The Versatile Hook Plate in Avulsion Fractures of the Hand.

Unlabelled: Avulsion fractures can pose technical difficulties for surgical fixation. The fragments are often small and around finger joints with access being difficult due to attachment of ligaments or tendons. Traditionally, these have been treated using K wires, lag screws, or pullout sutures.

Fasciotomy: a call for proper placement.

Introduction: It is important that acute compartment syndrome is recognised and treated early. Treatment involves surgical decompression and it is imperative that this is performed in a timely and appropriate manner. The knowledge of plastic and orthopaedic surgery trainees of the safe technique for performing lower leg fasciotomy was examined.

Free radial forearm fasciocutaneous flap in the treatment of distal third tibial osteomyelitis.

Background: Osteomyelitis of the lower limb, associated with soft-tissue defects, is a reconstructive challenge. Microvascular free-tissue reconstruction is an important surgical option with the superiority of free muscle and myocutaneous flaps being explored by various publications. Muscle flaps provide good quality vascularized tissue which can be contoured into defects, but their bulk can often lead to the reconstruction having a suboptimal aesthetic outcome.

Management of complex melanomas of head and neck region.

Though many of the melanomas encountered in the head and neck region are amenable to simple excision and direct closure or skin grafts, there is a subset of patients who are deemed complex cases in view of the large size of the tumour, depth of invasion or proximity to aesthetically and functionally important structures. This was a retrospective study which looked at complex melanomas of the head and neck region treated in the last 10 years. There were a total of 19 cases, including four women and 15 men.

Hand surface area--do racial differences exist?

The patient's own palm is used as a template in assessing small patchy burns and is traditionally believed to be 1% of body surface area. This does alter with the patient's age, sex and BMI and there have been suggestions that it can also differ between ethnic groups. We undertook this study to see if there were any differences in the hand surface area between Caucasians, Orientals and Asians.

Non-accidental burns in children--are we neglecting neglect?

Although many studies have described burn abuse in detail, burns that have occurred as a result of neglect have been studied to a much lesser degree. A retrospective study of 440 hospitalised paediatric burns patients during 2000-2002 inclusive was performed. A multidisciplinary team investigation of suspicious cases was used.

Burns area estimation-an error perpetuated.

In estimating small areas of burns, it is traditionally taught that the patient's palm is 1% of the body surface area. Whether the palm means the palmar surface of the whole hand or palm excluding the fingers, has not been very clear and is a source of confusion to many junior doctors. The ATLS teaching has been in contradiction to the evidence from literature and hence we undertook a study to examine the evidence and practices regarding this issue.