In order to determine the efficacy of the carpal compression test (CCT) in the diagnosis of the carpal tunnel syndrome (CTS), we conducted a prospective study on 200 consecutive hands diagnosed as having CTS. A control group of 100 healthy volunteers with no symptoms of CTS were also assessed. The results of the CCT in the patients and controls were compared with those obtained with Phalen's and Tinel's tests. CCT achieved a sensitivity of 87%, and a specificity of 95%. It is a simple, fast and very reliable provocative test, and should be routinely used in the diagnosis of CTS. This test is also an appropriate manoeuvre in wrists with limited range of motion or pain that cannot be assessed with Phalen's wrist flexion test.
Pressure sores, and especially ischial pressure sores, are a serious concern in the life of paraplegic patients. The treatment of this pathology is obviously surgery, and several local flaps can be used for coverage. However, recurrent pressure sores in an active patient can be frustrating if all local flaps have been used. Free flaps are therefore the next option. In our experience, the free medial gastrocnemius musculocutaneous flap is the best option. This paper reports the closure of ischial pressure sores with a free medial gastrocnemius flap, the patient selection criteria used, and the postoperative care provided.
The authors report a case of a 7-month-old infant with a right lateral parietal scalp lesion intermittently leaking fluid similar to cerebrospinal fluid that histologically demonstrated meningothelial and glial cells. At surgical removal, however, no fibrous stalk or bony defect could be identified connecting the lesion with the intracranial compartment. While the embryologic mechanism of this lesion is unclear, the prognosis for normal neurological development appears excellent.
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