Management of soft tissue defects of hand with local [posterior interosseous] flaps

Observational case series study. To evaluate the role of Local Flaps in the management of the soft tissue injuries of hand. Study was conducted at BV Hospital, Bahawalpur from June 2002 to May 2003. In this study, we selected cases in which direct skin closure was not possible due to large defect or skin grafting was contraindicated for example in cases where bones and tendons were exposed, or in certain conditions where some secondary procedures may have to be carried out like tendon repair, tendon grafting nerve repair or fixation of fracture. Patients with severely crushed, non-salvageable hands, manageable with primary suturing and skin grafts and Patients with peripheral vascular disease, Elderly diabetic and Patients medically unfit for anesthesia. A total of 10 patients were treated between June 2002 and May 2003. There were 8 males and 2 females [male to female ratio 4:1]. Mean age of the patients was 26.26 years with range between 10 and 60 years. Most common cause of skin defects was agriculture machine injury [6 cases] followed by roadside accidents [2 cases], blast injury [I cases], and electric burn [1 cases]. In 7 patients there was an uneventful recovery. One flap was lost completely, partial flap loss occurred in one case, marginal necrosis and infection noted in one case. Local [posterior interosseous island] flaps are useful for coverage of the skin defects over the hand when applied with proper indications

Profile of medicolegal cases at Jinnah hospital, Lahore

1] To physically equip accident / emergency department of Jinnah Hospital for the management of medico legal cases on scientific grounds 2] To Study the age group and the type of weapon involved 3] To create awareness amongst the social workers, law enforcement agencies and medical personnel about the management of such cases. 4] To suggest appropriate measures to reduce the incidence of these emergencies. Two hundred and fifteen cases of medicolegal nature were collected. These cases visited the Accident /Emergency Department of Jinnah Hospital Lahore during the first six months of the year 2000 [January to June]. A specialized proforma was designed to record the age, sex, and type of weapon inflicting injuries. Out of these 213 cases 182 [85.44%] were male and 31 [14.56%] were female. Majority of the patients were within the age groups of 11-30 year of age [62.91%]. 92 [43.19%] patients were injured because of the blunt weapon, 57 [26.76%] because of the firearms, 38 [17.85%] suffered injuries in road traffic accidents, 23 [10.80%] because of sharp edged weapons and 3[1.40%] patients because of the bums