Stenosing tenosynovitis from migrated skin staples.
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Biomedical subjects
Publications and source records attributed to C Balakrishnan.
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Male spouse abuse seems to be on the increase. Recognition of these injuries is often difficult as patients are reluctant to disclose the aetiology and press charges against the assailant. We identified a similar group of male patients who sustained burns to their external genitalia secondary to spouse abuse.
In most patients with lymphoedema, neither a medical nor a surgical approach can provide a cure. Due to the progressive nature of the disease, it is imperative that every attempt should be made at controlling oedema and preventing infection. As burn injury to the lymphoedematous extremity is associated with significant morbidity, we report a patient with deep burns affecting a lymphoedematous extremity.
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During the 4-year period 1980-1983, we carried out 338 operations for Dupuytren's disease of the hand. Of these 46 (13.6%) had a dermofasciectomy and skin graft for recurrent disease. In this sub-group, 34 patients (10.1%) were operated on by the same senior surgeon (H.G.B.). Only these cases were included in this study. Average follow-up was 100 months (range 80-120 months). It was found that graft durability was good, there was no clinical evidence of recurrence beneath grafts, contracture did not exceed 15 degrees at any joint and two point discrimination in the graft was equal to, or better than, 12 mm in the palm and 8 mm in the digit.
Burns involving skin and subcutaneous tissue are rarely associated with lymphoedema of the extremity due to the intact deep lymphatic system. We report an example of lymphoedema of the lower extremity in a burn patient 6 months after skin grafting.
Neoplastic lesions arising in recent burn scars are apparently quite rare and we could find no report of such an occurrence in the literature. Nevertheless we recently treated a patient with a metastatic adenocarcinoma from the lung in a 3-month-old burn scar.
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Position at the time of burning can be precisely determined by analysis of the depth, configuration, distribution of the burn, flexion creases and spared areas. This information is very useful in determining non-accidental injuries in children. Although specific pattern injuries are rare in adults, we report an example of a self-inflicted burn in a schizophrenic which resembles a 'forced immersion burn'.
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