: Hydatid disease is a parasitic condition that causes significant morbidity in endemic regions, with surgery being the standard treatment. However, extraordinary circumstances, particularly crises such as the COVID-19 pandemic and major earthquakes, have led to the postponement of elective surgeries and delayed patient presentation to healthcare facilities. This situation has resulted in more complicated clinical presentations of hydatid cysts and an increased need for emergency surgical interventions. The aim of this study was to evaluate the clinical characteristics, surgical approaches, complications, and outcomes of emergency hydatid cyst surgeries performed during crisis periods. : This retrospective study included 32 patients who underwent surgery for hydatid disease. Demographic data, presenting symptoms, surgical techniques, complications, and length of hospital stay were analyzed. Patients presenting with acute abdomen and requiring emergency surgery were defined as crisis-period cases and formed the main focus of the study, while those undergoing elective surgery were evaluated for comparison. Descriptive statistics were used; continuous variables were expressed as mean ± standard deviation, and categorical variables as frequency and percentage. : The mean age of patients was 51.9 years, and 62.5% were male. The most common presenting symptom was abdominal pain (71.9%). The rate of emergency surgery due to acute abdomen was 28.1%. The most frequently performed procedure was cystectomy (71.9%), and open surgery was required in 65.6% of cases. Preoperative complications included biliary fistula (9.4%) and rupture (6.3%), while postoperative complications most commonly included biliary fistula (9.4%) and atelectasis (9.4%). The mean length of hospital stay was 6.6 days. : During crisis periods, patients with hydatid disease more frequently present with conditions requiring emergency surgery. Our findings highlight the importance of emergency surgical preparedness under extraordinary circumstances and provide clinical insight into surgical practice during crisis periods.

• Median nerve variants within the carpal tunnel have a pooled prevalence of 12%. • Bifid median nerve is the most frequently reported morphological variant. • No consistent association was found between anatomical variants and carpal tunnel syndrome. • Coexisting vascular or muscular anomalies may influence surgical complexity. • Preoperative imaging may aid anatomical identification, although clinical benefit remains uncertain. Anatomical variants of the median nerve (MN) within the carpal tunnel are clinically relevant due to their potential impact on the development, diagnosis, and surgical management of carpal tunnel syndrome (CTS). Reported prevalence estimates vary considerably across populations and study designs. To systematically review the literature and estimate the pooled prevalence of morphological variants of the median nerve within the carpal tunnel, and to assess their laterality, geographic distribution, and reported clinical implications. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. MEDLINE, Scopus, Web of Science, CINAHL, and LILACS were searched from inception to November 2024. Google Scholar was used for supplementary screening of gray literature. Observational studies reporting the prevalence of MN variants identified through imaging, surgical exploration, or anatomical dissection were included. Methodological quality was assessed using the Anatomical Quality Assessment (AQUA) tool. Pooled prevalence estimates were calculated using a random-effects model (DerSimonian–Laird) with Freeman–Tukey double arcsine transformation. Sixty-three studies met eligibility criteria for qualitative synthesis, and 19 studies (n = 9,045 subjects) were included in the primary meta-analysis. The pooled prevalence of MN variants within the carpal tunnel was 12% (95% CI: 9–15%), with substantial heterogeneity (I² = 87%). Subgroup analysis showed similar prevalence in imaging-based studies (12%, 95% CI: 9–15%; I² = 87.8%). No clear laterality predominance was observed (right: 46%, 95% CI: 40–52%; I² = 0.0%; left: 53%, 95% CI: 48–59%; I² = 0.0%), whereas bilateral presentation demonstrated greater variability (21%, 95% CI: 6–36%; I² = 90.6%). Geographic subgroup analysis showed pooled prevalence estimates of 22% in Asia (95% CI: 13–31%; I² = 92.6%), 20% in Europe (95% CI: 14–27%; I² = 79.2%), and 18% in America (95% CI: 16–20%; I² = 19.4%). Morphological variants of the median nerve within the carpal tunnel are relatively common anatomical findings. Current evidence does not support their role as independent risk factors for CTS; however, their coexistence with vascular or muscular anomalies may influence local anatomical relationships and surgical complexity. Preoperative imaging may facilitate anatomical identification and surgical planning, although its impact on clinical outcomes and intraoperative complications remains uncertain and requires further prospective investigation.

This study aimed to examine the efficacy of an artificial dermal pocket supplemented with basic fibroblast growth factor (bFGF) to reduce congestion and improve tissue survival in a rat tail model lacking venous return, mimicking distal finger replantation. The congestion model was established in 45 Sprague-Dawley rats by preserving tail artery perfusion, while obstructing venous return. The rats were randomly allocated to three groups: Group 1 had artificial dermal pockets supplemented with bFGF; Group 2 had circumferential incisions with bFGF; Group 3 had a circumferential incision only. Tail congestion, oedema, circumference, and temperature were measured post-surgery. On day 1, all models showed tail congestion and oedema, peaking by day 3 (Group 2 and 3) and day 6 (Group 1). Significant differences in tail circumference and temperature were observed between Groups 1 and 2, and Groups 1 and 3 on days 3 and 6. By day 11, survival rates were 11/15, 9/15, and 3/15 in Groups 1, 2, and 3, respectively. Histological analysis revealed that Group 1 showed robust granulation tissue with abundant neovascularisation, superior than Group 2 and 3. These results suggest that in a rat tail model of venous congestion, the strategy of constructing an artificial dermal pocket combined with bFGF application is associated with enhanced granulation tissue bridging and neovascularisation, and significant reduction in congestion and improved tissue survival. The observed benefits likely represent the combined contribution of the dermal scaffold, growth factor, and protected wound environment provided by the surgical pocket.