Simultaneous transfer of free fibula and radial forearm flaps for complex oromandibular reconstruction.

Several composite free flaps have been described for use in oromandibular reconstruction. Particularly in extensive defects, there may be no single flap which combines sufficient bone stock with thin, pliable, soft tissue. By combining two free flaps, the best osseous and soft-tissue elements may be independently selected, to yield a result superior to that achievable with one free flap alone.

Complex dislocation of the index metacarpophalangeal joint with entrapment of a sesamoid.

Entrapment of a sesamoid in a complex dislocation of the index metacarpophalangeal joint is a rare finding that may make even open reduction difficult. A case of unusual anatomic derangement of the volar plate is reported that highlights the underlying pathophysiology of complex dislocations.

Total lower lip reconstruction with a sensate composite radial forearm-palmaris longus free flap and a tongue flap.

The technique of total lower lip reconstruction with a composite radial forearm-palmaris longus free flap was further refined in this report. A ventral tongue flap enhanced the lip aesthetics by recreating the vermilion. Lip suspension was enhanced by securing the palmaris tendon to the malar eminences as well as to the cut ends of the orbicularis oris muscle.

Transverse lag screw fixation of the midline mandibulotomy.

Transverse lag screw osteosynthesis of the midline mandibulotomy is a rapidly performed technique that results in reestablishment of mandibular integrity and avoids placement of hardware directly beneath a suture line. We have performed transverse lag screw osteosynthesis in four patients over the past 14 months. All patients received postoperative radiotherapy.

Endoscopic-assisted carpal tunnel release: a coupling of endoscopic and open techniques.

Endoscopic-assisted carpal tunnel release (CTR) is a blending of the techniques of the open and endoscopic methods of carpal tunnel release. Endoscopic-assisted CTR increases visualization and safety over commonly performed endoscopic techniques while retaining the advantage of a smaller, more distally located scar and less dissection.