Reconstruction of a deep burn-afflicted knee joint using a superior medial genicular artery flap

　We herein present a case of an 88-year-old female. The left knee joint was injured by a low-temperature burn due to a heater, and the patient had undergone conservative treatment at a local primary care physician. Since the skin necrosis was spreading, she was referred to our department on the 36th day after the injury. 8×4 cm black necrosis was observed on the left patella, and when debridement was performed, the patella was exposed but the joint was not exposed. For soft tissue defects, it was possible to sufficiently cover the exposed part of the patella with superior medial genicular artery flap. After the procedure, the knee joint did not show any contracture, had good mobility, and the patient was able to walk independently. Knee joint deep burn is often difficult to treat due to joint exposure and gait disorder associated with joint contracture. The superior medial genicular artery flap is considered to be a good indication for patients with advanced complications and the elderly because the procedure is simple

Fibrosarcomatous variant of dermatofibrosarcoma protuberans on the right cheek: A case report

A 52-year-old man presented with a subcutaneous mass on his right cheek. The tumor was resected. Histopathological examination of the resected tissue revealed fibrosarcomatous deromatofibrosarcoma protuberans (FS-DFSP). Since the resection resulted in a large skin defect, his cheek was reconstructed using a deep inferior epigastric artery perforator flap (DIEP). As the pathological findings showed positivity for tumor cells at the excised end, radiation therapy was applied to his right cheek. FS-DFSPs are found in about 10% of all DFSP cases, and are more malignant than other types of DFSP. Because there is a risk of local recurrence or distant metastasis, the patient should undergo close, long-term observation

Anatomical Analysis of Cutaneous Perforator Distribution in the Forearm

Background:. Few reports describe the distribution of cutaneous perforators from the radial and ulnar arteries in the forearm. This study aimed to map the location of the cutaneous perforators that arise directly from the radial and ulnar arteries in cadavers. Methods:. Twenty-nine human cadaveric forearms were dissected. All radial and ulnar arteries cutaneous perforators were analyzed for total number and distribution. To define the distribution of each cutaneous perforator, the forearm was divided into 10 sections, with the sections labeled as 10%, 20%, 30%, and so on, beginning at the wrist. Results:. From the radial artery, there were a total of 262 skin perforators with an average of 9.03 ± 2.28 (mean ± SD) per limb, whereas the total was 159 from the ulnar artery, with an average of 5.48 ± 1.49 per limb. Additionally, 128 (49%) radial artery cutaneous perforators and 75 (47%) from the ulnar artery were concentrated in the 0–30% section of the forearm. Both the radial and ulnar arteries had many cutaneous perforators in the forearm section labeled 70%, with 32 of 262 (12%) cutaneous perforators of the radial artery and 27 of 159 (17%) cutaneous perforators of the ulnar artery located here. Conclusions:. There were more cutaneous perforators from the radial artery than from the ulnar artery, and both were concentrated in the distal one-third of the forearm and in the forearm section labeled 70%. This information could be helpful when harvesting forearm flaps

Spindle Cell Lipoma of the Thumb

Summary:. We report the case of a 34-year-old man who presented with a 4-year history of a soft tissue on the palmar aspect of the thumb. Magnetic resonance imaging demonstrated the presence of a mass with heterogeneous high intensities on T1-weighted images and high intensities on T2-weighted images. We performed excisional biopsy. Histologically, the tumor was composed of mature adipocytes and spindle cells in a collagen background. Immunohistochemically, the tumor cells showed strong expression of CD34. Therefore, we diagnosed it as spindle cell lipoma. To the best of our knowledge, only 2 cases of spindle cell lipoma of the thumb have previously been reported