Bilateral Syndactyly Release of Third and Fourth Fingers
Sudhir B. Rao, MD1; Mark N. Perlmutter, MS, MD, FICS, FAANOS2; Arya S. Rao3; Grant Darner4
1Big Rapids Orthopaedics
2Carolina Regional Orthopaedics
3Columbia University
4Duke University School of Medicine
Amniotic band syndrome, or constriction ring syndrome, happens when a developing fetus gets tangled in the fibrous bands of the amniotic sac. Sometimes, fingers and toes can become trapped in these fibrous bands, with results ranging from amputation of the digits, to fusion of the fingers or toes, termed syndactyly. Syndactyly is amongst the most frequent congenital hand anomaly and is termed simple when the digits are connected by soft tissue only, and complex when one or more phalanges are fused. In complicated syndactyly, there are additional bony elements in between the digits making it challenging if not impossible to separate safely.
The patient in this case is a 1-year-old male with complex syndactyly of the left hand and simple syndactyly of the right hand. Here, both sides are released, with the left side involving a full-thickness skin graft taken from the patient’s groin crease. This case was filmed during a surgical mission with the World Surgical Foundation in Honduras.
Right Inguinal Hernia Repair on a 1-Year-Old Boy During a Surgical Mission
Yoko Young Sang, MD1; Domingo Alvear, MD2;
1Louisiana State University Shreveport
2World Surgical Foundation
This comprehensive video is intended to provide a detailed overview of the surgical technique used to repair a right inguinal hernia in Honduras on a 1-year-old boy who presented with a swelling in his scrotum, which had been present since he was two months old. The surgical procedure is narrated by an experienced pediatric surgeon, highlighting the unique challenges and innovative techniques employed in this case, which can be valuable for surgeons facing similar situations. The importance of this video lies in its educational value for surgeons, particularly those involved in surgical missions or practicing in resource-limited settings.
Aspiration of Ganglion Cyst on Right Wrist
Jonathan E. Sledd1; Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES2
1Edward Via College of Osteopathic Medicine – Auburn Campus
2Philippine Children’s Medical Center
Ganglion cysts are sacs containing a gel-like fluid that can form over tendons and joints. They are commonly seen as visible lumps on the hand and back of the wrist. Ganglion cysts are not cancerous, and most are asymptomatic. But if a cyst puts pressure on a nerve, it can cause pain, tingling, and muscle weakness. Initial treatment of a ganglion cyst is not surgical. Observation may be recommended because half of ganglion cysts may disappear over time. Activity often causes the cyst to increase in size, and thus immobilization may be an option. If a ganglion cyst causes pain and limits activities, aspiration of the fluid may decrease pressure and relieve pain. Surgical excision may also be recommended if symptoms are not relieved or if the cyst recurs. This article presents the case of a 51-year-old female who had a ganglion cyst on her right wrist. Treatment options were presented to the patient, and she opted to undergo aspiration over excision.
Open Proctocolectomy for Hirschsprung’s Disease
Mudassir Shah Akhter, MD1; Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES2
1Oregon Health and Science University
2Philippine Children’s Medical Center
Hirschsprung’s disease is the main genetic cause of functional intestinal obstruction. Most cases are diagnosed in the first few months of life given classical presentation and ease of testing with rectal suction biopsy. The disease is due to the absence of enteric ganglion cells in the distal colon that results in functional constipation. Resection of the affected segment and bringing the normal bowel close to the anus has been the mainstay of treatment. Due to advances in surgical treatment over the past decades, a significant reduction in morbidity and mortality has been observed, and the previously multistage procedure can now be completed in one stage, as presented here.
Bone Graft for Non-Union of Right Thumb Proximal Phalanx Fracture
Hospital Leonardo Martinez, Honduras
Sudhir B. Rao, MD
Big Rapids Orthopaedics
Mark N. Perlmutter, MS, MD, FICS, FAANOS
Carolina Regional Orthopaedics
The patient in this case is an 11-year-old female who fractured the thumb of her dominant hand 1 year ago and now has a well-established non-union of the head of the proximal phalanx of her right thumb. Here, Dr. Rao and Dr. Perlmutter repair the fracture by harvesting a bone graft from the patient’s iliac crest and transplanting it into the fracture site. This case was performed during a surgical mission in Honduras with the World Surgical Foundation.
Bilateral Simple Hydrocelectomy and Removal of Subdermal Implants
Romblon Provincial Hospital
Domingo Alvear, MD
Founder, World Surgical Foundation
Lissa Henson, MD
Philippine Society of Pediatric Surgeons
Jaymie Ang Henry, MD, MPH
Florida Atlantic University, G4 Alliance
In this case, Dr. Alvear perform a bilateral simple hydrocelectomy and removal of subdermal implants while on a surgical mission in the Philippines. The diagnosis of hydrocele had been confirmed via ultrasound following transillumination during the physical exam.
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