Extensor tendon injuries are very common injuries, which inappropriately treated can cause severe lasting impairment for the patient. Assessment and management of flexor tendon injuries has been widely reviewed, unlike extensor injuries. It is clear from the literature that extensor tendon repair should be undertaken immediately but the exact approach depends on the extensor zone. Zone I injuries otherwise known as mallet injuries are often closed and treated with immobilisaton and conservative management where possible. Zone II injuries are again conservatively managed with splinting. Closed Zone III or ‘boutonniere’ injuries are managed conservatively unless there is evidence of displaced avulsion fractures at the base of the middle phalanx, axial and lateral instability of the PIPJ associated with loss of active or passive extension of the joint or failed non-operative treatment. Open zone III injuries are often treated surgically unless splinting enable the tendons to come together. Zone V injuries, are human bites until proven otherwise requires primary tendon repair after irrigation. Zone VI injuries are close to the thin paratendon and thin subcutaneous tissue which strong core type sutures and then splinting should be placed in extension for 4-6 weeks. Complete lacerations to zone IV and VII involve surgical primary repair followed by 6 weeks of splinting in extension. Zone VIII require multiple figure of eight sutures to repair the muscle bellies and static immobilisation of the wrist in 45 degrees of extension. To date there is little literature documenting the quality of repairing extensor tendon injuries however loss of flexion due to extensor tendon shortening, loss of flexion and extension resulting from adhesions and weakened grip can occur after surgery. This review aims to provide a systematic examination method for assessing extensor injuries, presentation and management of all type of extensor tendon injuries as well as guidance on mobilisation pre and post surgery.

Our findings show that the vast majority of meniscal ossicles are associated with posterior horn or meniscal root tears and a high incidence of focal articular cartilage loss as well as anterior cruciate ligament tears.

Ten patients underwent 25 procedures and were followed for a median of 250 days. No abscesses developed. Our results suggest moxifloxacin alone may suffice for prophylaxis.

The superficial temporal artery (STA) flap is a versatile flap for head and neck defect reconstruction. It can be based on the frontal branch of the STA and an islanded 360-degree rotation arc for various defects on the scalp, cheek, and auricular region. It provides a nonmicrosurgical option for reconstructing such defects, which is itself relatively easy to perform. However, venous congestion is a problem than often can cause worry to the clinician and hence preclude its use. In this review, we revisit this flap in head and neck reconstruction, with case examples used for reconstruction of defects on the scalp, maxilla, lip, ear, and retroauricular area. The STA flap in our review can be used either as a fasciocutaneous flap or with its fascia alone. The main issue with the STA flap is that it is generally a high-inflow flap with variable outflow. Venous congestion is frequently encountered in our practice, and adequate management of the venous drainage in the postoperative period is crucial in ensuring its success as a versatile and viable option for head and neck reconstruction.

No abstract

No abstract

Viola odorata is traditionally used in the management of gastrointestinal, respiratory and vascular disorders. The present study was undertaken to validate its folkloric uses. The application of V. odorata to spontaneous contractions in isolated rabbit jejunum preparation exerted relaxant effect through decrease in magnitude and frequency of contractions. Moreover, it also caused relaxation of K + (80 mM)-induced contractions and shifted the Ca 2+ concentration response curves toward right in isolated jejunum similar to verapamil (standard Ca 2+ channel blocker), confirming Ca 2+ channel blocking activity. V. odorata also caused relaxation of carbachol (1 µM)-and K + (80 mM) -induced contractions in isolated rabbit tracheal preparations comparable to verapamil, reflecting that observed relaxant effect may be the outcome of antimuscarinic and/or Ca 2+ channel blocking activities. It also exerted relaxant effect on phenylephrine (1 µM)-and K + (80 mM)-induced contractions in isolated rabbit aortic preparations thus providing rationale for its folkloric uses to treat diarrhea, asthma and hypertension. Article Info Materials and Methods Plant material and preparation of extractThe aerial parts of V. odorata were collected in May, 2012 from the botanical garden of Pakistan Institute of Forestry, University of Peshawar and were identified by the kind cooperation of an expert taxonomist (Prof. Altaf Ahmad Dasti), at

The dorsal metatarsal artery perforator (DMtAP) flap is a relatively new flap in the reconstructive armamentarium. Our understanding has only recently increased with data from cadaveric dissections, which have increased our understanding of the DMtAP system of the forefoot. Sporadic reports in the literature have been published regarding its various uses for defects around the forefoot. This review aims to summarize the reports and results thus far in the literature and bring together the anatomical evidence of DMtAPs in the forefoot. We also demonstrate our experience in raising a DMtAP flap and its potential use for reconstruction of the forefoot after skin cancer surgery. This is a versatile and reliable flap.