Hyaluronidases, a family of enzymes that are able to degrade hyaluronic acid (HA), are employed in medicine to increase drug diffusion and reverse the effects o

Progressive hemifacial atrophy, widely referred to as Parry-Romberg syndrome or Romberg’s disease, is a rare pathologic process characterized by an acquired, idiopathic, self-limited, unilateral atrophy of the face, variably involving skin, subcutaneous tissues, fat, muscle and, less frequently, the underlying bone structures. Restoration of contour and symmetry is the main challenge in cases of Parry-Romberg syndrome; there are several different reconstructive techniques directed at augmentation of deficient soft-tissue volume. The present study describes the authors’ own experience with deepithelialized free parascapular flap transfer combined with Coleman’s lipoinjection in treatment of four severe cases affected by Parry-Romberg syndrome. The free microvascular parascapular flap, harvested and transferred for facial contour reconstruction, provided large volumes of tissue at the location of the greatest contour defect. It also has proven useful in restoring atrophic tissues trophism. To achieve the finest reconstructive result, Coleman’s lipoinjection technique was used for a modification of the free parascapular flap contour, to restore adjacent atrophic areas, and to treat the remaining small or moderate defects. Free parascapular flap transfer combined with Coleman’s lipoinjec-tion, according to the authors’ results, is the procedure of choice for facial contour restoration. Together, they can provide an excellent reconstructive solution directed at restoration of facial morphology, in terms of natural appearance and long-lasting results, with minimal donor-site morbidity.

Hyaloglide® is a hyaluronan-based gel based on a novel auto-crosslinked technology designed to reduce postsurgical adhesions. Its efficacy was assessed in a multicentred randomized controlled trial comparing the results of flexor tenolysis in zone 2 following failed flexor tendon repairs. In the control group a standard release was performed. In the treated group, Hyaloglide® was applied into the flexor sheath and around the site of tenolysis. Forty-five patients, 19 controls and 26 treated with Hyaloglide®, were enrolled in 13 centres. All the patients were evaluated at 30, 60, 90 and 180 days after surgery by testing Total Active Motion, Quick-DASH questionnaire and number of working days lost after surgery. Patients in the Hyaloglide® group had a statistically better recovery of finger motion at all time intervals and returned earlier to work and daily activities. The use of Hyaloglide® did not appear to increase the complication rate.

The aim of this study is to assess outcomes of a lateral surgical approach for proximal interphalangeal joint arthroplasty with NeuFlex^® silicone implants for primary degenerative osteoarthritis. We reviewed 51 arthroplasties performed on 43 patients. The mean follow up period was 36 months (range 18–42). The average preoperative range of motion (ROM) was 38°. The average postoperative ROM was 63°. In 21/51 (41%) cases, there was an average axial deviation of 17° (range 10–30°). VAS and Quick DASH scores improved. In 5/51 (10%) cases, further surgery was required. Our lateral approach seems to be effective and minimally invasive, providing adequate exposure. Contralateral incision and contralateral ligament reinforcement should be performed, whenever necessary, to improve lateral stability.