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Summary: We report a very rare type of tumor in the left nasal ala in an elderly patient. An 81-year-old Saudi woman known to have hypertension, osteoporosis, and rheumatoid disease (who had been compliant to her medications) presented with a 0.5-cm fixed, firm, round well-defined nodule on the left ala of the nose (with crusting, erosion, and telangiectasia of the overlying skin), whose size had been gradually increasing for 2 years. The patient underwent excisional biopsy, and the specimen was sent for a histopathologic analysis. Macroscopic examination showed a round tan-white homogenous nodule, measuring 0.6 × 0.5 × 0.5 cm3. Microscopic examination revealed a fairly circumscribed unencapsulated dermal lesion, featuring basaloid cells with peripheral palisading, and focal stromal clefting. The final diagnosis of basal cell carcinoma with sebaceous differentiation was made. The patient was managed with Mohs surgery with clear margins, and full-thickness skin graft was done. Four months after surgery, the patient had a recurrence, which was managed with a surgical excision (with 4-mm margin) and covered by a full-thickness skin graft.
Patient: Male, 30-year-old Final Diagnosis: Biceps brachii muscle necrosis Symptoms: Impaired elbow flexion Medication:— Clinical Procedure: — Specialty: Orthopedics and Traumatology • Plastic Surgery Objective: Rare disease Background: Several surgical procedures to restore elbow flexion have been reported in the literature. Multiple factors direct the selection of appropriate procedures for each patient, including hand dominance, neurovascular injury, and comorbidities. Traumatic damage to the anterior compartment of the arm is an indication for latissimus dorsi transfer, which can restore elbow flexion. Bipolar pedicled latissimus dorsi (LD) flap is a design used very rarely to simultaneously reconstruct biceps brachii soft-tissue defects and regain complete flexion function. We report the case of a 30-year-old man who underwent successful elbow flexion reconstruction using latissimus dorsi muscle transfer following a road traffic accident and upper limb trauma. Case Report: A 30-year-old man presented with acute compartment syndrome caused by a road traffic accident and impact trauma to the left arm. The surgical evaluation revealed proximal biceps tendons rapture; therefore, immediate repair and therapeutic fasciotomy were done. Subsequently, unsuccessful repair resulted in total necrosis of the biceps muscle, which necessitated debridement of the biceps muscle. Delayed reconstruction with an LD flap was successfully done after stabilization of the patient’s condition. The flap was harvested as free-pedicled, then modified into a tube-like shape to resemble the biceps muscle. Conclusions: This report has shown that the surgical procedure of latissimus dorsi muscle transfer can successfully restore elbow function following upper limb trauma; however, preoperative planning and postoperative follow-up are crucial for functional reconstruction of the upper extremity. In addition, carefully selecting reconstructive surgery considering patient factors, degree of injury, and the institution’s capacity are essential factors in achieving optimal function restoration with minimal complications.
Many theories have been suggested for the etiology of congenital swan neck deformity. The one main theory is that there is a lack of anatomical balance of the extrinsic and intrinsic muscles of the finger that is affected. Also, due to the imbalance between the flexors and extensors, flexion at the proximal interphalangeal joint results. As the patient gets older, there is increased lag in the extensors leading to worse flexion deformity, and this is mainly an aesthetic rather than a purely functional problem.A seven-month-old female infant presented with a hand deformity (congenital swan neck deformity on the fifth finger) that started appearing spontaneously and insidiouslywhen the infant was six months old. Operations for this type of deformity can range from skin plasties, artholysis, tenotomies, tendon transfers, and osteotomies to arthrodesis.Postoperative care consists of a splint, in which the duration in which it is kept is based on the technique used.
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