Glomus tumours are rare tumours accounting for only 1-5% of soft tissue tumours of the hand. They are described classically in the subungual region. We present the case of a 32-year-old woman with a late diagnosis of a glomus tumour that had caused her excruciating pain. Clinical examination was positive for Hildreth's sign and the Love test. Magnetic resonance imaging delineated the tumour, which was excised and confirmed histologically. This case highlights the continued delay in diagnosis of glomus tumours as well as the use of imaging in diagnosis and planning of surgery.

A case of morphea postbreast reconstruction is presented. It is a rare condition that can be easily mistaken for other inflammatory conditions or infection.

We present the case of a 47 year old male who sustained neuropraxia of the lingual, facial and hypoglossal nerves following general anaesthesia with nitrous oxide and a laryngeal mask airway. We believe this is the first report of three cranial nerves being simultaneously affected and highlights the importance of monitoring cuff pressure when using laryngeal mask airways.

No abstract

Background Studies carried out in 1998 by Khouri et al. established a benchmark for free flap survival. Whilst individual factors related to free flap survival have been examined since, there has been little contemporaneous data re-examining overall flap survival rates and factors related to complications to assess progress in the field and specifically European or UK practice. Methods Six plastic surgery units from four regions within the South West UK regional collaboration group prospectively collected data on all free flap surgery performed in a 6-month period between October 2013 and April 2014. Results Data on 264 free flaps were prospectively collected. Total flap failure was 2.7% and partial flap failure was 4.5%. Regression analysis identified obesity and previous recipient site radiotherapy as the most important factors in flap failure. The rate of intra-operative and post-operative flap thrombosis was 3.8% and 6.4%, respectively, and was associated with lower limb recipient site and surgeon grade. Post-operative haematoma occurred in 4.2%, associated with recipient site radiotherapy. Conclusions Our study establishes a UK baseline for standards in free flap surgery. With the recent introduction of a UK Free Flap Surgery Registry, this baseline will support unit audit and improvements in free flap surgery.Level of evidence: Level III, risk/prognostic study.