Absorbable sutures behave favourably in vitro and in an animal model. We report the outcome of flexor tendon injuries in a series of 272 consecutive patients treated over 45 months with a mean follow-up of 4 (range 3-12) months. Five hundred and seventy-six tendons were repaired in 416 digits. The patients were not randomised and all repairs were performed using a Strickland four-strand core technique. In 191 (73%) patients an absorbable core suture was used (Group 1) and in 81 (27%) a non-absorbable material was used (Group 2). There were six ruptures (2%) in Group 1 and two (2%) in Group 2. Using the original Strickland criteria, there were 72% excellent/good and 28% fair/poor results in the absorbable core suture group, and 73% and 27%, respectively, in the non-absorbable core suture group. This study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repair.

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Severe septicemic necrosis can result in extremely debilitating morbidity for patients, often resulting in 4-limb amputation. Further operative procedures to improve both function and cosmesis can be fraught with complexity and complications. The ideal aim in such patients would be to maintain sufficient length and provide soft tissue cover in a single 1-step procedure. We present a novel case in which twin free flaps were used acutely to provide 3 separate skin paddles to cover 2 hand stumps from a single anterolateral thigh donor site, thus maintaining the optimum digit length for subsequent function. We believe that this is the first reported case of using 3 separate flaps from 1 single anterolateral thigh donor site to resurface and salvage digit length in both hands following septicemic necrosis. Detailed knowledge of the anatomy of the anterolateral thigh flap and an understanding of the perforator flap concept can allow others to further develop the many and versatile uses of this flap.

because of pure osteosarcomatous component without epithelial elements and no connection between this tumor and underlying skeleton in imaging methods.We thought that there was a simple and unusual coexistence of benign CSP in one breast and pure osteosarcoma in the contralateral breast in our patient.A 36-year-old female presented with an enlarging left axillary mass and otherwise normal examination. Mammography was normal and a trucut biopsy inconclusive. Magnetic resonance imaging scan (a) (b) Figure 2. (a) Hypercellular tumor with osteoid deposits is seen in the lower half of the field. Normal breast ductal elements compressed by the tumor bulk are noted above (H&E, 100·). (b) Osteosarcomatous component with atypical osteoblastic proliferation, nuclear pleomorphism, and osteoid deposits (arrows) separated from compressed mammary parenchyma and ductal structures (H&E, 400·).(a) (b) Figure 3. (a) Benign cystosarcoma phyllodes. Ductal elements with narrow lumens compressed in hypocellular uniform stroma are seen (H&E, 100·). (b) High-power view of benign cystosarcoma phyllodes. Breast ductules are seen in fibroblastic stroma consisting of fusiform cells with no cellular atypia and no mitoses (H&E, 200·).