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Context:Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter's rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon.Aims:The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley's catheter as a cheaper and readily available alternative to Hunter's rod.Settings and Design:This was a prospective study.Materials and Methods:Seventy digits in 35 patients were treated by the staged flexor tendon reconstruction using silicone Foley's catheter in place of Hunter's rod, and the patients were followed for an average period of 18 months. Early controlled motion exercise protocol was instituted in all cases.Results:As per the Strickland scale, total active motion obtained was excellent in 70%, good in 20%, fair in 7.1% and poor in 2.9% of patients.Conclusions:Silicone Foley's catheter is cheaper, easily available and an effective alternative to Hunter's rod in staged flexor tendon reconstruction procedure, yielding high rates of excellent and good results with fewer complications.

Peculiar anatomy of human hand with flexing fingers and opposing thumb give human beings clear edge over other existing living beings. We use hands for carrying out most of our daily activities. But at the same time this makes our hands vulnerable for getting traumatized. Hand injuries which involve underlying tendons make digits dysfunctional, which in turn affects overall precise functioning of hand. In this chapter we will briefly discuss related surgical anatomy of flexor tendons and associated structures, features of flexor tendon injuries at different zonal levels, surgical methods involved and different post-operative protocols used for management of these flexor tendon injuries.

Background: The Dermabond (2-octyl cyanoacrylate) is a commonly used skin adhesive in plastic surgery. There are some reports in the literature regarding Dermabond associated contact dermatitis. In this retrospective cohort study, we evaluated the incidence and characteristics of contact dermatitis (type IV hypersensitivity reaction) post application of Dermabond (Trade name PRINEO manufactured by ETHICON) in patients who underwent plastic surgical breast procedures in our hospital. Methods: Sixty patients had undergone plastic surgical breast procedures (mastopexy and reduction mammoplasty) with Dermabond application over the period of last 3 years in our hospital. The records of these 60 patients were studied retrospectively. Results: Four patients (6.6%) out of the 60 patients taken for study had developed type IV hypersensitivity reaction to Dermabond. All of these patients presented with pruritus and skin rash in the second week of their post-operative period and none of them had any known past allergic history. Conclusion: We conclude that the incidence of type IV hypersensitivity allergic reaction post application of Dermabond (2-octyl cyanoacrylate) is significantly high and its possibility should be explained to the patients prior to its application.

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The nutrient foramen is defined as the largest foramen present on the shaft of long bones allowing nutrient artery to enter the bone, the role of which is important in providing nutrition and growth of long bones. Materials and Methods:The present study was conducted on 80 dry femur bones of unknown age and sex, which were obtained from Department of Anatomy, GMC Jammu. Adult femur bones were examined for number and position of nutrient foramen.Result: Out of 42 right sided femur bones, 4 (9.52%) had two nutrient foramina and 38 (90.47) had one nutrient foramen. Out of 38 left sided femur bones evaluated, only 1 (2.63%) had two nutrient foramina and 37 (97.36%) had single nutrient foramen. In 42 right femur bones, 28 nutrient foramina were present in upper one-third portion, 17 nutrient foramina were present in middle one-third and 1 nutrient foramen was present in lower onethird portion of femur bone. In 38 left femur bones, 24 nutrient foramina were present in upper one-third portion, 14 nutrient foramina in middle one-third and 1 nutrient foramen in lower one-third portion of femur. Conclusion:Knowledge of nutrient foramen number and position is of great importance for orthopedicians, radiologists, plastic surgeons and vascular surgeons for avoiding any damage to the nutrient vessels during surgical procedures.