Sixty paired cadaver upper extremities were dissected to study the anatomy of the flexor pollicis longus in the forearm and its relation to the median and anterior interosseous nerves. An accessory head was noted in 33 (55%) of 60 specimens. The accessory head was noted to pass anterior to the anterior interosseous nerve in all specimens. The accessory head was noted to pass posterior to the median nerve in 57 specimens, and anterior to the nerve in three. Tendon or muscle anomalies were noted in eight specimens (13%), seven of which involved an anomalous attachment between the FPL and the flexor digitorum profundus of the index.
Malignant melanoma is extremely rare in patients with albinism. To date, in the English language literature, there have been only sixteen documented cases of malignant melanoma in albino patients. These cases include thirteen cutaneous, one oral, one ocular, and one anal; only one of these was in a child. Here, we present the case of the youngest known albino patient to have cutaneous malignant melanoma.
A retrospective review of congenital cleft foot was done on 16 patients with 32 involved feet. The average age at the time of surgery was 4 years (range, 5 months to 13 years). The average follow-up after surgery was 7.8 years, with a range of 2-45 years. A simple classification based on severity of deficiency was developed. Twenty-three of the 24 procedures performed gave a satisfactory result. Six of the nine untreated feet were satisfactory. Based on our classification, the following treatment is recommended: type I, central partial forefoot cleft was treated by a soft-tissue syndactylism and a partial hallux valgus correction, if needed. Type II, for a complete forefoot cleft to the tarsus, soft-tissue syndactylism with first-ray osteotomy if necessary before age 5 years is recommended. First-ray amputation is advised after age 5 years. Type III: Complete absence of first through fourth ray did not need forefoot surgery.
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