Rotation flaps are curvilinear pivotal flaps ideal for triangular defect repair, commonly used for facial, cheek, chin, and scalp reconstruction. Success depends on defect triangulation, flap circumference, and pivot point positioning. Post-op focuses on hematoma prevention and sun avoidance.
Finger replantation restores function, sensation, and aesthetics following the traumatic or surgical loss of a digit. Success depends on injury type, ischemia time, and microsurgical repair. Complications like venous insufficiency and arterial thrombosis require early management.
Laser treatments provide minimally invasive procedures in resurfacing, scar revision, & lesion removal. Mechanisms involve collimated, monochromatic, & coherent light-targeting chromophores.
Breast Ptosis is the descent of the nipple below the inframammary fold, caused by aging, pregnancy, weight changes, and genetics. Classified into Grades 1–3 (Regnault system), it’s managed with mastopexy, augmentation, or reduction, with risks like hematoma, infection, and scarring.
BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) features include delayed seroma and swelling, with diagnosis relying on imaging and CD30 immunohistochemistry. En-bloc resection is critical, with chemotherapy or radiotherapy for advanced cases.
Cleft lip results from incomplete fusion of embryologic structures, leading to lip and nasal deformities. It is classified by laterality and completeness. Repair occurs at 3–6 months using techniques like Millard’s and Fisher’s subunit repair to restore function, symmetry, & aesthetics.
Oncological breast reconstruction aids recovery post-mastectomy or lumpectomy, using autologous tissue, implants, or both. Decision-making involves preoperative assessment, radiation plans, and patient preferences.
Keloids are fibrotic scars extending beyond the original wound, driven by genetic predisposition, inflammation, and abnormal fibroblast activity. Treatment involves non-surgical options like lasers and silicone sheeting, pharmaceuticals like corticosteroids, or surgery with adjuvant therapy.
The DIEP flap is a gold standard for autologous breast reconstruction, offering superior vascularity and minimal donor-site morbidity.
Trigger finger, or stenosing tenosynovitis, occurs when the flexor tendon is trapped at the A1 pulley, leading to pain during finger movement. Common risk factors include manual labor, older age, and diabetes. Treatment options range from splinting and corticosteroids to surgical A1 pulley release.
Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain disorder. It involves dysregulation of the nervous system with sensory, motor, and autonomic disturbances. Diagnosis is clinical, and treatment is multidisciplinary, including physical therapy, medications, and surgical options.
Infantile haemangiomas (IHs) are caused by dysregulated vasculogenesis and angiogenesis, and can be superficial or deep. Diagnosis is primarily clinical but may include imaging and histology. Treatments include propranolol, laser therapy, and surgery for complications.
Pressure sores are localized skin and tissue injuries over bony prominences, caused by prolonged pressure, shear, friction, and moisture. Treatment varies by stage, from conservative care to debridement, antibiotics, and reconstruction.
Penile reconstruction addresses tissue loss from trauma, fibrosis, cancer, and infection. The primary goal is to construct a phallus with a neo-urethra for standing urination and sufficient bulk for a prosthesis. Techniques include glans, shaft, and scrotal reconstruction.
Wound dressings vary from non-occlusive to occlusive, with antimicrobial options like silver dressings. Dressing choice depends on wound factors, and adjuncts like NPWT can enhance healing.
Soft tissue sarcomas are rare, malignant tumors of mesenchymal origin. They are classified into over 70 subtypes, with risk factors including environmental exposures and genetic predispositions. Management involves surgery, radiotherapy, and sometimes chemotherapy, tailored to the sarcoma type.
Median nerve tendon transfers restore thumb opposition, flexion of the index and middle fingers, and thumb flexion. The procedure involves relocating functional tendons to compensate for lost function due to nerve injury.
Nipple-Areolar Complex (NAC) reconstruction aims for symmetry, projection, pigmentation, durability, and minimal complications while addressing functional sensation and patient needs. Techniques include tattooing, flaps, and grafts, with careful pre-op marking and post-op care.
Thoracic outlet syndrome (TOS) is the compression of neurovascular structures at the brachial plexus. It commonly presents with neurogenic symptoms, such as pain and tingling. Management involves physiotherapy, pain control, and surgery for severe cases.
Capsular contracture is the thickening and hardening of the capsule around breast implants, leading to pain and deformity. Classified by Baker's system (I-IV), treatment ranges from conservative management to surgical interventions such as capsulectomy.
