High-pressure injection injury is a traumatic injury caused by the accidental subcutaneous injection of a substance at high pressure. Previous studies have reported a poor prognosis. A 41-year-old man was injured when hydraulic hose oil was injected into the palm of his right hand. The injury was debrided at 6 hours after the injury. A penrose drain was used for drainage. The injury healed well without any serious functional impairment. The prognosis of this case was influenced by several factors, including the relatively early time that elapsed between injury and surgery, the substance that was injected, the site of injury, and the effectiveness of the drainage method. To shorten the time between injury and surgery, it is important to promote awareness in workplace settings about the risks of high-pressure injection injury and create an environment that encourages early consultation in the event of injury.

 Amputation is often the treatment of choice for wounds that expose the joint cavity. A 46-year-old man was admitted to the hospital in poor general condition following coronavirus infection. The patient had developed bilateral knee joint ulcers caused by pressure sores. Skin ulcers that exposed the joint space were observed at the knee joints. Bacterial cultures were negative; however, the patient underwent negative-pressure wound therapy with continuous irrigation (NPWTci) in case of culture-negative infection. The patient's lower extremities were salvaged and the patient could walk using a walker. NPWTci and flap reconstruction are effective treatments for patients with persistent knee ulcers.

 Subclavian artery stenosis causes pain, coldness, and claudication in the upper limbs due to the narrowing at the base of the artery. In addition, the compensatory blood supply from the vertebrobasilar artery system can lead to cerebral ischemic symptoms such as fainting and dizziness. Herein, we report the case of an 86-year-old female patient who presented with unilateral progressive dry necrosis of the digits caused by subclavian artery stenosis. The patient did not exhibit cerebral ischemic symptoms. Contrast-enhanced computed tomography revealed stenosis at the bifurcation of the subclavian artery and vertebral artery, which impeded the development of a compensatory blood supply and consequently prevented cerebral ischemia. We performed percutaneous transluminal angioplasty followed by amputation, which yielded favorable results. Common causes of finger ulcers and necrosis include critical hand ischemia and hemodialysis-associated steal syndrome. Subclavian artery stenosis should be considered as a differential diagnosis.

 A 36-year-old woman experienced cardiac arrest due to trigeminocardiac reflex (TCR) during surgery for a right orbital floor fracture. The cardiac arrest lasted for 22 seconds and resolved spontaneously upon cessation of orbital tissue traction and administration of atropin. Postoperative recovery was uneventful, with no complications observed.
 TCR, caused by trigeminal nerve stimulation, can lead to sudden bradycardia, hypotension, or cardiac arrest. Risk factors include hypoxia, hypercapnia, shallow anesthesia, and either prolonged or strong stimuli. Effective management requires the prompt cessation of triggering stimuli and the administration of vagolytic agents such as atropine. This case emphasizes the importance of intraoperative vigilance and close collaboration between anesthesiologists and operating room staff to recognize and promptly respond to TCR.

 Clinodactyly commonly presents as a radial inclination of the little finger and cases involving the index finger are relatively rare. We report a case of a 14-year-old girl who was diagnosed with clinodactyly of the index finger at 8 years of age. She underwent osteotomy at 14 years of age leading to improvement of angulation (40º to 20º) and digital pinching. The patient recovered uneventfully without recurrence. The patient had no medical history of common causes of acquired clinodactyly including trauma, frostbite, inflammatory arthritis, and bone tumors. She was diagnosed with malignancy at 2 years of age, for which she underwent multimodal oncological therapy. The patient developed endocrine dysfunction, delayed skeletal maturation, and stature deficits. Our findings suggest that clinodactyly may have developed as a sequela of chemoradiotherapy.

 Distraction osteogenesis was introduced in 1998 for the treatment of craniosynostosis. Due to its minimal invasiveness, it became the primary procedure in Japan. Since the late 2000s, its application has expanded worldwide to include posterior cranial expansion. During this period, spring-assisted cranial expansion was reported from Scandinavia. However, a similar technique consisting of groove widening using springs had already been published in Japan approximately 30 years earlier. Herein, we present witness testimonies and historical documents.