An infant presents with a large erythematous lesion on the face. Diagnosis of infantile hemangioma is confirmed with GLUT-1 positive immunohistochemistry. First-line treatment is propranolol (2mg/kg/day). Surgery may be indicated for visual obstruction, airway issues, or ulceration.
A patient presents with trigger finger in the right middle finger. Initial treatment includes activity modification, splinting, NSAIDs, and a corticosteroid injection. Due to persistent symptoms, A1 pulley release surgery is planned, ensuring the A2 pulley is preserved to prevent bowstringing.
A patient with a mallet finger injury is unable to extend his fingertip. X-rays show a small bony avulsion fragment. This is a closed, bony mallet injury classified as Doyle Type I. Management includes continuous splinting of the DIP joint in extension for 6–8 weeks.
A postpartum woman presents with radial wrist pain. Diagnosis of De Quervain's is confirmed with a positive Finkelstein test. Initial treatment includes rest, splinting, NSAIDs, and corticosteroid injections. Surgery is considered if symptoms persist after conservative management.
Also: The Sunday quiz, evidence on LA use, & tissue expansion article.
A patient with a history of mastectomy and axillary lymph node dissection presents with progressive swelling in her left arm. Lymphoedema is suspected, classified as Stage II. Treatment includes complete decongestive therapy, and surgical options like Vascularized Lymph Node Transfer (VLNT).
Lymphedema is a chronic condition caused by impaired lymphatic drainage, leading to swelling, typically in the limbs. It can be primary (congenital) or secondary (from surgery, radiation, or infection). Treatment focuses on complete decongestive therapy, with surgery reserved for severe cases.
Also: The Sunday quiz, operating on Enchondromas, & glomus tumours - clinical scenario.
Also: Macrodactyly, Sunday Quiz and 3 recommended reads.
Also: The Sunday quiz, cervical lymph nodes of the neck illustration, & mandibular defects feature.
In this week's edition 1. ✍️ Letter from P'Fella How We Hit 100: The Journey of ThePlasticsPaper
This guide provides four key tips, along with practical examples, to help you approach the FRCS Plastic Surgery Oral Exam with confidence and clarity.
Also: Anatomy illustration of the week, macrodactyly feature, & 3 recommended articles.
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.
A patient seeks NAC reconstruction post-DIEP flap. NAC reconstruction is indicated post-mastectomy, breast reduction, congenital absence, trauma, or gender-affirming surgery.
Also: Sunday quiz winners, tuberous breast deformity, & nipple flap recon options.
A patient with bilateral arm paraesthesia and heaviness, along with a history of sciatic nerve injury and crutch use, is diagnosed with thoracic outlet syndrome (TOS) through clinical examination and imaging. Treatment includes physiotherapy, pain management, and surgical decompression.
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.
Also: New podcast episode, the Sunday quiz, & ganglion cyst clinical case.
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.
A patient with pain and breast shape changes presents with bilateral capsular contracture post-augmentation (Baker III left, IV right). Assessment includes history, exam, & MRI. Treatment options are implant removal, capsulectomy, pocket change, or autologous augmentation.
Also: The Sunday quiz, podcast snippet, & recommended articles on reconstructive surgery.