Macrodactyly involves disproportionate digit overgrowth, often due to lipofibromatosis of the nerve and PiK3CA mutations. Diagnosed via X-rays, MRI, and genetic tests, it's treated surgically to debulk and stop growth. Surgical management focuses on nerve issues to reduce recurrence.
An overview of congenital dermoid cysts, benign growths from ectodermal entrapment, common in the head and neck. Focus on orbital and nasal presentations and surgical management to prevent complications.
Thatte and Thatte classify venous flaps into three types based on vein number and function. Venous flaps are infrequently used due to low survival rates and venous congestion, despite their reliable anatomy and minimal donor site morbidity.
The Mathes and Nahai Classification, introduced in 1981, describes the vascular supply to muscle and musculocutaneous flaps based on major and minor pedicles. This system is essential for planning reconstructive surgeries to ensure optimal flap survival and function.
The cervical lymph nodes of the neck are organized into levels based on their anatomical locations and drainage patterns. These nodes drain specific areas of the head and neck, aiding in identifying primary tumor sites and guiding surgical management.
Congenital Brachial Plexus Palsy: Upper limb movement loss at birth, often from birthing traction. Early surgical exploration recommended if no biceps function after 3 months.
Breast augmentation uses implants to enhance size and shape, with techniques tailored to patient needs and potential complications like BIA-ALCL.
Giant Cell Tumours are neoplastic lesions on tendon sheaths, often in hands. Diagnosed via physical exam and imaging, often treated with surgical excision. Recurrence is common.
Dupuytren's disease causes progressive hand contractures from fibrous nodules in the palm. Common in older Northern European men, it's linked to genetics and manual labor. Diagnosis is clinical, with treatments including collagenase injections, needle aponeurotomy, or surgery.
Gynecomastia is male breast enlargement due to glandular growth and fat, caused by hormonal imbalances. It often presents as painless and bilateral. Diagnosis involves history, tests, and imaging. Treatment ranges from lifestyle changes and medication to surgery for persistent cases.
Poland syndrome is a congenital condition involving unilateral chest wall deformity and hand anomalies. It can be managed surgically for functional and aesthetic improvement.
Hemifacial microsomia is the commonest craniofacial abnormality. This article details the genetics, clinical features, classifications and management.
Treacher Collins Syndrome is a genetic craniofacial syndrome characterised by hypoplasia, external ear and eyelid malformations and visual disturbance.
Pierre Robin Sequence is glossoptosis, micrognathia and upper airway respiratory obstruction. This article details pathophysiology, causes and treatment.
Ulnar Tunnel Syndrome involves compression of the ulnar nerve at the wrist. It manifests as motor and sensory issues, varying based on the compression site. Diagnosis primarily uses X-rays, while management ranges from non-surgical interventions to surgical decompression.
Anterior Interosseous Nerve Syndrome (AINS) affects the median nerve's motor branch, leading to muscle paralysis without sensory loss. Diagnosis involves physical exams, EMG, and imaging. Initial treatment is conservative, followed by surgery if symptoms persist.
Pronator Syndrome involves compression of the median nerve in the forearm, often affecting middle-aged women. It typically presents with forearm pain and a positive Tinel sign. Management starts conservatively with rest and splinting, progressing to surgery if symptoms persist.
Progressive Hemifacial atrophy is the progressive wasting of facial structures. This article details the causes, clinical features and management.
Craniofacial clefts are skeletal and soft-tissue abnormalities. This article details the Tessier Classification, types of clefts and their management.
Burns Fluid resuscitation aims to restore volume and preserve perfusion. This article details indications, types of fluids, formula calculations and complications.
Electrical Burns can be high voltage, low voltage, direct, or alternating current. They cause skin and deep tissue injury. This article details their causes, management, and complications.
Neck dissections are described as radical, extended, modified, and selective. This article details the indications, anatomy, and complications of neck dissections.
Tumours of the oral cavity are most commonly squamous cell carcinoma. This article details anatomy, staging, surgical, and reconstructive options.
The most common chemical burns are acids and alkalis. This article details their mechanisms, clinical features, and management.
Burns result in local and systemic complications. This article details these complications and management in burn patients.
Thumb MCPJ UCL injuries range is typically diagnosed with stress tests and imaging. Conservative treatment for partial tears to surgical repair for complete tears and avulsions.
Seymour fractures are open, displaced distal phalangeal fractures in children, often caused by crushing injuries and associated with nail bed damage. Treatment includes irrigation, debridement, reduction, fixation, and antibiotics.
