Background/Objectives: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Traditional diagnostics like EMG and NCSs are invasive and do not visualize nerve morphology. This study aims to evaluate the diagnostic and prognostic value of high-resolution ultrasonography in patients with CTS using a standardized scanning protocol and to evaluate the relationship between sonographic findings and traditional electrodiagnostic results. Methods: In this observational study with both prospective and retrospective components, 31 subjects were included. Between November 2023 and June 2024, 11 symptomatic CTS patients were scheduled for surgical decompression and 14 healthy controls were prospectively enrolled. Additionally, six post-surgical CTS patients who had undergone decompression between 2016 and 2021 were retrospectively included for comparative analysis. All underwent clinical and ultrasonographic assessments of the median nerve at predefined anatomical landmarks. EMG was performed in the CTS groups. Ultrasound was repeated at 1, 3, and 6 months postoperatively to monitor morphological changes. Results: CTS patients had significantly increased the median nerve CSA compared to controls. Postoperative ultrasound showed progressive CSA reduction correlating with clinical improvement and EMG recovery. The CSA correlated moderately to strongly with distal motor latency. Conclusions: High-resolution ultrasound is a reliable, non-invasive tool for diagnosing and monitoring CTS. Standardized protocols are needed to support broader clinical adoption and establish it as a standalone diagnostic method.

Background: Injuries to the digital distal phalanx often result in functional impairments such as loss of grip and sensation, along with aesthetic challenges. Various reconstructive techniques, including the use of adipofascial flaps, have been explored to address these issues. The homodigital dorsal adipofascial reverse flap (HDARF) has demonstrated promising results in restoring both functionality and aesthetics. However, a comparative evaluation between adipofascial flaps and other commonly used techniques, such as V-Y advancement flaps and cross-finger flaps, remains limited. Objective: This retrospective study evaluates the long-term functional and aesthetic outcomes of adipofascial flap reconstructions for pulp defects, focusing on sensory recovery and patient satisfaction. Methods: Between 2010 and 2022, 20 patients (14 men, 6 women) with digital pulp defects underwent reconstruction using adipofascial flaps in a single-stage procedure. Injuries included avulsion and crush injuries, distributed across various digits. Sensory recovery was assessed using the Semmes–Weinstein monofilament test and two-point discrimination. Joint mobility, cold intolerance, and aesthetic satisfaction were also evaluated. Results: All flaps were successfully reconstructed within 24 h of trauma. Sensory recovery was excellent, with Semmes–Weinstein scores ranging from 1.65 to 2.83, comparable to the uninjured hand. Two-point discrimination averaged 1–5 mm in most cases. Cold intolerance persisted in four patients, and mild nail dystrophy was noted in three cases, with one case of nail absence. Aesthetic satisfaction was high in 19 patients. Conclusions: The adipofascial flap effectively restores function and aesthetics in pulp defects, offering superior sensory recovery, high patient satisfaction, and minimal complications. Its regenerative potential and adaptability make it a valuable option for fingertip reconstruction, supporting its continued use in clinical practice.

Background: Scar management remains a significant challenge in plastic and reconstructive surgery, particularly when addressing atrophic, retractile, or fibrotic scars. Autologous fat grafting and hybrid fractional laser therapy have independently shown efficacy in improving scar quality. This study aims to evaluate the synergistic effect of their combination on clinical and functional scar outcomes. Methods: A prospective, comparative study was conducted on patients with cutaneous scars of various etiologies. Participants were treated with either hybrid fractional laser therapy alone (CO₂ and 1570 nm Erbium-glass wavelengths) or a combined protocol of laser plus autologous lipofilling. Clinical outcomes were assessed at baseline and at 30, 60, and 90 days post-treatment using the Vancouver Scar Scale (VSS), patient satisfaction scores, and Visual Analog Scale (VAS) for pain and discomfort. Results: Patients receiving the combined treatment demonstrated significantly greater improvement in scar pigmentation, elasticity, pliability, and thickness compared to those treated with laser alone. Subjective symptoms, including pain and itching, were also more effectively alleviated. The volumetric and regenerative properties of adipose tissue, particularly its content of adipose-derived stem cells (ADSCs) and stromal vascular fraction (SVF), likely contributed to the enhanced outcomes observed. Conclusions: The combination of hybrid fractional laser therapy and autologous lipofilling offers a superior therapeutic strategy for scar remodeling compared to laser monotherapy. This integrated regenerative approach addresses both structural and biological aspects of scar tissue, making it a valuable protocol for personalized and effective scar management. Further randomized trials with larger sample sizes and histological validation are warranted to confirm these preliminary findings and refine therapeutic protocols.

The incidence of nonmelanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), is increasing globally, driven by factors such as chronic UV exposure, climate change, and aging populations. This comprehensive retrospective cohort study examined 1252 patients treated for NMSCs at the Plastic Surgery Unit of the University of Messina, Italy, from 2012 to 2023. The study aimed to assess demographic characteristics, histological types, lesion attributes, recurrence rates, and geographical variations in NMSC incidence. Beyond confirming global epidemiological trends, this study highlights clinically relevant factors influencing tumor presentation, including environmental risk exposure, lesion recurrence, and histological aggressiveness. Data were collected on patient demographics, tumor location, histological subtype, lesion diameter, presence of ulceration, recurrence, and differentiation grade. Statistical analysis was conducted using R software (Version 4.2.0). Findings demonstrated that patients residing in coastal areas had a significantly higher incidence of NMSCs, reinforcing the role of exposure and environmental pollutants in carcinogenesis. These findings align with global trends and highlight the urgent need for early diagnosis, targeted dermatological surveillance, and public health interventions to mitigate the rising burden of NMSCs. The study underscores the necessity of enhanced sun protection awareness, integration of dermatological screenings in primary care settings, and improved treatment protocols to reduce recurrence and morbidity.

Background: Hand tumors encompass a heterogeneous spectrum of benign, malignant, and tumor-like lesions with diverse clinical behavior. While international studies have reported epidemiological and clinicopathological features, large-scale data in Italian populations are scarce. This retrospective analysis represents one of the largest Italian surgical series of histologically confirmed hand tumors. The objective was to evaluate clinicopathological characteristics, anatomical distribution, and surgical outcomes of these lesions over a 5-year period. Methods: A total of 250 patients who underwent surgery for hand tumors at the Department of Plastic and Reconstructive Surgery, University Hospital “G. Martino,” Messina, Italy, from January 2020 to December 2024, were retrospectively reviewed. Data from clinical records, imaging, and histopathology were categorized as tumor-like lesions, benign neoplasms, or malignant tumors. Demographic and clinical variables were compared across diagnostic groups. Results: The cohort included 127 males and 123 females (mean age 49.3 ± 18.6 years). Lesions were most frequently located in the digits (62%), followed by palm (21%), dorsum (11%), and wrist (6%). Tumor-like lesions represented 37.6% of cases, predominantly mucous cysts and foreign body granulomas. Benign tumors accounted for 49.2%, with giant cell tumors of the tendon sheath as the most common (31.7%). Malignant tumors were rare (10.4%), mainly squamous cell carcinoma, basal cell carcinoma, and melanoma. Patients with malignant lesions were significantly older (67.4 years) compared with those with benign or tumor-like lesions (p < 0.01). Conclusions: Benign and tumor-like lesions predominate among hand tumors, whereas malignancies are infrequent but clinically important. Surgical excision remains the treatment of choice, guided by preoperative imaging and confirmed histopathologically. Expanding this cohort and integrating molecular diagnostics with patient-reported outcomes may enhance future management strategies.