Upper Extremity Blocks for Hand Surgeons: A Literature Review of Regional Anaesthesia Techniques, Efficacy, and Safety.

Regional anaesthesia (RA) techniques have increased in popularity due to evidence of reductions in acute pain, chronic pain, postoperative nausea and vomiting (PONV), and pulmonary complications. While upper extremity blocks (UEBs) have been the subject of several comprehensive reviews, no review to date has synthesised the information on their use in hand surgery. A search of PUBMED and Cochrane databases was performed to identify the evidence associated with upper extremity blocks.

Compressive median neuropathy caused by brachial artery pseudoaneurysm.

Background: Brachial artery pseudoaneurysms (PSAs) are a rare complication of trauma and medical intervention, estimated to constitute 0.3-0.7% of all PSAs.

Cutaneous Mucormycosis of the Upper Extremity: Case Reports Highlighting Rapid Diagnosis and Management.

Mucormycosis is a devastating fungal infection known for its angioinvasive spread and hematogenous dissemination, quickly resulting in multiorgan involvement and potentially fatal complications. Timely diagnosis is essential to facilitate early, aggressive debridement, yet the diagnosis remains difficult to obtain because of the need for culture and microscopy diagnosis. We provide case examples, which highlight diagnostic pearls and the multidisciplinary approach that are critical for improving local outcomes, preventing systemic spread, and reducing mortality.

Systematic Review of Replant Salvage and Cost Utility Analysis of Inpatient Monitoring After Digit Replantation.

Purpose: Digit replantation is a high-stakes procedure that has been shown to be cost-effective, especially for multiple-digit replantation. However, it is associated with prolonged lengths of stay (LOS) for monitoring and attempts at salvage. The cost-effectiveness of prolonged inpatient stays presumes that this is necessary and inherent to the replantation.

Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy.

Circumcision is the most common surgical procedure in males in the United States, and minor complications are not uncommon. Major complications like partial penile amputations have been reported with successful replantation. Complete penile amputations in adult males have been described, and successful replantation has been reported with increasing success.

Limited surgical treatment of suspected necrotizing fasciitis of the upper extremity with a benign clinical presentation.

Necrotizing fasciitis is a rapidly evolving, potentially fatal infection. Current recommendations advocate antibiotic administration and early aggressive surgical debridement. Aggressive surgery is associated with significant morbidity, leaving patients with substantial tissue loss and complex wounds.

Surgical Treatment for Thumb CMC Joint Arthritis.

Thumb carpometacarpal (CMC) joint arthritis is a common and debilitating condition. The mainstay of treatment is conservative management. Surgery is only indicated following failure of a prolonged and comprehensive trial of nonoperative treatment.

Ethical considerations in face transplantation.

Human face transplantation is now a clinical reality. The surgical techniques necessary to perform these procedures have been used routinely in reconstructive microsurgery for many years. From an immunological standpoint since face and hand contain mostly the same tissues it is reasonable to assume that the same immunosuppressive regimen found to be effective in human hand transplants should also work in face transplantation.

Research and events leading to facial transplantation.

Facial transplantation has long captured the interest and imagination of scientists, the media, and the lay public. Facial transplantation could provide an excellent alternative to current treatments for facial disfigurement caused by burns, trauma, cancer extirpation, or congenital birth defects. This article discusses the major technical, immunologic, psychosocial and ethical hurdles that have been overcome to bring facial transplantation from an idea to a clinical reality by providing the reader with a chronologic overview of the research and events that have led this exciting new treatment into the clinical arena.

Composite tissue allotransplantation of the hand and face: a new frontier in transplant and reconstructive surgery.

Each year an estimated 7-million people in the USA need composite tissue reconstruction because of surgical excision of tumors, accidents and congenital malformations. Limb amputees alone comprise over 1.2 million of these.