Ring avulsion injuries range from lacerations to amputation, typically caused by a ring catching on an object. Proper assessment and treatment depend on the severity, involving everything from suturing to amputation.
Salivary gland tumours involve the parotid, submandibular, sublingual, and minor glands. This article details the anatomy, classifications and treatment options.
The facial nerve has intracranial, intratemporal and extracranial anatomical sections. This article details the origin, course, branches and variations of the facial nerve.
Mandibular defects are classified and reconstructed based on their location and size. This article details the anatomy, classifications, and reconstructive algorithms.
The lip is a composite soft tissue structure of the skin, muscle and mucosa. This article details lip innervation, blood supply, muscles and function.
The radial artery forearm flap is a fasciocutaneous flap. This article details the flap's anatomy, elevation, and dissection.
An ectropion is an eversion of the lower eyelid. This article details the causes, classification, assessment, and treatment of an ectropion.
Congenital Melanocytic Naevi are pigmented lesions present at birth. This article details clinical features, management and risk of malignancy.
Lip reconstruction is guided by defect location, size, and depth. This article details the local flap, free flap, and primary closure options for lip reconstruction.
Dynamic facial nerve palsy reconstruction involves nerve grafts, nerve transfers, muscle transfers or muscle flaps. This article details the decision-making process and techniques.
Hypertelorism is an increase in interorbital distance. This article details causes, classifications, and treatment options.
Squamous cell carcinoma (SCC) of the skin arises from epidermal keratinocytes. This article details the clinical picture, treatment options, risk groups, staging and guidelines
Polydactyly is the radial, ulnar, or central duplication of digits. This article details the classification, treatment, and aetiology of this congenital condition.
Upper Limb development occurs during weeks 4-8 of gestation. This article details the mechanisms of development and critical milestones.
Septic arthritis of the hand arises from direct inoculation, local infection spread, or hematogenous routes, often due to Staphylococcus aureus. Diagnosis involves clinical signs, imaging, and lab tests, with treatment requiring surgical debridement and antibiotics.
Flexor Tenosynovitis is a surgical emergency needing admission, elevation, IV antibiotics, and usually surgical washout within 24 hours.
Camptodactyly is the progressive flexion deformity of the PIPJ. This article details the aetiology, features, classification, and management of this congenital hand condition.
Syndactyly is the fusion of soft tissue and bone of the finger. This article details the aetiology, diagnosis, and treatment of syndactyly.
Necrotising fasciitis is a severe infection causing tissue death. Symptoms include severe pain and rapid tissue destruction, requiring immediate medical and surgical intervention to prevent high mortality.
Thumb hypoplasia is congenital undergrowth of the thumb. This article details its diagnosis, classification, and treatment.
Craniosynostosis is the premature fusion of one or more cranial sutures. It most commonly involves the sagittal suture. It can be isolated or part of a syndrome.
Microtia is a congenital hypoplastic malformation of the ear. This article details the assessment, classification, and surgical management of microtia.
Pharyngeal arches (branchial arches) provide nerve, artery, bone and muscle to the craniofacial development. This article explores arches, pouches and grooves.
The breast is a composition of alveoli, lobules and lobes. It receives blood and sensory supply from a diverse number of arteries and nerves.
Infantile haemangiomas are benign proliferative tumours. This article details their aetiology, clinical features, investigations and management.
Basal cell carcinomas are the most common skin cancer. This article details their aetiology, diagnosis and treatment options.
The scaphoid bone, as the largest carpal bone in the proximal carpal row, is crucial in the wrist's mechanical integrity. This article explores scaphoid bone's anatomy, mechanics, and significance.
Melanoma is a malignant proliferation of melanocytes. This article details the features, diagnosis, role of sentinel node biopsy, and staging.
Ganglion cysts are common soft tissue tumors in the hand, often linked to joint capsules or tendons. Their diagnosis is primarily clinical. Treatment options are observation, aspiration, injection & surgical excision.
The lower eyelid is a bilamellar structure composed of skin, muscle, tarsus and conjunctiva. This article details the anatomy, blood supply, and lacrimal system.
Cubital Tunnel Syndrome is a compression neuropathy of the ulnar nerve at the level of the elbow. This article reviews the current literature in relation to anatomy, clinical diagnosis, and treatment options of Cubital Tunnel Syndrome.
"Intrinsic Plus" is a condition caused by tight interossei and lumbricals, leading to MCPJ hyperflexion and PIPJ hyperextension, managed through therapies or surgical procedures like intrinsic release to alleviate symptoms and restore hand function.
