Finger replantation: a review of replantation of four fingers in three patients

Finger amputation is a physical and mental trauma. It can disrupt individuals' daily life. Numerous advances are made regarding the replantation of amputated fingers. These all owe to the advances of microscopic surgical methods and respective specialists' understanding of hand traumas. Establishing arterial blood circulation and venous flow are taken to be the most important factors in successful finger replantation. Replantation of four fingers were carried out in three patients. Surgery was done without any additional surgical incision whether in distal fragment or in proximal fragment. Patients were between 18 to 54 years old. One case had smoking background of 15 years given up for 3 months from surgery. Hospital admission was 48 h. Mean surgery time was 5.5 h for each finger. In all cases, replantation was successful. Although our method is technically time-consuming, it can be promising with respect successful results

Subciliary approach for inferior orbital rim fractures; case series and literature review

Objectives: To report the outcome of subciliary approach for inferior orbital rim fractures in a series of Iranian Patients

Methods: This was prospective cross-sectional, being performed during a 12-month period during 2013 in plastic surgery department of Emamreza Hospital of Mashhad. We included 12 patients with traumatic inferior orbital rim fractures who underwent surgical repair through subciliary approach. All the patients were followed for 12 months and were evaluated regarding paresthesia and function as well as presence of a visible scar and lower-eyelid malposition

Results: There were 9 [75.0%] men and 3 [25.0%] women among the patients with mean age of 26.3 +/- 10.6 [range 16-48] years. Of the 12 patients treated with the subciliary approach, 4 [33.3%] experienced complications. One [8.3%] patient showed 1.5 mm sclera at the end of one year follow-up. No ectropion or entropion was reported in our series. In contrast to 3 [25.0%] cases of lower lid visible scar, there was no occurrence of hypertrophic scar

Conclusion: It would be expected that the transorbital approach as it offers good visualization of anterior fractures would result in good outcomes in cases of orbital rim and floor fracture

Diagnostic value of leukocytosis, ESR and CRP in patients with suspected acute appendicitis

This study aimed to determine the value of the ESR, CRP and Leukocyte count in the diagnosis of acute appendicitis. This is a retrospective [descriptive-analytic] study which was conducted from August 2007 until October 2008 in Zahedan. A sample of 426 available patients with suspected acute appendicitis -who had been admitted to Ali-ebne- Abitalib and Khatam-al-Anbia hospitals- were recruited to participate in this study. Patients' demographic data, their blood samples for ESR, CPR and Leukocyte count were collected and sent to the laboratory for analysis. SPSS-16 was used to analyze data. A number of 426 patients were investigated. Nearly 59.9% were male and 81% of the patients had leukocytosis. 214 cases of inflamed papillae [50.4%], 102 cases of exudation [23.9%], 36 cases of gangrene [8.5%] and 25 cases of perforated appendicitis were observed during the operations. Seven cases had abscess or flegmon. Pathological reports of 84 patients [19.7] showed normal appendices. Sensitivity and specificity value of ESR and CRP tests were [71.9 and 39.0%] and [85.0% and 57.0%] respectively. Positive and negative predictive value [PPV and NPV] of both tests were 83, 25, 89, and 48% respectively. ESR and CRP and leukocytosis had significant statistical correlation with phonological results. The results of this study showed that in addition to physical examination, some basic laboratory findings such as ESR, CPR and leukocytosis can be helpful. Among these, the value of CPR in the diagnosis of acute appendicitis is higher

rare case of aplasia cutis congenita

Aplasia cutis congenita is a rare anomaly presenting with the absence of skin. No definite etiology is available. The most common site is the scalp. We present an instance with ACC occurring symmetrically in both sides of the body from chest to flank

Prevalence of palmaris longus agenesis in a hospital in Iran

Background: the prevalence of the palmaris longus agenesis [PLA] has been variously reported to be from 1.5% to 64% in different ethnic groups. Lack of reliable information about the state of the PLA in Iran made us to design a study on the agenesis of the palmaris longus [PL] among Iranian population during 2009

Materials and Methods: one thousand participants were included in this descriptive study. Subjects were patients and personnel of a sample of a major orthopedic surgery center in Iran. The Schaeffer test was used to detect the presence or absence of the PL. An orthopedic resident conducted the test [observer reliability 98%]. The prevalence of agenesis was determined in the sample and its actual prevalence was estimated for the whole population. The role of gender and handedness was also considered in the presence or absence of the PLA

Results: the prevalence of the PLA was estimated to be 22.8% ; 10.2% agenesis on the right side, 5.9% on the left side, and 6.7% bilateral PLA. The relationship between PLA and gender didn’t appear to be significant. Among people with PLA 43% and among people without PLA 17% were left handed [P < 0.05, odds ratio [OR]: 3.7]

Conclusion: the prevalence of the PLA in Iranians seems to be comparable with the average Caucasian values which is estimated to be 22.4% . Furthermore, significant relationship exists between the PLA and left hand dominance