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Polydactyly is one of the hand's most frequent congenital deformities. Classification of this deformity distinguishes radial or thumb duplication, central duplication that is almost constantly associated with syndactyly (called polysyndactyly) and ulnar duplication. The latter is important especially in caucasian people because it can be part of a syndrome. Surgical techniques are briefly mentioned for the different forms.

The authors present a series of 44 cases of sensory disorders in the radial nerve territory. Eighteen cases of pure painful neuromata gave, excellent results according to Herndon criteria in 11 cases with various techniques. Wartenberg neuritis (22 cases) was found to respond favorably to conservative treatment in the majority of cases (19 cases). A legal problem can arise from association with De Quervain disease if the condition has not been recognized before surgical release of the first compartment. Finally 9 cases are presented with intricate pathology of neuroma plus neuritis. Treatment addressing both conditions provided good results.

From 1982 to 1988, 127 flaps were performed after ablative surgery for head and neck squamous cell carcinoma: 86 pedicled pectoralis major island and 41 free flaps of different types. One hundred and four were evaluable for this retrospective study: 66 after definitive radiotherapy (6000-8000 cGy) and surgery for recurrent or persistent disease and 38 after elective surgery for Stage III and IV tumors without previous irradiation. Wound healing, hospital stay, survival rate and complications are compared between irradiated and nonirradiated areas. The indications, advantages and disadvantages of each type of flap are reviewed according to the main goals of our treatment: i.e. local disease control, restoration of function, cosmetic appearance and short hospital stay.

A considerable body of literature defines techniques to restore glottic function after partial laryngectomy. The authors of this paper describe a new original technique for glottic and hypopharyngeal reconstruction after vertical hemipharyngolaryngectomy. Using a radial forearm free flap including the tendon of the palmaris longus and a sensitive branch of the radial nerve, they were able to reconstruct the missing vocal cord and a pyriform fossa. This procedure permits an extended resection without the usual phonatory or swallowing inconveniences. There is no contraindication for postoperative radiotherapy. The technique and preliminary functional results are reported.

The statistical analysis of results obtained with splinting treatment of finger and hand stiffness, and derived from a series of 635 motion range measurements taken on 249 hand joints, provided us with sufficient data to identify the various factors likely to have an impact on the therapeutic outcome. A mean increase of 25.8% in the range of movements is enough to justify the use of orthosis, although this figure actually varies substantially with the patient's age, the duration of the stiffness, the latter's degree and origin, the joint involved, and the duration of the orthotic treatment. An analysis of the time factor enabled us to establish the date beyond which changes for recovery are quite limited, whereby allowing to schedule surgical mobilization.