Arterial complications in primary total knee arthroplasty operation are rare. An 83 year old lady is described who presented with three recurrent haemorrhagic episodes eroding through the medial skin 4 weeks following primary total knee arthroplasty. A pseudoaneurysm of the geniculate artery should be suspected with recurrent or persistent haemarthrosis/haemorrhagic episodes. Early exploration, evacuation of the aneurysmal cavity and ligation of the feeding vessel should be undertaken if the false aneurysm is large in diameter.

Graft extrusion following anterior cervical discectomy and fusion is a recognized complication. We report a case of oral extrusion of a synthetic graft (BOP B, Biocompatible Orthopaedic Polymer).

The vascular anatomy of the radial forearm flap, incorporating the brachioradialis and palmaris tendons together with the superficial radial nerve in 20 fresh cadavers, is described. The radial artery in the cadaveric forearm was irrigated and injected with blue latex. The number and distribution of the cutaneous branches supplying the skin, brachioradialis tendon, palmaris tendon, and superficial radial nerve, were then documented in relation to the distance from the radiocarpal joint. The radial artery was found to provide adequate blood supply to the above structures. This flap has been used as a composite neuro-teno-cutaneous flap to resurface a large defect involving tendon, nerve, and skin loss in the ankle and the foot as a one-stage procedure. This technique avoids multiple-staged operations and thus shortens the convalescent period in rehabilitation of severely traumatized limbs.

No abstract

An anatomical study in 25 cadaveric upper limbs quantified the communications between the radial and ulnar arteries immediately proximal to the carpus. These studies suggest that the reverse radial forearm flap can safely be used in severe hand trauma where reliable pre-operative assessment of the palmar collateral circulation is not possible. It is recommended that the pedicle is pivoted 4 cm from the styloid process at which point there is a 96% probability of leaving the superficial palmar branch and one other communication intact and a 77% probability of leaving two other communications intact. Two clinical cases are outlined for illustration.