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Seventy-seven skin and bone defects caused by high velocity missiles have been repaired with various combinations of microvascular free transfer of skin flaps and vascularised bone grafts. We concluded that the free osteoseptocutaneous fibula transfer (1,4) is the best method of reconstruction if a long bone defect is associated with skin loss.

Background:Nerve injuries resulting from major or minor trauma often cause some disabilities for patients. Neurotmesis, characterized by complete anatomical rupture of the nerve, is the most severe form of the injury which will not recover without reconstructive surgery and nowadays such neural damages are improved by microsurgical procedures. Some studies have used low power laser for nerve cell growth in order to improve the rehabilitation results of peripheral nerves. Low power laser can complement the reformation of postsurgical nerve injuries.Objectives:The current study aimed to assess the effects of laser therapy after repair of median nerve rupture in the distal third of the forearm and to compare the results with that of the standard method.Patients and Methods:The current study was a case-control clinical trial of 36 patients with volar surface rupture of the distal third of forearm admitted to the emergency ward of Hazrat-e-Fatemeh Hospital within 72 hours of injury, they had anesthesia in the first, second, and third fingers as a result of Median Nerve Injury. Patients were divided into two groups. The first group included subjects treated with standard methods and the second group included those treated with low power laser therapy (LT) along with the standard method. The same surgeon operated the subjects in the two groups. The second group underwent 10 sessions of LT every other day. Clinical Examination, Electromyography and Nerve Conduction Velocity (NCV) were done after six months and the results were compared.Results:In the two -point discrimination- test, there was no significant difference between the two groups in the thumbs but a significant improvement was observed in the index finger of the LT group. Improvement of muscular examinations such as opposition and thumb abduction supported the usage of laser in the second group. Regarding electromyography and NCV, significant statistical difference was observed in the motor part of the laser group and, to a great extent, was compatible with the physical examinations.Conclusions:Accordingly, laser therapy in our protocol seemed to affect some of the nerve growth parameters, mostly on motor rather than sensory fibers.

The new nerve approximator device is cheap, feasible to use and reduces the time of tendon repair with sustained outcomes comparable to the conventional methods.

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