Novel management of methylene blue extravasation: A case report and review of literature

Methylene blue is a highly irritant drug and has been used intraoperatively. Its accidental extravasation can lead to tissue necrosis. In this report, a unique management is described, and the patient recovered without any morbidity

The use of acellular dermal matrix in palatoplasty to decrease the rate of postoperative oronasal fistula

Different cleft palate repair techniques have been described to achieve optimum results and minimise complications. Postoperative fistulae are one of the most challenging complications after palate repair. In this clinical study, we reviewed the records of patients who underwent palatoplasty using acellular dermal matrix (ADM) as an addition to facilitate difficult cleft palate and palatal fistula closure.  It was a retrospective, comparative, single-centre study, in which records of patients who underwent cleft palate surgeries between 2015 and 2018 were reviewed. Patients who underwent cleft palate or palatal fistula repair with and without ADM were included. Fischer’s exact test was used to compare the two groups (primary cleft palate repair with and without ADM) in relation to the rate of fistula occurrence postoperatively. Continuous..

A Modified Bilhaut–Cloquet Procedure for Zigzag Thumb Polydactyly Types III and IV

Background:. A review of the English literature over the least 43 years revealed only a total of 53 cases of Wassel types III, IV, and VII treated by the Bilhaut–Cloquet (B–C) procedure. Furthermore, the detailed results and range of motion were only given in 2 series (a total of 9 cases). Methods:. Four cases of Wassel types III and IV thumb duplications with zigzag deformity were treated with a modified B–C procedure. The main modification was minimal central resections at the joints aiming for joint preservation to improve the postoperative range of motion of the new thumb. Results:. The results showed an excellent overall functional score (Tada score of 5 of 5 in all cases). The mean range of motion at the metacarpophalangeal joint was excellent (60°), but the mean at the interphalangeal joint was only 20°. Cosmetically, all thumbs were “too wide” and a panel of 3 hand surgeons scored the cosmetic result (0–10 scoring system) between 5.7 and 6.7. No secondary procedures were done, and all parents were “very satisfied” despite the wide thumbs and split nails. This was attributed to the presence of an ugly preoperative zigzag appearance, and hence the comparative postoperative appearance was satisfactory. Conclusion:. The modified B–C procedure gives a satisfactory function, but the cosmetic outcome is suboptimal