Reconstruction of a floating thumb with an excess big toe.

In a three-year-11-month-old girl, an excess big toe was transferred microsurgically to replace a congenital floating thumb. The reconstructed thumb was evaluated nine years after the transfer. It showed almost normal growth, compared with the contralateral side, and the aesthetic result was excellent.

Dorsal dislocation of the D.I.P. joint with fracture of the volar base of the distal phalanx.

Between 1978 and 1985, we treated 12 cases of dorsally displaced fracture-dislocation of the I.P. joint of the thumb or of the D.

Operation for the stiff elbow.

Forty two cases of stiff elbow were treated by operation. Thirty three were subsequent to trauma, seven were due to ectopic ossification after quadriplegia, and two were associated with massive ectopic ossification after long term coma following head injury. Two separate skin incisions, postero-medial or medial and anterior, were used in most cases.

Transfer of latissimus dorsi to replace a paralysed anterior deltoid. A new technique using an inverted pedicled graft.

A new method of replacement for the paralysed anterior deltoid is described. The latissimus dorsi with its neurovascular pedicle is freed and rotated, and then placed over the anterior part of the paralysed muscle. The lever arm of the transposed muscle is as long as that of the deltoid, and the muscle volume is enough to restore the natural contour of the shoulder.

An experimental study on the "double crush" hypothesis.

An experimental study investigated the vulnerability of peripheral nerves in the "double crush" situation. Canine sciatic nerves were studied by means of electrophysiologic and histologic examination. Compression was applied by the KEIO compression clamp, with compression force of 15 g (approximately, 27.