Microsurgery
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Two hundred twenty patients with soft tissue defects in the hand and forearm were treated with 226 free and island flap transfers. Reconstructed sites involved the thumb in 74 cases, the fingers in 117, the hand in 30, and the forearm in 5. Seventy-nine patients received 82 free flaps, and 141 patients received 144 island flaps. ⋯ Of the five-failures in the free flap transfers, four were dorsalis pedis flaps, two of which were on patients with an arteriovenous fistula. Of the four failures in the island flap transfers, two were posterior interosseous flaps and two were digital island flaps. All four were reverse-flow island flaps.
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We report on two cases of true aneurysms of the palmar arch, both of which were post-traumatic. One was due to repetitive blunt trauma and the other to a glass cut wound. ⋯ The presence of elastic fibres and smooth muscle in the aneurysm wall proved it to be a true aneurysm. Both aneurysms were excised and replaced by a vein graft from the foot.