The Supraclavicular Artery Perforator Flap: A Comparative Study of Imaging Techniques Used in Preoperative Mapping.

Background:  The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap.

Methods:  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography.

Mechano-transduction effect of shockwaves in the treatment of lumbar facet joint pain: comparative effectiveness evaluation of shockwave therapy, steroid injections and radiofrequency medial branch neurotomy.

Objective: Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain.

Carpal tunnel syndrome caused by a fibrolipomatous hamartoma of the median nerve treated by endoscopic release of the carpal tunnel.

Fibrolipomatous hamartoma has up to now been considered a rare anomaly that most commonly affects the median nerve. Its pathogenesis is controversial. The magnetic resonance (MR) appearance is pathognomonic and precludes the necessity for a diagnostic biopsy.

Analysis of wrist motion following vascularized bone graft to the proximal scaphoid.

Purpose: To determine whether there is any motion loss associated with the 1,2 intracompartmental supraretinacular artery (ICSRA) bone graft to the dorsal scaphoid. The null hypothesis is that placement of a vascularized bone graft in the dorsal scaphoid does not lead to a significant change in range of motion.

Methods: Seven fresh-frozen cadaveric upper extremities were examined.

Blastomycotic hand infections.

We report two cases of disseminated blastomycotic infections with involvement of the hand occurring in the absence of identifiable risk factors.

Factors that affect the clinical course of group A beta-haemolytic streptococcal infections of the hand and upper extremity: a retrospective study.

Group A beta-haemolytic streptococcus is a well-known cause of necrotising fasciitis, which is increasing in incidence and severity. More aggressive soft tissue infections of the hand and upper extremity caused by this organism have been noted in our plastic surgical unit, prompting a five-year retrospective study to find out which factors affect clinical outcomes. The records of 31 patients, 27 male and 4 female, with Group A beta-haemolytic streptococcal soft tissue infections with a mean (SD) age of 25 (12) years were reviewed.

A 7-year experience in utilizing the latissimus dorsi myocutaneous flap for bilateral breast reconstruction.

Due to the benefits of prophylactic mastectomy in women at risk of breast cancer or recurrent disease, we have noted an increase in the number of women presenting for bilateral breast reconstruction. Current dogma stipulates that flaps of abdominal origin constitute the gold standard of breast reconstruction.However, women presenting for bilateral breast reconstruction may either have medical contraindications or be unwilling to undergo a procedure with a significant risk of donor site and/or flap complications.

A 12-year experience using the Brown two-portal endoscopic procedure of transverse carpal ligament release in 14,722 patients: defining a new paradigm in the treatment of carpal tunnel syndrome.

Background: Compared with the open technique, endoscopic carpal tunnel release has a shorter postoperative recovery period but has been associated with an increased risk of iatrogenic injury. Because of morbidity of the open method, including painful scars, pillar pain, tendon adhesions, scar entrapment of the median nerve, chronic regional pain syndrome, and a longer postoperative recovery period, many patients have been treated nonoperatively to circumvent or forestall surgery, resulting in unrelieved median nerve compression and an increased risk of permanent nerve injury.

Methods: Inclusion criteria included a diagnosis of carpal tunnel syndrome based on history and physical examination and electrodiagnostic studies; failure of a short trial of conservative therapy; and advanced disease as evidenced by sensory, motor, or atrophic changes in the median nerve distribution.

Single-cuff Bier's block in the forearm: factors affecting its efficacy and need for supplementation with local anaesthetics.

Bier's block in the forearm is a safe, effective, and reliable method of regional anaesthesia for operations on the upper extremity. We report 155 patients, of whom only 25 had residual sensation after placement of the block, that required additional local anaesthetic. The purpose of this study was to identify the factors responsible for the residual sensation using the single-cuff Bier's block technique.

Hot oil burns--a study of predisposing factors, clinical course and prevention strategies.

A 10-year retrospective study of hot oil scalds was conducted at the Yorkshire Regional Burns Centre from the years 1995-2004. The number of admissions was noted to have increased over this period. Peak occurrence was noted in the 1-5 and the 30-40-year-old age groups.

Hot beverage burns: an 11-year experience of the Yorkshire Regional Burns Centre.

A retrospective study was performed at the Yorkshire Regional Burns Centre from 1994 to 2004 inclusive to determine the changes in treatment and clinical outcomes of patients admitted with hot beverage burns and the effect of changes in referral patterns over this period. Although children under the age of 3 years accounted for 77.5% of all cases of hot beverage scalds, this injury was represented in all age groups.

A variant of Kaplan's accessory branch of the dorsal cutaneous branch of the ulnar nerve: a case report and review of the literature.

Kaplan's accessory branch is an aberrant branch of the dorsal cutaneous branch of the ulnar nerve that arises proximal to the styloid process of the ulna and courses ulnar to the pisiform. Variations of this anomaly have been described as having an end point of connection to the sensory branch of the ulnar nerve, to the motor branch of the ulnar nerve (rare), to the digital nerve at the level of the midhypothenar eminence, or to the proximal interphalangeal joint of the small finger or as running as an independent branch to the volar aspect of the small finger. We report a variant of Kaplan's accessory branch that coursed through the insertion of the flexor carpi ulnaris, a groove on the ulnar aspect of the pisiform, and connected to the ulnar nerve trunk proximal to its bifurcation into its motor and sensory branch.

Injury to the long thoracic nerve as a complication of neck dissection: a case report.

Injury to nerves by dissection of the neck is well recognised. A case report of injury to the long thoracic nerve follows, which has not been previously described.