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Flaps finger

Zhenglin Chi, Peng Yang, Dajiang Song, Zan Li, Liang Tang, Weiyang Gao, Yonghuan Song, Tingang Chu
INTRODUCTION: To investigate the results of resurfacing completely degloved digits using bilobed innervated radial artery superficial palmar branch (RASPB) perforator flap in a spiral fashion. METHODS: A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The flap-raising procedure was performed using four fresh cadaver specimen...
October 21, 2016: Surgical and Radiologic Anatomy: SRA
Guangliang Zhang, Jihui Ju, Guangzhe Jin, Linfeng Tang, Yi Fu, Ruixing Hou
PURPOSE: The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. METHODS: Ten patients who had received replantation or revascularization surgery for hand degloving injury between 2002 and 2014 were included for this study. The average age at the time of surgery was 34.5 years (range 18-49 years). There were nine left and one right hand replantations. The cause of injury was an industrial machine press in all of them...
September 19, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Satoshi Usami, Mutsumi Okazaki, Tomohisa Nitta, Noriko Uemura, Tsutomu Homma, Keiichi Akita
OBJECTIVE: Many skin flaps have been described for fingertip reconstruction; however, they have not been compared histologically. The aim of this study is to compare the histological features of common insensate flaps that are used for fingertip reconstruction. METHOD: Skin from fingertips and common flap donor sites on the hand and forearm of cadavers were harvested. This study investigated four histological characteristics, namely thickness of the epidermis and dermis; the ratio of collagen to elastic fibres (C/E ratio) in subdermal tissues, and distribution densities of Merkel cells and Meissner's corpuscles...
August 15, 2016: Journal of Plastic Surgery and Hand Surgery
Hyun Ho Han, Byung Yeun Kwon, Sung No Jung, Suk-Ho Moon
Occupational injuries to digits due to hydrofluoric acid (HFA) are frequently encountered. They have distinctive features, including intense pain, progressive tissue necrosis, and possible bone erosion. To minimize tissue damage, it is of great importance to execute prudent preoperative assessment and determine the correct surgical modality to reconstruct and maintain the function of the hand. However, proper protocols for fingers have not been presented in previous studies. Eight cases with HFA burn to digits were presented to the emergency room...
September 17, 2016: Burns: Journal of the International Society for Burn Injuries
S H Lee, S J Cheon, Y J Kim
: Unsuccessful reconstruction of injured fingers can lead to poor outcomes. The aim of this article was to investigate the clinical application of the radial artery superficial palmar branch flap for soft-tissue reconstruction of the finger. We treated 125 patients with various finger injuries who underwent free radial artery superficial palmar branch flap reconstruction between October 2010 and March 2015. There were 46 distal finger injuries, 25 distal finger amputation following failed replantation and 54 palmar digital injuries with tendon, bone or joint exposure requiring soft-tissue reconstruction...
September 8, 2016: Journal of Hand Surgery, European Volume
Bommie Florence Seo, Byung Yeun Kwon, Hyun Ho Han
In this report we present a case of large sized volar surface defect of a digit reconstructed by hypothenar perforator free flap coverage. A 57-year-old male patient presented with a 5 × 2 cm sized avulsive injury on his left little finger involving near total loss of the volar surface. The perforator arteries of the hypothenar area were identified around 5-15% on the x-axis and 25-50% on the y-axis (y-axis: a line from the pisiform base to the metacarpophalangeal joint, x-axis: a line perpendicular to the y-axis...
September 4, 2016: Microsurgery
Cosma Calderaro, Matteo Guzzini, Marco Pagnottelli, Mattia Fabbri, Dario Perugia
We report a case of post-traumatic trigger finger due to a partial longitudinal tear of the flexor digitorum superficialis. The suspect came from the clinical history and the young age of the patient. It was successfully treated with tendon flap suture and pulley A1 release.
2016: Case Reports in Plastic Surgery & Hand Surgery
Masayuki Okochi, Masami Saito, Kazuki Ueda
We treated nine patients with skin defect produced by digital mucous cyst (DMC) excision on the finger and toe using lateral finger flap (LFF). The postoperative scars were esthetically acceptable and no recurrence of mucous cysts was observed. Our LFF is a simple method to repair minor distal dorsal finger defects.
