A Case of Intramuscular Lipoma of Thenar Eminence With a Short Review of Published Hand Lipoma Case Reports.

Lipoma is a common soft tissue tumour in the human body, but at the same time is very rare in the palm and rarer still in the thenar region. These lipomas in the hand can give rise to various problems such as cosmetic, functional, and neurological compromise among others and removing them becomes important when symptomatic. Diagnosing a hand pathology becomes important as a missed diagnosis can have long-term functional consequences for a patient. In the case report, we discuss a hand palmar prominence which presented as an effusion and later turned out to be a large lipoma. Further, we also present a literature review of published thenar lipoma cases to throw light on the nuances of this rare pathology location, which, to our knowledge, has not been done comprehensively.

The Outcomes of Flexor Tendon Injury Repair of the Hand: A Clinico-Epidemiological Study.

Background and objective The incidence of flexor tendon injury is estimated to be 7-14 per 100,000 population. In India, such injuries are common and about 5% of these injuries require repair of the flexor tendon. In the present study, we share our experience of hand flexor tendon repair at a tertiary care center in western India. Material and methods Over a period of three years, 45 patients were admitted for tendon repair. After performing a proper evaluation, patients were taken for tendon repair. Primary outcome and secondary outcome parameters were assessed at the end of three months. Physiotherapy was continued for a longer duration in patients with movement restrictions. Data were compiled at each stage. Results The mean age of the patients was 28.84 years (range: 13-68 years) with a majority of the cases belonging to the age group 15-60 years. The majority of hand injuries were accidental (caused by work-related accidents, machine injuries, or animal bites) amounting to 80% (n=36), followed by assault cases (11%, n=5) and self-inflicted injuries, i.e., attempted suicides (around 9%, n=4). Among all injuries, the majority were in zone V (60%, n=27) followed by 24.4% (n=11) of cases in zone II. A few cases were in zone I, III, and IV (2.2%, 11.2%, and 2.2% respectively). The Buck-Gramcko scoring for primary injury was excellent with a recovery rate of 57.78%. Conclusion Flexor tendon injuries should be repaired with the aim of recovering strength as well as mobility. For optimal outcomes, total active motion protocol should be commenced immediately after the surgical repair. However, long-term physiotherapy may be required for attaining desired benefits.

Pisiform dislocation.

A pisiform dislocation is an uncommon injury which can lead to significant morbidity if missed. The literature regarding pisiform dislocation is limited and largely from case reports. In this case, we present a 51-year-old right-hand dominant male who sustained the injury after a fall. He attended the emergency department on the same day and a closed reduction was able to be performed under a haematoma block. On review in follow-up clinic the patient's symptoms had completely resolved.

Comparative study of silver-sulfadiazine-impregnated collagen dressing versus conventional burn dressings in second-degree burns.

BACKGROUND: The advantages of biological skin dressings like collagen are well-known. It makes wound impermeable to bacteria and creates the most physiological interface between the wound surface and the environment. Silver-sulfadiazine-impregnated collagen (SIC) is a type 1 collagen impregnated with silver sulfadiazine (SSD)-loaded alginate microspheres to deliver SSD in a controlled fashion to manage infected burn wounds for an extended period of time with lesser dressing changes. MATERIALS AND METHODS: In this study, we used SIC for the treatment of second-degree burn wounds in 25 patients and compared with similar burn wounds in 25 patients treated with conventional dressings. RESULTS: For SIC-treated group, we observed improved wound healing in all the patients after 7 days except two patients who required skin grafting, and none of them had any serious complications. For conventionally treated group, improved wound healing was seen in 14 patients, whereas the rest of the patients required prolong dressing or skin grafting. All the patients who were treated with SIC were satisfied with healing of wound and pain relief. CONCLUSION: Second-degree burn wounds are well-treated with SIC in the form of good healing, control of infection, and reducing pain without any serious complications when compared with conventional dressing.

Nasal Glial Heterotopia with Cleft Palate.

Congenital midline nasal masses are rare anomalies of which nasal glial heterotopia represents an even rarer subset. We report a case of a 25-day-old male child with nasal glial heterotopia along with cleft palate suggesting embryonic fusion anomaly which was treated with excision and primary closure for nasal mass followed by palatal repair at later date.