Can J Plast Surg
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High-voltage electrical burns involving the extremities may cause marked loss of skin and subcutaneous tissue exposing underlying bone and tendon. Treatment of electrical burns has historically involved serial debridement with late wound closure. Success has been reported with the use of microvascular free-flap transfer within three days of injury. ⋯ Delay of microvascular free-flap coverage beyond the previously published three-day protocol may not dramatically affect treatment success.
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Extensor pollicis longus (EPL) tendon ruptures have been treated succesfully with the transfer of the extensor indicis proprius (EIP) tendon. Situations exist in which, due to intraoperative observations, another tendon transfer may be considered preferable to the standard EIP transfer method. ⋯ These case reports suggest that either index finger tendon may be successfully transferred in EPL tendon ruptures.
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Regional anesthesia of a single finger is commonly achieved by the traditional ring block, which requires at least two painful injections in the digit. Single injection digital block techniques have been described to avoid this problem. Among these, the subcutaneous technique described by Harbison appears to be safe and to allow most procedures to be carried out with good tolerance. ⋯ The subcutaneous single injection digital block is safe, efficient and easy to perform. It allows the treatment of all conditions on the volar aspect of the finger and on the dorsal aspect of the distal and middle phalanxes. For surgery on the dorsal aspect of the proximal phalanx, a combined single injection technique or a supplementary dorsal block should be used.