Free myocutaneous flap transfer to treat congenital Volkmann's contracture of the forearm.

The purpose of this study is to report our experience with free functional muscle transfer procedures for the late sequelae of the rare condition of congenital Volkmann's ischaemic contracture of the forearm. Four children, with an average age of 9.5 years (range 1.5-17), were treated and were followed for a mean of 6 years (range 1-14). Two patients had dorsal forearm contractures, and two had both flexor and extensor forearm contractures. We carried out free functional muscle transfers to replace the flexor or extensor muscles. The functional result was assessed according to the classification system of Hovius and Ultee. All patients had wrist contractures and skeletal involvement with limb length discrepancy that influenced the outcome. All five transferred muscles survived and improved the function of the hand in three of the four patients. LEVEL OF EVIDENCE 4.

Erythromycin: drug interactions.

The purpose of this article is to provide the dental hygienist with an understanding of potential drug interactions that can occur between the antimicrobial agent, erythromycin, and other medications. Erythromycin is the drug-of-choice against oral infections and to prevent infective endocarditis in patients who are allergic to penicillin. Erythromycin has the potential to interact with many medications by inhibiting drug metabolism in the liver. Several reports and controlled studies have shown that erythromycin may interact with theophylline, carbamazepine, cyclosporin, tacrolimus, warfarin, digoxin, terfenadine, astemazole, cisapride, lovastatin, triazolam, and disopyramide. During data collection, the hygienist can identify potential drug interactions with erythromycin. The majority of these interactions can be safely managed by using another antimicrobial with a similar spectrum of activity. If this cannot be done, the patient's physician should be consulted.