By Alain C. Masquelet
The writer of a few acclaimed, best-selling surgical atlases has collaborated back with an award-winning artist to supply one other precious surgical source. This very hot group offer a master-class within the demonstration of surgically appropriate anatomy. Masquelet has attained world-renown specifically for his leading edge flaps for reconstructive cosmetic surgery of the limbs, during this booklet he screens his unrivalled wisdom of surgical procedure of the trunk, head, and neck. each element of access in required surgeries is defined, and each strategy is illustrated with a series of drawings, displayed because the medical professional could see them, including anatomical cross-sections.
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B Release of the lateral band. 31 Hand and peripheral nerve surgery C Release of the central band. D The fibrous tissue of healing is resected to shorten the central band. 32 The ‘boutonnière’ deformity E The PIP joint is immobilised in extension with a wire. The central band of the tendon is sutured. F Distal suture of the lateral bands. 33 Hand and peripheral nerve surgery Arthrolysis of the PIP joint (limitation of extension) A The cruciate pulley of the sheath is incised and reflected. The blood supply is provided by a small artery which courses just beneath the ‘check rein’ of the capsule.
Dupuytren’s disease B At the digitopalmar junction and in the finger, pathological tissue is often very thick. It is necessary to identify the arteries and nerves at the level of the finger. 1 radial collateral nerve of the thumb 2 ulnar vascular bundle of the thumb 3 radial collateral nerve of the index finger 3 2 1 41 Hand and peripheral nerve surgery C Zig-zag digitopalmar incisions on two adjacent fingers. D At the digitopalmar junction and in the finger, pathological tissue is often very thick.
The pivot point is at the wrist. The flap is convenient for covering the dorsum of the hand. 19 Reconstructive surgery Pronator quadratus muscle flap This flap is rarely used. However, the dissection is very fine and so are the drawings. A Skin incision. B Exposure of the pronator quadratus muscle. 4 5 3 6 2 7 1 8 B 1 2 3 4 5 6 7 8 palmaris longus anterior interosseous vessels radius flexor carpi radialis flexor hallucis longus median nerve flexor digitorum superficialis pronator quadratus 20 Flaps from the upper limb C The flap is raised on the anterior interosseous artery.