[Double flap reconstruction of extended facial defects]

The authors report the reconstruction of large facial defects remaining after resection of two advanced facial cancer cases. In both cases double flap closures were carried out. In the first case the internal flap was created from the remaining part of the oral mucosa membrane, while in the second a forearm fascio-cutan free flap was used. For external closure in both cases platysma based transpositional flaps were used, prepared from the neck. On the basis of excellent aesthetic results and safe applicability the authors recommend the more frequent use of this method.

[Laryngopharyngectomy and free jejunal graft reconstruction in the treatment of hypopharyngeal tumors]

The authors performed a total laryngopharyngectomy due to a hypopharyngeal neoplasm. The continuity of the alimentary tract was restored by the insertion of a vascularized free jejunal graft, using microsurgical technique. On the occasion of this case the authors give a survey of the therapeutical methods used in the therapy of hypopharyngeal tumors, of the indications of the free jejunal transplant and of the technical issues and complications of this procedure.

[Substitution of the thumb by transplantation of the second toe]

Authors perform for the substitution of the thumb beside several other operations the transplantation of the second toe. The transplantation is carried out with the reconstruction of the arterial circulation, built on the I. metatarsal artery. Until now 18 substitutions of the thumb were carried out. The etiology of the lack of the toe is variable, in the great majority it is of traumatic origin however purulent process and attempt of suicide occur. With the observation of the rules of structural reconstruction good functional result may be reached. In more than a third of the cases both the sensitivity and the mobility are excellent. The use of this method is suggested first of all in cases where alternative substituting operations are out of question.

[Use of a distally pedicled radial artery as an island flap for covering traumatic skin losses]

Authors performed plastic operation using lower arm insulated flap with distal pedicle in 2 cases for covering traumatic skin defects on the dorsal side of the hand. Attention is called to the advantages of this method. Beside the shorter time of treatment in many cases a series of operations can be avoided by the primary covering with an insulated flap.

[Complex evaluation of hand function]

The authors offer a method of assessment of hand function which renders numerical data, in which all functions of the hand are represented with appropriate emphasis. The result of the examination is expressed as a percentage of perfect function. The method, which seems on first reading somewhat complicated, can be simplified very much with a computer aided work-up of data. The method is suggested first of all for the assessment of the results of healing in severe complex hand injuries. It is also suitable for the expression of hand function in all cases (for example, judgement of the decrease of working capacity and decisions on insurance claims, etc.).