[Treatment of traumatic facial injuries]

Correct treatment of traumatic facial lacerations is essential to achieve the best cosmetic and functional outcome. This article discusses wound management, anatomy and techniques to repair lacerations of scalp, eyelid, nose, lip and ear. Scalp lacerations should be sutured in layers. Injury to the eyelid mandates a careful examination of the eye. Accurate adaptation of the lid margin is required. Nasal septum haematoma must be drained and the nares and alar margins aligned. The key to proper repair of lip laceration is alignment of the vermillion border. Injury to the ear can often be closed in one layer.

[Arsenical keratosis treated by dermatome shaving]

Cutaneous malignancy in association with arsenic exposure is a rare but well-documented phenomenon. Signs of chronic arsenic exposure are very rare in Denmark today. However, arsenic was used in the medical treatment of psoriasis vulgaris up till the 1980's and several patients suffer from this arsenic treatment today. This case report shows that arsenical keratosis can be treated by dermatome shaving, a superficial destructive therapy.

[Healing of scaphoid fractures assessed by tomography. A follow-up study of treated patients]

Thirty-five of 40 patients who had sustained an undisplaced fracture of the waist of the scaphoid were reviewed clinically and radiographically (including tomography) at a median of 70 (13-120) weeks after injury. All fractures had been retained in a below elbow scaphoid plaster for a period of median eight (3-12) weeks. End of treatment was based on the absence of "tenderness" over the scaphoid and on radiographical signs of fracture union median ten (5-24) weeks after injury. At review 28 (80%) of the fractures were united based on standard radiographs and tomography. Four fractures ((11%) 95% confidence limits: 3-27%) were nonunions and three fractures (9%) were probably united. Tomography gave additional information about the state of union if the fracture was visible but unclassifiable on standard radiographs. Tenderness over the scaphoid was only found in the nonunions and probably united fractures. Radiographic and clinical evaluation of the fracture six months after injury is recommended.