Management of postburn contractures of the upper extremity.

Postburn contractures of the upper extremity are better prevented than treated, but many patients still suffer from this disability, especially after suboptimal primary care or major burns. Principles applicable to release of postburn contractures of the upper extremity are discussed, with a joint-specific review of relevant techniques to accomplish the release of the contracture. Pre- and postoperative care is discussed.

Medial plantar artery island flap for heel reconstruction.

Coverage of soft tissue defects of the heel has been a challenge to reconstructive surgeons in the past. The medial plantar artery flap has facilitated heel coverage since its development in the 1980s. This was a prospective study in 2 centers assessing the complications and durability of this flap primarily in patients with sensory impairment.

Combined repair of lip and palate with pharyngoplasty for late presenting clefts.

A combined lip and palatal repair with an Orticochea sphincter repair was done in nine patients presenting to our cleft team in Nepal and Tibet for the first time after the age of 8 years. This retrospective study assessed the procedure using the outcome measurements of operative morbidity and postoperative nasality and intelligibility of speech. The total median postoperative hospital stay was 2 days (range 1-4).

A rational approach to nasal reconstruction in leprosy.

Destruction of the nasal septum and nasal bones by Mycobacterium leprae and subsequent infection is still seen regularly in leprosy endemic areas. The social stigma associated with this deformity is significant. Many different procedures have been developed to reconstruct the nose.

Assessment of results of opponensplasty.

One hundred and fifty-six opponensplasties carried out on 115 patients at Anandaban Hospital between 1987 and 1997 were reviewed. In most cases a flexor digitalis superficialis opponensplasty was performed. The outcome was assessed by measuring the finger to which the thumb could obtain a pinch grip, the gap between the thumb and little metacarpophalangeal joints, and the satisfaction of the patient.