This article explores tuberous breast correction, detailing aesthetic improvement strategies and symmetry via specific surgical techniques, guided by Von Heimburg's classification for precise and optimal outcomes.
Mohs Micrographic Surgery (MMS)is a technique pioneered by Dr. Frederic Mohs in the 1930s. This article explores the indications, techniques & advantages.
The hard and soft palate is composed of bone and soft tissue. This article details structures, neuromuscular supply and abnormal anatomy.
Maxillary reconstruction aims to recreate soft tissue and bone. This article details anatomy, indications for resection, classification and treatment algorithms of the Maxilla.
Understanding thumb osteoarthritis: Covering anatomy, pathophysiology, diagnosis, classification, and treatments including surgery and non-operative methods for improved joint function.
Flexor Tendon Injury Repair is a common surgical operation in hand surgery. This article discusses diagnosis, surgical options, and post-operative recovery.
Posterior Interosseous Nerve (PIN) Palsy is a syndrome characterised by a reduction in extensor movements of the fingers. It most commonly due to a compression at the radial tunnel. This article explores the causes, signs and symptoms, and management of this entrapment.
The VRAM Flap is a Type III Mathes & Nahai myocutaneous flap. This article details its indications, anatomy, and surgical technique.
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of clinical practice and exams.
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of clinical practice and exams.
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of both practice and exams.
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of both practice and exams
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of both practice and exams
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of clinical practice and exam
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of clinical practice and exam
This assesses your clinical expertise, decision-making, and management skills through an oral "viva" structure, using real-world scenarios representative of clinical practice and exams
Cleft hand is a central longitudinal congenital deficiency. This article details the aetiology, features, classification and treatment.
This journal club analyses and reviews the original publication by Mustarde for the correction of prominent ears.
An inhalation injury is caused by a direct thermal burn or chemical exposure. It is a clinical diagnosis and treatment ensures a patent airway. This article discusses these aspects of inhalational injury in burns.
Tissue expansion increases the availability of soft tissue by optimising the skin's viscoelastic properties. This article details the mechanism of creep, tissue expander types and indications.
Local Anaesthesia has two main types, amides and esters. This article discusses dosing, side effects, calculations with examples.
Nerve injury is a common plastic surgery condition. The degree of nerve injury helps guide its classification, management and outcomes.
Cartilage grafts can be used as supportive adjuncts in reconstruction surgery. They are autografts, prone to warping and are slow to heal due to a lack of blood supply.
Bone grafts are biological scaffolds and support structures. They can be autografts (patient's own bone), allografts (from a donor) or alloplastic. This article details their indications, properties and types of grafts.
Bone healing can be classified as primary or secondary. It undergoes haematoma formation, inflammation, proliferation, callus and remodelling.
Full-thickness and split-thickness skin grafts have a donor and recipient wound. Their healing process occurs in 4 phases. This procedure is seldom unsuccessful.
The delay phenomenon increases flap survival by increasing axial blood, increasing ischaemia tolerance, and reducing sympathetic fibres.
Angiosomes are a vascular territory. An underlying named artery supplies 3D composite blocks which are connected by choke vessels and can be used for tissue transfer.
The anatomy of the skin is composed of 3 main skin layers and 4 main skin appendages. This article details and illustrates these layers and structures of the skin.
Vascular anomalies can be classified as malformations or tumours. This article details their pathology and classification systems
Wound Healing is most commonly by primary and secondary intention. It involves hemostasis, inflammation, proliferation and remodelling.
Z-Plasty is a double transposition flap used to surgically treat scars. This article details indications, design, variations and complications of Z-plasty.
Brachial Plexus anatomy is a complex topic that can be difficult to learn. This article details the key anatomical points, provides mnemonics and detailed illustrations.
A burn can be classified as superficial, partial thickness, or full-thickness. This article details the assessment of burns with charts, tables, and illustrations.
The quadriga phenomenon is a clinical diagnosis characterized by reduced flexion of non-injured fingers most commonly due to an injured FDP. This article explores the pathophysiology, causes and treatment options.
Lower Eyelid Reconstruction can be explained in relation to the defect or the type of reconstruction options. This article details direct closure, graft, or flaps to partial or full-thickness defects.
There are 5 Flexor and 9 Extensor Zones of the Hand. They are used to describe the location of a tendon injury, guide post-operative therapy and predict prognosis.
A flap can be classified or described by its tissue composition, vascularity, type of movement, and location in relation to the defect. This article details these classifications with illustrations and examples.
