We present a rare case of ulnar nerve compression caused by concurrent lumps-a lipoma and a ganglion at the wrist, with no prior report cited in the English literature. This case illustrates the possibility of dual concurrent pathologies causing ulnar neuropathy and the importance of not missing one.
Introduction: Larger soft tissue defects over critical areas of the lower limb involving the knee and proximal two thirds of the tibia present a challenge to the reconstructive surgeon. Options include a large free flap or pedicled local flaps. The gastrocnemius or soleus flap alone is not sufficient. Combined gastrocnemius-soleus flaps can be used adequately without the need to resort to free flaps. We review the use and outcomes of the combined pedicled gastrocnemius and hemi-soleus double muscle flap to cover large defects of the leg and discuss our technique. Material and methods: A retrospective review of the patients who underwent the pedicled double muscle (gastrocnemius and soleus) flap for wound resurfacing in our institution between 2008 and 2013 was performed. The patients' case notes were analyzed and data collected included their age, comorbidities, wound characteristics, surgical procedures and post-operative outcomes and complications. Results: There was a total of ten double flaps in ten patients; eight due to trauma and two due to infection. Mean follow up period was 12 months. All flaps achieved primary healing without major complications. There were two cases of minor complications: flap tip necrosis and superficial infection. Nine patients were able to achieve ambulation without aid at final follow up.
Conclusion:The combined pedicled gastrocnemius and hemisoleus double muscle flap is a useful alternative for reconstruction of large critical soft tissue defects around the knee and leg.
Background:Intravascular lymphoma is a rare and fatal disease that can have central nervous system (CNS) manifestations. It is usually a diagnosis made postmortem. This is partly due to its varied presentation, which lends itself to the complexity of diagnosis.Case Description:We report a rare case of intravascular lymphoma in the brain found antemortem.Conclusion:Review of the literature shows that a timely diagnostic tissue biopsy together with aggressive combination chemotherapy treatment can improve patient outcome.
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