In-transit metastases are described in 31 patients, of whom the majority was immunocompetent. The scalp, forehead, and temple were the most common sites. New clinical and histological diagnostic criteria are proposed. Prognosis was poor with 5-year survival of 13%. Recommended management is a combination of surgery and adjuvant radiotherapy. Reduction of any iatrogenic immunosuppression should be considered.

Cubital tunnel syndrome is the second most commonly encountered compression neuropathy of the upper limb. Multiple techniques for surgical management have been proposed but no universally accepted algorithm for management exists. Six cadaveric upper limbs underwent ulnar nerve decompression and anterior transposition into subcutaneous and then submuscular positions. After marking nerves with tungsten, radiological examination of nerve motion was performed and nerve angulations were measured in the region of the flexor carpi ulnaris (FCU) origin. Comparison of ulnar nerves in each position revealed statistically significant greater angulation after subcutaneous transposition than after submuscular transposition with the elbow held in full flexion. This point of angulation may act as a secondary point of compression or as a focus for neuritis and scar formation. This finding can contribute to the understanding of why differing outcomes may be observed after different forms of anterior transposition.

Driving with an arm protruding through a window can result in limb threatening injury. A series of seven upper limb injuries sustained during motor vehicle accidents (MVAs) with a limb protruding from the vehicle window is described. The severity and complexity of these injuries are related to the ultimate functional recovery for the limb. This study serves to highlight the severity of injury and morbidity following these modalities of trauma, which although rarely fatal, carry extensive consequences and could be easily prevented with appropriate education programmes and legislation.