Soft Tissue Chondroma Presenting as a Dermal Mass in the Toe

No abstract available.

Aesthetic Improvement of Burn Scar by Tangential Excision and Thin Split Thickness Skin Graft

BACKGROUND: Burn injuries of the extremity can result in cosmetically offensive appearance. Postburn scar can improve by the combination of tangential excision and thin split-thickness skin graft. METHODS: From January 2005 and December 2012, 17 patients (10 males and 7 females) with postburn scar of the extremity underwent the combined techniques. The median time from initial injury to surgery was 66.2 months (range: 11-288 months). In the operation, burn scar was excised until viable dermis could be observed using electrical dermatome, after which thin split thickness skin graft was performed. RESULTS: Tangential excision and thin split thickness skin graft gave excellent grafting results without the need of reoperation. Depigmentation in the majority of patients were recovered within a year by the operation of thin split thickness skin graft. Recovery of range of motion and cosmetic results were good in all patients. CONCLUSIONS: Tangential excision and thin split thickness skin graft are a good way of the reconstruction of deformed and depigmented skin from burns on extremity.

C-Arm Fluoroscopy for Accurate Reduction of Facial Bone Fracture

BACKGROUND: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. METHODS: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. RESULTS: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. CONCLUSION: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.

Heterodigital Free Flap of Index Finger Amputee for Coverage of the Long Finger Soft Tissue Defect

If the replantation on the original position is not possible, the amputated tissue of a hand may be used as a donor for recovering hand functions at other positions. This procedure is termed 'heterodigital replantation'. An 63-year-old male patient who was in press machine accident came to our hospital. He had large dorsal soft-tissue defects (5x3 cm) on his left long finger and complete amputation on his left index finger through the proximal interpharyngeal joint. Replantation was not indicated because crushing injury of index finger was severe. So we decided to use index finger soft tissue as heterodigital free flap for the coverage of the long finger defect. The ulnar digital artery and dorsal subcutaneous vein of the free flap were anastomosed with the radial digital artery and dorsal subcutaneous vein of the long finger. The heterodigital free flap provided satisfactory apperance and functional capability of the long finger. The best way to treat amputation is replantation. But sometimes surgeon confront severely crushed or multi-segmental injured amputee which is not possible to replant. In this situation, reconstructive surgeons should consider heterodigital free flap from amputee as an option.