The fingernail has an important role in hand function, facilitating the pinch and increasing the sensitivity of the fingertip. Therefore, immediate and proper strategy in treating fingernail injuries is essential to avoid aesthetic and functional impairment. Nail-bed and fingertip injuries are considered in this review, including subungual hematoma, wounds, simple lacerations of the nail bed and/or matrix, stellate lacerations, avulsion of the nail bed, ungual matrix defect, nail-bed injuries associated with fractures of the distal phalanx, and associated fingertip injuries. All these injuries require careful initial evaluation and adequate treatment, which is often performed under magnification. Delayed and secondary procedures of fingernail sequelae are possible, but final results are often unpredictable.

Dislocation is a common and important complication of total hip arthroplasty (THA). Larger femoral heads may reduce the risk of dislocation and improve the range of movement. The aim of this study was to compare the relative risk (RR) of dislocation during the first year after THA between implants with 28mm and 36mm femoral heads. 198 consecutive hips with 28mm femoral head (Group-28) and 259 hips with 36mm femoral head (Group-36) were studied. The patients were assessed preoperatively and periodically using the Harris hip score (HHS) and radiographic analysis. The relative risk (RR) of dislocation was calculated. The average HHS significantly improved from a preoperative baseline to the last follow-up at 82.1 months (28mm) and 44.3 months (36mm). No statistically significant differences were revealed between the two groups for HHS results and complications (p>0.05), but the difference in RR of dislocation within the first year between the two groups was 7.85 (95%CI: 1.34–46.03), p=0.046. Although dislocation is multifactorial in etiology, the two groups were homogenous for all principal contributing factors except the diameter of the femoral head. Therefore, the use of 36-mm heads can reduce the risk of dislocation following THA by a factor of 8 compared to conventional 28mm heads.

Volume 10 (2015)ISSN: 1749-7221

End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible. In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results. In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.