Management of this infectious entity should be aggressive. Several techniques that are used to reconstruct the lost tissue have shown good results. The superomedial thigh skin flap has proven to be a reliable method of resurfacing large scrotal defects. Reconstructive surgery makes the return to a normal social life possible in many cases.

The principles of neurocutaneous flaps, first described by Masquelet in 1992, represented a new concept in skin vascularization. The distally based superficial sural artery flap is an example of this kind of flap, which is supplied by the vascular axis that accompanies the sural nerve. The authors treated 36 patients with 36 distally based superficial sural artery flaps. All flaps survived, but six of them exhibited partial necrosis. No patient experienced anesthesia of the lateral side of the foot or neuroma at the donor site 12 months after surgery. The authors confirmed that this flap is very useful for soft-tissue reconstruction of the distal third of the leg and foot. Additionally they conclude that the principal advantages are that the blood supply is reliable, execution is easy and fast, the operation can be performed under regional anesthesia, the flap has a large arc of rotation, direct closure of the donor area is possible for small flaps, major arteries or nerves are not sacrificed, and excellent durability is achieved, even on weight-bearing areas. The major drawback is the donor site scar.

We studied the records of children and adolescents admitted to our hospital with facial fractures between 1993 and 2002. During the 10-year period, 492 patients with 555 midfacial fractures were treated. Their ages ranged from 1 to 18 years, the peak incidence being between 16 and 18. Three-hundred and eighty (77%) were boys. The zygoma was the most commonly fractured bone (n = 286), and the hard palate the least commonly fractured (n = 6). Motor-vehicles were responsible for 272 (55%) of all fractures. Most fractures were treated by closed reduction, and only 139 (25%) were treated by observation. Complications, including unsatisfactory fracture repair and infection, were recorded in 18 (4%) and the overall mortality was 1% (n = 8).

No abstract