Reverse on-top plasty in mutilating hand injuries.

For crushing injury of the hand that involves 4-digit amputations sparing the thumb, lengthening of amputated stump and covering the defect are important for hand function. From March 2007 to September 2011, the authors performed "reverse on-top plasty" in 5 patients. The fifth metacarpal bone was disarticulated, turned over 180 degrees, and embedded in reverse direction so that the metacarpal base becomes the tip of new finger.

Ulnar artery perforator free flap for finger resurfacing.

Introduction: The ulnar forearm flap has been performed by many authors for the reconstruction of finger injuries. This article describes the refinement of the perforator anatomy based on ulnar artery and presents our clinical experience using ulnar artery perforator free flap for finger resurfacing.

Methods: An anatomical study conducted in 10 cadaver forearms demonstrated the consistent origin of the ulnar perforator from the ulnar artery 40 mm proximal to the pisiform.

Forehead abscess caused by Klebsiella oxytoca with undiagnosed type 2 diabetes.

Klebsiella is an opportunistic pathogen that is known to cause septicemia, pneumonia, urinary tract infections, hepatobiliary tract infections, and soft tissue infections in patients who have severe underlying diseases or are under immunosuppression. Most Klebsiella species found are Klebsiella pneumoniae, and Klebsiella oxytoca is rarely cultured in humans. We report a case of a 48-year-old man presenting with a soft fluctuating mass on his forehead.

Fibroma of the flexor hallucis longus tendon sheath.

Fibroma of tendon sheath is a rare benign tumor that usually occurs in upper extremities. It is mostly asymptomatic and grows slowly within the tendons or tendon sheaths. Histopathologic findings show well-demarcated nodules consisting of haphazardly arranged fibroblast-like spindle cells, which are embedded in a dense, collagenous matrix.

Reconstruction of fingertip defects with great toe pulp grafts.

Various methods have been used to treat fingertip defects that are caused when distal parts are amputated. In this study, we used the pulp graft harvested from the lateral aspect of the great toe. Between September 2004 and August 2006, the great toe pulp graft were performed on 16 patients.

Giant epidermal inclusion facial cyst.

Epidermal inclusion cyst is one of the most common subcutaneous tumors, and its size normally varies from 1 to 5 cm in diameter. Only few giant epidermal inclusion cysts have been reported in the literature, and giant epidermal cyst of the face has never been reported. An 83-year-old woman visited our hospital for a huge mass on the right side of her face extending to the temporal area, creating deformity of her right ear.

Lymph node compression of the lesser occipital nerve: a cause of migraine.

Recent investigation has focussed on the concept of peripherally triggered migraine headaches caused by compression, irritation or entrapment of the sensory nerves in the head and neck. We report a case of a 52-year-old male suffering from an occipitoparietal migraine that presented with a mass in the right occipital area. The mass was found in the deep layer of subcutaneous tissue just over the semispinalis muscle, sitting on top of the lesser occipital nerve, which was preserved through delicate dissection using loupe magnification.

Cellulitis related to bioabsorbable plate and screws in infraorbital rim fracture.

An absorbable plating system is most commonly used to fix the bones in craniomaxillofacial surgery. Many studies focused on the advantages and clinical utility of absorbable plate and screws, but there are no reports on the complications related to these devices. From March 2004 to March 2009, 430 patients with facial bone fractures including infraorbital rim fractures underwent craniomaxillofacial surgery, in which rigid fixation was achieved with an absorbable plate and screws (Stryker, Freiburg, Germany).

Use of split thickness plantar skin grafts in the treatment of hyperpigmented skin-grafted fingers and palms in previously burned patients.

Palmar and finger burns are often seen in children, and are usually as a result of contact burns. Some patients with deep hand burns are treated with full-thickness or split-thickness skin grafts. Skin graft is commonly used for hand reconstruction.

Submuscular fibrolipoma of the forehead.

Fibrolipoma is a rare variant of lipoma with a mixture of fibrous connective tissue. Clinically, it presents as an asymptomatic, slowly growing mass with a smooth, firm, or soft consistency. Although fibrolipoma can occur in any part of the body, in the head region it mainly occurs in the oral cavity and sometimes in the lip, parotid gland, nose, and cheek.

Extraskeletal chondroma in the auricle.

Extraskeletal chondroma is a rare benign tumor that develops in soft tissues, and histologically, it is a lobulated nodule surrounded by a fibrous capsule, and the inside consists of mature cartilage cells and diffuse hyalinized matrix. It occurs preferentially in the hand and foot area of adults, and the development in the head and neck area is very rare. We had a very rare case of extraskeletal chondroma that developed in the auricle and report the case together with a review of the literature.

Intramuscular lipoma of the sternocleidomastoid muscle.

Intramuscular lipoma is a rare benign mesenchymal tumor that infiltrates the skeletal muscle. These lipomas are usually found on the extremity, but rarely occur in the head and neck. To our knowledge, only 4 cases of intramuscular lipoma in the sternocleidomastoid muscle have been reported in the literature.

Angiomyoma in the buccal space.

Angiomyoma is a rare benign tumor originated from vascular smooth muscle cells, in other words, the tunica media, and the characteristic is the detection of numerous blood vessels together with spindle-shape smooth muscle cells. In most cases, it occurs in the subcutaneous tissue of the limbs, especially in the lower limbs, but it is very rare that it occurs in the head and neck area. In the head and neck area, it is developed most frequently in the larynx and the turbinates, and in addition, the development in the oral cavity (lip, hard palate, tonsil), nose, ear, cheek, parotid gland, and submandibular region has been reported.