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Objective: First web space is very important for overall hand function. One of the methods frequently utilized to manage contractures in this area are skin transposition flaps harvested from dorsal radial aspect of the index finger. In this study, we present our results with bilobed flap modification of the dorsoradial transposition flap we designed to facilitate the transposition of the flap and to minimize the contour deformity at the donor site. Materials and Methods: A retrospective chart review was made to gather information on eight cases operated using this modification Results: Satisfactory results were achieved and no serious complications were observed in our series consisting of eight patients (10 hands in total) with an average follow-up of 15.3 months. Conclusion: Modification of dorsoradial transposition flap in a bilobed fashion safely minimizes problems related to donor site and at the same time facilitates transposition of the flap. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative lesion of the breast stroma characterized by slit-like pseudovascular spaces lined by endothelial-like spindle cells. It is frequently found as incidental microscopic foci in the female breast and in gynecomastia of the male breast, but it rarely presents as a clinical problem. We report a case of bilateral extreme breast enlargement caused by PASH in an adolescent girl who was treated with subcutaneous mastectomy and reconstruction with breast implants following a recurrence after treatment with free nipple graft breast reduction. [ABSTRACT FROM AUTHOR]

Cutaneous myiasis is a localized infectious disease which affects humans and vertebrate animals. Most common causes of cutaneous myiasis worldwide are dipterous larvae of "Dermatobia hominis" and "Cordylobia anthropophaga." Clinical presentations include nodules, ulcers, creeping eruption, and wound infections which may be localized anywhere on skin including trunk, scalp, and extremities. Here, we present a 30-year-old female patient consulted to our clinic who presented with erythematous lesions on her lower extremities after a visit to South America. According to her travel history, laboratory and imaging results, she was diagnosed with cutaneous myiasis. Etiology, clinical presentation, and surgical treatment options of myiasis, which is very rare in Turkey, are discussed. [ABSTRACT FROM AUTHOR]

Objectives: The problems encountered during recovery of traumatic brachial plexus injuries despite adequate treatment has important socioeconomic impacts. Neurotization of median nerve with brachialis muscle branch of musculocutaneous nerve has become popular recently. Whether it is superior to transfer of brachialis muscle to finger flexors is still unclear. Our research on human cadavers is aimed at examining the possibility of this nerve transfer by quantitatively describing the courses of related nerves. Patients and Methods: Ten upper extremities of 5 fresh cadavers (4 males, 1 female; mean age 46.3 years) were dissected and measurements were made on related nerves. Results: The neurotization of median nerve with brachialis muscle branch of musculocutaneous nerve is not possible in every case due to the distance between posterior fascicular group of median nerve and the brachialis branch, and the size discrepancy between these two nerves. Conclusion: Frequent variations of the anatomic structure originating from interracial differences decrease the applicability of the neurotization of median nerve with brachialis muscle branch of musculocutaneous nerve. [ABSTRACT FROM AUTHOR]

We report outcomes of 17 children with brachial plexus birth palsy that underwent extensor carpi ulnaris to brachioradialis and brachioradialis to abductor pollicis longus transfers to correct supination and ulnar deviation deformity. Mean age at the time of surgery was 8.7 years and mean follow-up time was 21 months (8-44). These patients had marked increases in active forearm rotation and Canadian Occupational Performance Measure scores. Activity performance score on the measure increased from 1.1 to 6.7 and satisfaction score increased from 0.8 to 8.7 at final follow-up. We conclude from our patient series that these tendon transfers are effective in correction of the supination and ulnar deviation deformities in brachial plexus birth palsy. Level of evidence: IV.

Objectives: The aim of this study was to evaluate surgical treatment and follow-up results of patients who presented to our department with sciatic nerve injuries., Methods: The study included 13 patients (12 males, 1 female; mean age 23 years; range 11 to 35 years) who underwent surgical treatment for sciatic nerve injuries. The etiologies of sciatic nerve injuries were penetrating trauma in five patients, firearm injuries in four patients, and motor vehicle accidents in four patients. Injuries involved the knee level in five patients, and above-the-knee level in eight patients. Peroneal nerve involvement was seen in all the patients, and the tibial nerve was involved in 11 patients. Primary repair was performed in six patients, neurolysis in three patients, and nerve grafting in three patients. One patient underwent neurolysis for the peroneal portion, and nerve grafting for the tibial portion. Muscle strength and reflex changes were recorded at every stage of the treatment. Muscle strength was assessed according to the British Medical Research Council scale. The Semmes-Weinstein monofilament test was used for sensory evaluation. The mean follow-up period was 4 years (range 1 to 6 years)., Results: In 11 patients with tibial nerve injuries, the soleus/gastrocnemius strength was measured as follows: M1 in one patient, M3 in four patients, M4 in four patients, and M5 in two patients. Plantar sensation was absent in four patients, while seven patients had at least adequate protective sensation. In 13 patients with a peroneal nerve injury, the strength of the anterior tibial muscle was measured as follows: M0 in three patients, M2 in three patients, M3 in one patient, M4 in three patients, and M5 in three patients. Of these, four patients had persistent insensitivity in the dorsum of the foot, while six patients had protective sensation, and three patients had normal sensation. Two patients with inadequate anterior tibial muscle strength following nerve repair underwent posterior tibial tendon transfer for restoration of foot dorsiflexion. The greatest functional improvement was obtained in cases in which neurolysis was performed; patients undergoing primary repair had better outcomes compared to those where nerve grafts were used. The results were better in thigh level injuries than those in the gluteal region., Conclusion: Low expectations after sciatic nerve repair in the past are now being rapidly replaced by a more optimistic approach. Advances in microsurgery and use of treatment algorithms based on scientific research account for this significant improvement in outcomes after sciatic nerve surgery. Tendon transfers can enhance the success rate and be combined with nerve repair in selected cases.