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.
Breast augmentation consultation: A patient seeks fuller breasts. Steps include assessing medical history, expectations, and explaining implant options.
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.
Also: Sunday quiz, tuberous breast deformity, and evidence on capsular contracture.
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.
A patient presents with severe, sharp thumb pain and bluish nail discoloration, suggesting a glomus tumor.
Also: Pronator Syndrome, theFellow's Corner and Evidence Deep-Dives.
A glomus tumor is a benign lesion from glomus cells in the Sucquet-Hoyer canal, often causing severe pain in young adults’ nail beds or palms. It aids in thermoregulation. Diagnosis involves imaging and histology. Excision is the main treatment; for multiple lesions, consider laser or sclerotherapy.
A newborn presents with a limp left arm since delivery, suspected of congenital brachial plexus palsy.
A 57-year-old woman presents with signs of deep sternal wound infection (DSWI).
A 65-year-old male farmer presents with stiffness and contracture in his middle finger, impacting daily activities.
A 45-year-old male experiences numbness and tingling in his right ring and little fingers, suggesting ulnar tunnel syndrome.
A 52-year-old woman presents with numbness in her right thumb, index, and middle finger, and pain in the anterior forearm.
A 2-month-old presents with right chest wall hypoplasia and syndactyly of three middle digits.
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Sternal wound infections (SWIs) are classified into superficial and deep infections. Diagnosis involves clinical evaluation, lab tests, and imaging. Treatment includes antibiotics, debridement, and flap reconstruction.
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.
Gynaecomastia Case: A 35-year-old man presents with 6-month breast enlargement. Objectives include history-taking, identifying investigations, and treatment options.
Also: Upcoming podcast episode and a new article on gynaecomastia.
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.
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Poland syndrome is a congenital condition involving unilateral chest wall deformity and hand anomalies. It can be managed surgically for functional and aesthetic improvement.
