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Background Flexor tendon injury zone V is a multicomponent soft tissue injury involving tendons, nerves, and vessels. Outcome assessment of repair thus requires evaluation of the hand as a whole rather than solely evaluating tendon function. The purpose of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses -compliant systematic review was to identify and assess the components of outcome measures used in flexor zone V.

Electrical current can cause neurological damage directly or by conversion to thermal energy. However, electrical injury causing isolated brachial plexus injury without cutaneous burns is extremely rare. We present a case of a 17-year-old boy who sustained accidental electrical injury to left upper extremity with no associated entry or exit wounds. Complete motor and sensory loss in upper limb were noted immediately after injury. Subsequently, the patient showed partial recovery in muscles around the shoulder and in ulnar nerve distribution at 6 months. However, there was no improvement in muscles supplied by musculocutaneous, median and radial nerves. On exploration at 6 months after trauma, injury to the infraclavicular plexus was identified. Reconstruction of musculocutaneous, median and radial nerves by means of sural nerve cable grafts was performed. The patient has shown excellent recovery in musculocutaneous nerve function with acceptable recovery of radial nerve function at 1-year post-injury.

The head and neck region is an aesthetically demanding area to resurface because of its high visibility. Tissue defects in this area often require distant flaps or free flaps to achieve an aesthetically acceptable result. The use of the Supraclavicular artery flap represents an extremely versatile and useful option for the resurfacing of head, neck and upper torso defects. Furthermore, islanding the flap gives it a wide arc of rotation and the color and texture match is superior to that of free flaps harvested from distant sites. In our study, we used the flap (both unexpanded and expanded) predominantly for resurfacing neck defects resulting from the release of post-burn contractures. However, its applicability in other indications would also be similar. Except one, all our flaps survived almost completely and the post-operative morbidity was very low. We conclude that the supraclavicular artery flap not only provides a reasonably good color and texture match but also maintains the multi-directional activity in the neck region.

Background: Soft tissue defects on the posterior aspect of the elbow are commonly seen in patients treated with internal fixation for fractures around the elbow joint. An axial flap based on the radial recurrent artery (RRA) is very useful for such defects, especially if a posterior midline arm incision has been taken for skeletal fixation. The aim of this study is to describe the usefulness of RRA flap (based on the RRA) in the management of such defects. Materials and Methods: We present a retrospective analysis of 4 cases managed with the RRA flap for soft tissue reconstruction of defects around the elbow joint at our institute from January 2015 to August 2016. All the patients were males with a history of exposed implant following internal fixation of olecranon/distal humerus fracture. The size of defects ranged from 4 cm × 4 cm to 7 cm × 5 cm. Results of the analysis are presented here. Results: All flaps survived completely. There was no infection, hematoma or distal neurovascular deficit. There was minimal donor site morbidity. Conclusion: The RRA flap is a useful, simple flap for defects around the elbow joint in select patients providing one stage, reliable, cosmetically acceptable coverage.

The head and neck region is an aesthetically demanding area to resurface because of its high visibility. Tissue defects in this area often require distant flaps or free flaps to achieve an aesthetically acceptable result. The use of the Supraclavicular artery flap represents an extremely versatile and useful option for the resurfacing of head, neck and upper torso defects. Furthermore, islanding the flap gives it a wide arc of rotation and the color and texture match is superior to that of free flaps harvested from distant sites. In our study, we used the flap (both unexpanded and expanded) predominantly for resurfacing neck defects resulting from the release of post-burn contractures. However, its applicability in other indications would also be similar. Except one, all our flaps survived almost completely and the post-operative morbidity was very low. We conclude that the supraclavicular artery flap not only provides a reasonably good color and texture match but also maintains the multi-directional activity in the neck region.

Context: Surgery for the release of temporomandibular joint (TMJ) ankylosis is a commonly performed procedure. Various interposition materials have been tried with varying success rates. However, none of these procedures attempt to recreate the architecture of the joint as the glenoid surface is usually left raw. Aims: We aimed to use a vascularised cartilage flap and to line the raw surface of the bone to recreate the articular surface of the joint. Settings and Design: There is a rich blood supply in the region of the helical root, based on branches from the Superficial Temporal Artery (STA), which enables the harvest of vascularised cartilage from the helical root for use in the temporomandibular joint. Materials and Methods: Two cases, one adult and the other a child, of unilateral ankylosis were operated upon using this additional technique. The adult patient had a bony segment excised along with a vascularised cartilage flap for lining the glenoid. The child was managed with an interposition graft of costochondral cartilage following the release of the ankylosis, in addition to the vascularised cartilage flap for lining the glenoid. Results: The postoperative mouth opening was good in both the cases with significant reduction in pain. However, the long-term results of this procedure are yet to be ascertained. Conclusions: The vascularised cartilage flap as an additional interposition material in temporomandibular joint surgery enables early and painless mouth-opening with good short-term results. The potential applicability of this flap in various pathologies of the temporomandibular joint is enormous.

Context: Surgery for the release of temporomandibular joint (TMJ) ankylosis is a commonly performed procedure. Various interposition materials have been tried with varying success rates. However, none of these procedures attempt to recreate the architecture of the joint as the glenoid surface is usually left raw. Aims: We aimed to use a vascularised cartilage flap and to line the raw surface of the bone to recreate the articular surface of the joint. Settings and Design: There is a rich blood supply in the region of the helical root, based on branches from the Superficial Temporal Artery (STA), which enables the harvest of vascularised cartilage from the helical root for use in the temporomandibular joint. Materials and Methods: Two cases, one adult and the other a child, of unilateral ankylosis were operated upon using this additional technique. The adult patient had a bony segment excised along with a vascularised cartilage flap for lining the glenoid. The child was managed with an interposition graft of costochondral cartilage following the release of the ankylosis, in addition to the vascularised cartilage flap for lining the glenoid. Results: The postoperative mouth opening was good in both the cases with significant reduction in pain. However, the long-term results of this procedure are yet to be ascertained. Conclusions: The vascularised cartilage flap as an additional interposition material in temporomandibular joint surgery enables early and painless mouth-opening with good short-term results. The potential applicability of this flap in various pathologies of the temporomandibular joint is enormous.

We report a rare case of internal maxillary artery pseudoaneurysm in a patient with a subcondylar fracture of the mandible. Though traumatic pseudoaneurysm in the craniofacial region is a known entity, a situation in which a closed mandibular fracture presents as a rapidly growing swelling in the neck and facial region is a rare presentation. Such a warning sign should be taken seriously and investigated further.

We report a rare case of internal maxillary artery pseudoaneurysm in a patient with a subcondylar fracture of the mandible. Though traumatic pseudoaneurysm in the craniofacial region is a known entity, a situation in which a closed mandibular fracture presents as a rapidly growing swelling in the neck and facial region is a rare presentation. Such a warning sign should be taken seriously and investigated further.