Management of zone II and III finggertip injuries

Hand injuries account for approximately 10 percent of accident and emergency department attendance [6]. The majority of these cases are fingertip injuries. The appropriate treatment following loss of tissue by amputation or avulsion depends upon the level and plane of injury, the functional requirements, the age of the patient and the skill of the surgeon Fifty three injured fingertips distal to the distal interphalangeal joint in 39 patients in El Haram hospital in the period between 2001 and 2003 were subjected to history tacking, clinical examination, first aid management, x-ray examination, suitable coverage and rehabilitation. These cases were seen weekly until healing was completed and then at 3 and 6 months Patients with fingertip injuries were 31 males and 8 females. All males except 3 received their injuries during work, but all females except two received their injuries during household activities. They sustained 53 fingertip injuries, 5 patients had 3 fingers injured, 3 patients had 2 fingers injured, and 31 had only one finger injured. Index middle and thumb were most commonly injured fingers. Index The tactile sensibility was good or excellent in [57 percent] of flaps and the nail looked good in [78 percent] of flaps. Received 21 injuries, middle 16, thumb 9, ring 5, and little 2. There are several options available to the surgeon and it is important to chose the most appropriate procedure for each type of injury. While it is desirable for the patient to return to maximum function as soon as possible

Results of Z-plasty procedure for treatment of complicated pilonidal sinus

In the past, various methods of surgical or non-surgical treatment of sacrococcygeal pilonidal sinus have been used. The most common problem in the treatment of this disease is recurrence. Relatively few data exist that focus on an optimal surgical approach that should be followed in cases of recurrent pilonidal disease. In the present study, our aim was to determine the long-term results of the z-plasty procedure, twenty one patients with complex sacrococcygeal pilonidal sinus, four of them had recurrent disease, underwent Z- plasty procedure between 1997 and 2003. Under general anesthesia, all sinus tracts were resected en bloc, and Z-plasty procedure prepared from the gluteal region. We used a suction drain. We met all patients and recorded their complaints and complications of treatment. Minimal flap necrosis occurred in only one patient [5 percent]. In three patients [15 percent], seroma developed. Wound infection occurred in one patient [5 percent]. The mean hospital stay was 3 days, whereas the mean time to return to work was 14 days. No recurrences have developed in a short median follow-up period of 12 month. The Z- plasty procedure is a good treatment choice for complicated pilonidal sinus because of its low recurrence rate, the short time to return to normal activity, and good long-term results. This procedure has good postoperative results and is a comfortable surgical method for the patient