The Pediatric Upper Limb

Reconstruction of the First Web Space in Symbrachydactyly Using the Reverse Radial Forearm Flap

“…In severe contractures, or in complete and/or complex thumb/index syndactyly, this kind of releasing technique and/or skin grafting are reported as inadequate because of the insufficiency of the primary reconstruction or recurrent contractures. 2,12,13 These problems are dealt with by using a variety of local flaps. These flaps are based on the dorsal or palmar aspect of the hand, extending onto the thumb or index fingers.…”

“…In severe forms, 1, 2, or all central finger rays may be absent, forming a gap; or the fingers may be gradually reduced, leaving only bud-like fingers. [1][2][3][4][5][6] The thumb is affected least frequently with an adduction contracture. Because adequate breadth of the first web space is critical for normal hand function, satisfactory pinch action, grip, and prehension often are severely limited in adduction contractures seen in patients with symbrachydactyly.…”

Blunt femoropopliteal trauma in a child: Is stenting a good option?

“…In fact, however, the use of fine microvascular reconstruction techniques under the microscope has demonstrated that small vessels (1 mm in diameter) can be successfully reconstructed by using fine 8-0 to 10-0 sutures. 15 Of course, in very small children with limb-threatening ischemia and in poor general condition, thrombolytic agents should be considered as the initial therapeutic approach. Nevertheless, the timing of surgery in cases of chronic vascular insufficiency remains controversial.…”