A Clinical Analysis of Friction Burns Caused by Electric Scooters

Purpose@#Electric scooters have recently entered into wide use in South Korea because of their eco-friendliness and convenience. Associated accidents resulting in friction burns are also increasing, due to a lack of recognition of the regulations regarding drivable roads and speed limits. We present the clinical characteristics of friction burns induced by electric scooters.M ethods: We retrospectively evaluated the clinical records of 48 patients who visited our institution after accidents involving electric scooters from January 2018 to February 2022. Demographic data, including age, sex, time of the accident, the type and location of the friction burn, and associated injuries, were reviewed. @*Results@#The age of the patients ranged from 15 to 51 years. The most common injuries were superficial partial-thickness dermal burns, while 14 cases involved deep partial-thickness dermal burns. Multifocal injuries were present in a single patient in most cases. The face was the most commonly affected region, followed by the knees. The average treatment period was 13.0 days, but the follow-up period was longer in patients with facial bone fractures or other comorbidities. @*Conclusion@#Friction burns from electric scooters are increasing, but their clinical presentation and related statistics have not been reported yet. Since most patients were not injured or had only mild epidermal burns in regions with enough clothing, appropriate safety equipment can prevent burns from electric scooters. However, once accidents occur, patients often present with multiple other injuries in the extremities, so proper injury evaluation and management should be emphasized for shorter hospitalization and optimal outcomes.

MRI-Induced Full Thickness Burn on the Ear Lobule due to Pulse Oximetry: A Case Report

Magnetic Resonance Image (MRI) has been used as a safe, conventional and harmless diagnostic tool. However, thermal injuries have frequently been reported during MRI scanning due to the heat generated by the reaction with the magnetic field. It is recommended that metal-containing monitoring devices such as pulse oximetry and ECG monitoring leads should be removed prior to the start of the MRI scan, but these monitoring devices are inevitably placed in children or patients in the intensive care unit who have low compliance with the scan. Since the interaction between the metal probe or wire loop of pulse oximetry and the magnetic field can result in high thermal conduction, full-thickness burn can occur over the entire body surface during the MRI examination. Several cases of thermal burns from pulse oximetry on the fingers have been reported. However, we present a case of a full-thickness burn arising left earlobe in a 2-month-old child caused by the high conduction heat from pulse oximetry metal probe.

Huge Abscess due to Mycobacterium Abscessus Infection after Breast Augmentation

Periprosthetic capsular contracture, implant rupture, and deflation are well-known delayed complications of augmentation mammaplasty. However, infection remains the most common cause of reoperation after breast implant surgery. We report the case of a nontuberculous mycobacterial infection with huge abscess formation after augmentation mammaplasty. A 29-year-old woman visited our clinic with enlarged breasts after undergoing breast augmentation at a local clinic 4 years ago. She had no pain and tenderness, except some hardness around the breast margin. Nine months after surgery, her breasts began to grow larger, but showed no other typical symptoms, which led the patient to neglect the enlargement. After exploring through an inframammary approach, a large amount of serous fluid leaked out on both sides and we identified a huge abscess in a pocket localized in the submuscular plane. During exploration, the infected implants, which contained a pus-like fluid with a foul odor, were completely drained. The specimen culture revealed growth of Mycobacterium abscessus, which is a rare cause of infections after breast augmentation. While the overall incidence of mycobacterial infections after breast augmentation is low, our case demonstrates that huge abscess and granuloma formation should be considered as a potential complication of breast surgery.

Early Coverage with Advancement Flap in Laser Induced Dermal Injury on Neck: A Case Report

Burn injury is one of the most common complications associated with laser procedure. A 38-year-old woman underwent laser procedure for skin rejuvenation on her neck at a local aesthetic clinic. At that time, the cooling system installed in the laser machine was out of order without known origin. The patient complained of pain during the procedure, but it was neglected. It resulted in 3(rd)-degree burn involving the subcutaneous fatty layer on her neck. On the fifth day after injury, early debridement and advancement flap was done under local anesthesia. After 7 days postoperatively, total stitch out was done and a 6cm-length linear and transverse scar remained. When deep dermal injury occurs, it will take a long time to heal on its own. Early debridement and advancement flap will be helpful to prevent wide burn scar.

Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates

We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

Atypical Presentation of Subungal Melanoma

Malignant melanomas sometimes present with nail or periungual pigmentation, as a subungual melanoma. This pigmentation also occurs in nonmelanoma skin disorders. Therefore, biopsy is mandatory for the absolute diagnosis. We present an atypical presentation of subungual melanoma in an 81-year-old female patient with no specific periungual pigmentation. She suffered from a crushing injury in her right thumb 2 years ago and had undergone repetitive stump plasty at a local clinic. Recently, she felt intermittent pain at the thumb tip. During the revisional stump plasty, we unexpectedly noted a spread out of dark colored soft tissues the distal phalanx. Pathological examination revealed subungual malignant melanoma. This unusual form of melanoma has a predilection for an acral location, particularly the paronychial region. Even when small pigments are found on the periungual area, careful examination and identification of a component of melanoma is necessary in order to not miss any malignant finger lesion.

Wrist Pain due to Abnormal Extensor Carpi Ulnaris Tendon

No abstract available.

Wrist Pain due to Abnormal Extensor Carpi Ulnaris Tendon

No abstract available.

A Ganglion Cyst of the Temporomandibular Joint

No abstract available.

Complication of Augmentation Mammoplasty using Polysaccharide Hydrogel Breast implant: Two Cases Report

After the use of silicone-filled breast implant was restricted in 1992, PIP Hydrogel (Poly Implant Prosthesis, France) was temporarily used as an alternative which is an organic polymer of polysaccharide and water. This case report draws attention to an unusual presentation following the insertion of a PIP Hydrogel implant for breast augmentation. The first case is about 43-year-old woman who has undergone breast augmentation using PIP Hydrogel implant was admitted to the hospital because of painful swelling in her right breast. On examination, the right breast was larger than the left. At the operation, it was found that the implant on the right side has a large tear in the shell. And the other case is about 47-year-old woman who had capsular contracture on the outer-lower quadrant of both breasts. She came to our institution to replace bigger implants. We removed existing both breast implants (170cc, subglandular), and replaced cohesive gel implant (300cc, submuscular). From 1992 to 2000, the breast implant filled with a polysaccharide gel had been widely used because of its viscoelastic properties and biodegradability. However, there is no long-term safety data that the filler material as a polysaccharide hydrogel is toxic to humans or not. We wish to highlight its unpredictability and unreliability.

Reconstruction of Mutilating Hand with Pollicization and Anteromedial Thigh Perforator Free Flap: A Case Report

PURPOSE: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. METHODS: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. RESULTS: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. CONCLUSIONS: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

Herpes Zoster Infection Involving the Hand and Upper Extremity

PURPOSE: Herpes zoster, or shingles is caused by reactivation of varicella zoster virus lying latent in the ganglion of the dorsal root. It is rare in hand and upper extremities. The aim of this study is to report the shingles occurred in the hand, upper extremity along the various dermatome. MATERIALS AND METHODS: Between October of 2006 and August of 2009, patients with herpes zoster infection in hand and upper extremity were reviewed. The mean age of the patients was 61.4 years, and there were four female patients, one male patient. With the appropriate diagnosis, antiviral agent such as acyclovir(Zovirax(R)), Zovirax(R) cream were applied within 72 hours of skin lesions. Analgesics and wet dressing were commonly applied for relief of acute pain. To prevent the secondary infection and postherpetic neuralgia, tricyclic antidepressants, anticonvulsants and opioids were also prescribed. RESULTS: Herpes zoster infection was occurred along the distribution of ulnar nerve in three cases, radial nerve in one case and medial antebrachial cutaneous nerve in one case. Four patients developed unilateral vesicular eruption with dermatomal rash in addition to severe pain. But, one patient did not show any significant signs on physical exam except dysesthesia along the ulnar nerve distribution in hand and forearm. All of the patients were relieved acute pain, skin rash within 1-2 weeks. There were no recurrence and complications during the one year follow-up period. CONCLUSIONS: It is important that hand surgeons should not misdiagnose the possibility of herpes zoster infection even without developed skin rash. Early diagnosis, appropriate treatment can lower the risk of its complications.

Reconstruction of Trochanteric Pressure Sores using Perforator-based Flap from the Ascending Branch of Lateral Circumflex Femoral Artery

PURPOSE: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. METHODS: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. RESULTS: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was 6 x 4 cm. The largest flap dimension was 14 x 7 cm. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. CONCLUSION: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.