical and academic settings with its failsafe and encrypted technology. In hand surgery, a teleconsultation technology must communicate details of finger vascularity effectively.

Necrotizing soft tissue infection of the upper extremities in patients with diabetes mellitus in a tertiary care center-a retrospective study.

Background: Necrotizing soft tissue infection (NSTI) of the upper extremities is a rare, but potentially life-threatening infection in patients with type 2 diabetes mellitus (T2DM). We analyzed the clinical characteristics and the outcome of NSTI of upper extremities in these patients.

Methods: This was a retrospective study analyzing the clinical characteristics and the outcomes of 33 T2DM patients with NSTI of upper extremities, who were treated in the department of hand surgery between January 2011 and December 2017.

Synovial sarcoma of the brachial plexus - a rare tumor in a rare area: a case report.

Background: Synovial cell sarcomas are usually seen in a juxta-articular location. However, they occur rarely in the head and neck region.

Case Presentation: We report a rare case of brachial plexus synovial sarcoma in a 24-year old South Asian man treated successfully with surgical excision followed by radiotherapy.

Multiple Stab Incisions and Evacuation Technique for Contrast Extravasation of the Hand and Forearm.

Extravasation of intravenous contrast agents in the hand and forearm during computed tomography scanning is rising with the use of automated pressure injectors. The main concern in such a situation is progression to acute compartment syndrome and necrosis of the overlying skin. Management has been mainly nonsurgical comprising upper limb elevation and orthosis, with surgical techniques such as liposuction and saline evacuation mainly used for large volume (>50 mL) extravasations.

The zonal pattern of arterial supply to the brachial plexus and its clinical significance.

Purpose: To provide the anatomical basis of blood supply of brachial plexus for the clinical microsurgical treatment of brachial plexus injury.

Methods: Thirteen adult anticorrosive cadaveric specimens (8 males, 5 females) were dissected in this study. 3 fresh cases (2 males, 1 female) were used to observe the zonal pattern of arteries supplying brachial plexus, and 10 cases (6 males, 4 females) were used to observe the source and distribution of the brachial plexus arteries under microscope.

Management of Hemophilic Cysts and Pseudotumors of the Hand in Bleeding Disorders: A Case Series.

Purpose: Hemophilic cysts and pseudotumors (HCPTs) of the hand are rare and are secondary to bleeding disorders such as hemophilia A and B. This is a report of our experience in the management of this rare condition.

Patients And Methods: Seven male patients with hemophilia A presenting with progressive swelling of the hand were treated between 2004 and 2013 at a tertiary referral hospital.

The clinical and microbiological profile of the diabetic hand: A retrospective study from South India.

Background: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre.

Patients And Methods: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010.

Results: This study included 39 patients, among whom 23 (59%) had necrotizing fasciitis (NF), and 16 (9-abscess and 7-tenosynovitis) had nonnecrotizing infection.

En bloc Excision and Matched Metatarsal Transfer for Expansive Benign Osteolytic Lesions of the Metacarpal.

Purpose: Benign aggressive expansile osteolytic lesions such as giant cell tumors and aneurysmal bone cysts involving the metacarpal head pose problems in management. Unacceptably high rates of recurrence are reported after curettage and bone grafting. An en bloc excision of such tumors ideally requires osteoarticular replacement of the excised metacarpal heads to retain mobility and function.

Open proximal phalangeal shaft fractures of the hand treated by theta fixation.

Background: Many implants and techniques are used for the treatment of open phalangeal fractures with varying grades of stability. The ubiquitous and simple Kirschner (K) wiring does not provide adequate stability to allow early mobilization of fingers. Lister described a combination of coronal interosseous wire and oblique K-wire technique for phalangeal fracture fixation with a stable construct that allowed early mobilization.

Tuberculous botryomycosis of the hand: case report.

We report a case of a 17-year-old boy who presented with botryoid lesions of both hands. These lesions resembled those of cutaneous botryomycosis. We treated him with surgical debridement and were unable to isolate infective agents initially.