Salvage of fibular osteocutaneous flap with creation of arteriovenous fistula.

In utilizing free-tissue transfers to reconstruct complex wounds, occasionally a mismatch exists between the donor-flap inflow and the recipient vessel outflow. This occurs more often with fasciocutaneous flaps as opposed to muscle flaps due to their higher resistance. The result of this may be microvascular thrombosis within the system and ultimately flap failure.

Free palmaris longus graft tenodesis effectively treats swan neck adduction collapse secondary to thumb basilar joint arthritis.

Background: Compensatory thumb metacarpophalangeal joint hyperextension may occur with basilar joint arthritis and subluxation. Instability at the metacarpophalangeal joint must be corrected when the basilar joint is operated on. The authors use a simple surgical procedure that provides correction of thumb metacarpophalangeal joint hyperextension by a free palmaris longus graft to provide volar tenodesis across the metacarpophalangeal joint.

Aberrant course of a communicating branch of the ulnar nerve to the median nerve contributing to hypothenar Hammer syndrome.

This presentation represents a unique anatomic predisposition to the development of hypothenar hammer syndrome (HHS). In this case, a communicating branch of the ulnar nerve to the median common digital nerve of the ring finger was identified crossing volar to the superficial palmar arch. This relationship caused thrombosis of the superficial palmar arch proximal to this crossing nerve branch.