Dorsal chevron flap for exposure of the proximal interphalangeal joint.

We have used a dorsal V-flap, or chevron flap, to expose the proximal interphalangeal joint. A retrospective clinical study of its use in 16 patients over 5 years is presented, including indications, functional return of movement, and complications. Long-term follow-up showed an average range of active movement of 70 degrees (range, 13-84 degrees).

The injured hand.

Careful evaluation and diagnosis of the injured hand, with appropriate early treatment, can reduce the morbidity of a hand injury substantially. Aim for uncomplicated primary healing of injured structures, keeping oedema, inflammation and subsequent scar immobility to a minimum. If the repair is beyond your surgical skills or experience--refer early.

Simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist.

Simultaneous laceration of both major nerves with flexor tendons at the wrist is a combination injury familiar to any hand surgeon, which has received scant attention in the English-language literature. The causes and pattern of injury in twenty-six patients treated for this condition over a 10-year period were reviewed. Intensive reassessment of eight of these patients revealed good restoration of hand mobility and strength from the repair of tendons, but the results of nerve repair were less reliable.

BMX handlebar. A threat to manhood?

Two cases of a severe scrotal injury--a new, hitherto unreported pattern of injury peculiar to BMX bicycle riding--are reported. Two such injuries occurring within a short period of time prompted us to suggest that scrotal protection, as well as a crash helmet and limb padding, should be made standard safety equipment for all BMX bicycle riders who engage in the sport of jumping.