Bilateral Opponens Replacement in Post Polio Thenar Paralysis, Using Different Techniques. A Case Report.

A patient is presented with bilateral thenar paralysis, due to poliomyelitis. On the right hand a successful abductor digiti minimi transfer was performed. On the left hand weakness of the hypothenar muscles prevented a good result. Subsequently an opponens replacement, using flexor digitorum superficialis from the ring finger, yielded a good result.

Management of the Frostbitten Hand

Twenty cases of moderate and severe frostbite of the hands were analysed to establish trends in surgical treatment. Excision of large blisters and early mobilization in flamazine bags were found to be beneficial. In those patients whose initial skin changes did not extend to the base of the fingers only minor amputations were necessary. The small amounts of necrotic tissue did not interfere with hand movement and operation was therefore delayed until six or seven weeks, so that maximal digital length could be preserved. In contrast, those patients whose initial skin changes involved the whole length of the fingers or extended on to the hands, more proximal amputations were necessary and these amputations were performed at three to four weeks in order to remove the larger amounts of necrotic tissue and facilitate early mobilisation.

The Role of Carbon Fibre as a Flexor Tendon Substitute

Experiments have been carried out on Rhesus monkeys to determine the effectiveness of carbon fibre as a flexor tendon substitute. Though the strength, flexibility and capacity to induce a neotendon make carbon fibre an ideal flexor tendon substitute, induction of fibrosis and accompanying increase in bulk of the implant resulted in failure.

A Review of the Long Term Results of Electric Bar Fire Burns of the Hand in Children

This paper reports on the long term problems of a group of patients who had sustained burns to the palmar aspect of one or both hands between eleven and eighteen years previously. Two of the eight patients who were re-examined had abnormalities of bony development in the hand. It is thought that the contracted scars resulting from the injury affect the growth of the bones of the hand. As development of contracted scars can develop at any time until growth of the hand is complete it is necessary to follow up these children until they reach maturity.

Dupuytren's Contracture—The Role of Fasciotomy

This paper summarises the results obtained in 95 patients treated by fasciotomy, defines the indications for this procedure and describes the operative technique. During a period of seven years a total of 95 patients with 137 fingers affected by Dupuytren's Contracture have been treated by fasciotomy. The minimum follow-up is two years. The oldest patient was 79 years and no patient younger that 50 years was accepted for this form of treatment.

Carpal Tunnel Syndrome Produced by a Post Traumatic Calcific Mass

A report of a case in which a large calcific mass arising after a relatively minor trauma caused a reversible compression of the median nerve at the wrist; another point of interest in this case was that the mass was shortlived and resolved completely without any use of surgical measures.

Recurrent Cavernous Haemangioma of the Extensor Tendons of the Hand.

Haemangiomas arising from tendons are very uncommon and are not usually considered in the differential diagnosis of lesions of tendons. The following report is of specific interest for it presents a case of recurrent haemangioma of the extensor tendons of the hand which could be excised and the hand reconstructed at the same operative procedure.

A Nail Island Flap for Treatment of Macrodactyly

A case of macrodactyly of the middle finger is presented. An easy and versatile one stage surgical method, using an Island axial nail flap is proposed. This method eliminated the need for secondary intervention.