The proximal interphalangeal joint (PIPJ) is a bicondylar, synovial, hinge joint. It is stabilized by the volar plate, collateral ligaments, and joint capsule. This article details the anatomy of the PIPJ.
This article details the anatomy, technique, indications, benefits and disadvantages of the gracilis flap.
The goal of chest wall reconstruction is to achieve a functional and aesthetic outcome by focusing on skeletal support, soft tissue coverage, and patient optimization.
Liposuction is one of the most commonly performed cosmetic procedures. This reviews the science of liposuction and its indications, techniques, and outcomes.
A zygomaticomaxillary complex (ZMC) fracture is a fracture that involves the zygoma and its surrounding bones. They are the second most common facial fractures after nasal bones. This article details the anatomy, evaluation, and treatment.
The bilobed flap is a common reconstructive option for nasal tip defects. This article describes the indications, design, geometry, and modifications of this double transposition flap.
Carpal Tunnel Syndrome is the most common upper extremity compression neuropathy. This article reviews the current literature in relation to anatomy, clinical diagnosis, and treatment options of Carpal Tunnel Syndrome.
Pressure sores or ulcers are a chronic condition often seen in patients with poor mobility, hygiene, and perfusion to areas that receive increased pressures. This article references 22 peer-reviewed publications.
Swan-neck and Boutonnière deformities are caused by an imbalance in mechanics at the proximal interphalangeal joint (PIPJ). This article explains their aetiology, features, biomechanics and treatment.
The anatomy of the nose is centred on the notion that it can be broken down into 3 sections. The upper bony vault, the middle and lower cartilaginous vaults. These areas are supplied by branches of the facial artery and trigeminal nerve.
Craniofacial Distraction Osteogenesis is a key principle in paediatric craniofacial surgery. These articles explores techniques, types, biology & indications
5 Key Points – Velopharnygeal Insufficiency Velopharyngeal Insufficiency and its aetiology, clinic picture, diagnosis and management can be summarised in 5
A plastic surgery guide to upper eyelid anatomy with images and comprehensive annotations.
Major adjuvant oncological trials in melanoma show a significant survival benefit in patients with completely resected stage III disease, as discussed here.
Hidradenitis Suppurativa is a chronic inflammatory condition of hair follicles. Treatment involves lifestyle changes, biologics and surgery.
Facial nerve's frontal or temporal branch has significant anatomical varation. This details its origin, course, innveration, clinical findings when injured.
Van der Woude syndrome is a rare autosomal dominant disorder characterised by lower lip pits and cleft lip with or without cleft palate. Clinical presentation is variable because of the autosomal dominant inheritance with incomplete penetrance. Management is a multidisciplinary approach.
Surgical techqniues for Otoplasty are well-described. They are best understood by classifying them into manouvres aimed at correcting prominent ears.
Transversus Abdominis Plane (TAP) block uses the space between internal oblique & transversus abdominis muscle. Technique can be direct or ultrasound-guided.
Abnormal scars can be defined as Hypertrophic or Keloid. They do not follow normal scar evolution and difference from clinical, morphological and treatment perspective.
Soft Tissue Reconstruction in lower limb trauma is a complex area to understand theoretical principles and practical nuances. This article provides a decision algorithm as a guide.
Hartrampf's Zones of Perfusion refers to the subdivision of the lower abdominal flap into 4 equal zones based on their level of perfusion and viability. This article examines the history, clinical significant and current concepts.
Squamous Cell Carcinoma has 3 main staging systems: AJCC, BWH and NCNN. There is no universally accepted method.
The rhomboid flap is a type of transposition local flap commonly. This article on rhomboid flaps explains the classification, design repair and modifications with location-based examples and pictures.
A Bennett Fracture is an oblique, intra-articular fracture at the volar-ulnar base of the thumb metacarpal. This article details the anatomy, diagnosis and treatment of Bennett's Fracture.
The total body surface area (TBSA) of a burn can be calculated with a Lund and Browder Chart, Wallace Rule-of-Nines or the palmar method. An accurate estimation of a burn guides acute management, fluid resuscitation, nutrition supplementation and prognosis.
There are different techniques described for volar hand surgery. This article describes, illustrates, and compares Bruner, Mild-lateral, and other incisions.
Compartment syndrome of the hand is an uncommon but acute surgical issue. With reference to 41 peer-reviewed publications, this article discusses the definition, pathophysiology, diagnosis and treatment of compartment syndrome.
Radial Tunnel Syndrome is a common entrapment neuropathy of the posterior interosseous nerve. This reviews anatomy, diagnosis and treatment.
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