Experimentation (. . .) is justified primarily by the individual's and not by the community's interest. However, this does not exclude that, provided that one's own substantial integrity is preserved, the patient could legitimately bear a part of the risks to contribute with his/her initiative to the progress of medicine, and in this way, to the welfare of the community. Within the community, the purpose of medicine is to free the human being from the infirmities that block him, and from the psycho-somatic fragilities that humiliate him John Paul II From the address to the participants to two surgical meetings in Rome, Italy
We present a new method for the treatment of painful neuromas of the palmar cutaneous branch of the median nerve. A preliminary cadaver study was done to investigate the extraneural and intraneural course of the palmar cutaneous branch of the median nerve with respect to the main trunk of the median nerve. Seven patients presented with a painful neuroma following previous surgery on the palmar aspect of the wrist. The neuroma was dissected and excised by stripping the whole of the palmar cutaneous branch from the main trunk of the median nerve. In all cases complete relief from pain and discomfort was achieved. The resulting area of numbness in the palm did not represent a significant problem.
The authors describe the most critical aspects of transplantation of the hand. Three successful cases are presented from the Italian Hand Transplantation National Program. The key issues of this new type of surgical reconstruction for major amputations are selection criteria of suitable candidates, technical aspects of surgery, postoperative regime and functional rehabilitation. Other important aspects are staff requisites and organisation of the clinical trial, ethical and legal implications, dealing with the media. The authors comment on the fact that we might be ready to accept that almost anything could come from a cadaver, even if it is not a life-saving organ, to reconstruct missing parts and restore anatomical integrity and, especially, function.
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