2016: Case Reports in Plastic Surgery & Hand Surgery
Jack C Exell, Mark J Thompson, L David Finger, Steven J Shaw, Judit Debreczeni, Thomas A Ward, Claire McWhirter, Catrine L B Siöberg, Daniel Martinez Molina, W Mark Abbott, Clifford D Jones, J Willem M Nissink, Stephen T Durant, Jane A Grasby
The structure-specific nuclease human flap endonuclease-1 (hFEN1) plays a key role in DNA replication and repair and may be of interest as an oncology target. We present the crystal structure of inhibitor-bound hFEN1, which shows a cyclic N-hydroxyurea bound in the active site coordinated to two magnesium ions. Three such compounds had similar IC50 values but differed subtly in mode of action. One had comparable affinity for protein and protein-substrate complex and prevented reaction by binding to active site catalytic metal ions, blocking the necessary unpairing of substrate DNA...
October 2016: Nature Chemical Biology
Ricardo Horta, Ricardo Nascimento, Alvaro Silva, Rui Pinto, Pedro Negrão, Ricardo São-Simão, Jorge Carvalho, Marta Santos Silva, Jose Amarante
Radial club hand may be congenital or acquired; radial deviation of the hand is usually found, associated with palmar flexion-pronation and treatment of severe forms of radial club hand is often difficult. Here we present a case of reconstruction of a severe postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure in a 28-year-old man. The patient had a radial deviation of the wrist and right upper limb shortening as a result of an infected pseudarthrosis of the radius...
October 2016: Microsurgery
Diogo Casal, Teresa Cunha, Diogo Pais, Paula Videira, Joana Coloma, Carlos Zagalo, Maria Angélica-Almeida, João Goyri O'Neill
BACKGROUND: Although unconventional perfusion flaps have been in clinical use since 1975, many surgeons are still deterred from using them, because of some reports of high necrosis rates. METHODS: The authors performed a systematic review and meta-analysis of all articles written in English, French, German, Spanish, and Portuguese on the clinical use of unconventional perfusion flaps and indexed to PubMed from 1975 until July 15, 2015. RESULTS: A total of 134 studies and 1445 patients were analyzed...
August 2016: Plastic and Reconstructive Surgery
Luis C Díaz, Enrique Vergara-Amador, Lina M Fuentes Losada
The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Report of cases a series of fingertip amputation covered with this technique...
July 19, 2016: Techniques in Hand & Upper Extremity Surgery
Kostopoulos Epameinondas, Agiannidis Christos, Konofaos Petros, Dounavis Avraam, Papadopoulos Othon, Casoli Vincent
BACKGROUND: The proper digital arteries as any other axial vessel give rise to multiple cutaneous perforators either volar or dorsal along their course. Their identification is performed with Doppler flowmetry. The vasculo-cutano-tendino-osseous complex (VCTOC), which was described by the senior authors, was responsible for the vascularization of all digital anatomic structures (extensor apparatus, skin, periosteum). Their consistent appearance to well measured distances from the digital joints led the way to the present clinical study for highlighting this described anatomy in-vivo and demonstrating the predictability in digital artery perforator (DAP) flap harvest...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Shuming Ye, Xiaofeng Teng, Hong Chen, Juehua Jing, Jisen Zhang
OBJECTIVE: To explore the effectiveness and operation of repairing multiple soft tissue defects in hands with lateral arm lobulated flaps. METHODS: Between October 2013 and September 2015, 13 cases of multiple soft tissue defects in the hand with tendon or bone exposure were treated with lateral arm lobulated flaps. All patients were males with average age of 28 years (range, 23-45 years). Defects were caused by penetrating injury in 7 cases, traffic accident injury in 3 cases, and hot-crush injury in 3 cases...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
Shuaizhi Yang, Lu Chen, Canbin Zheng, Jungui Yang, Yu Huang, Jiande Cui
OBJECTIVE: To investigate the application of the double skin paddle arterialized venous flaps for reconstruction of soft tissue defects in the middle and proximal parts of double fingers. METHODS: Between September 2011 and December 2014, 6 cases (12 fingers) of soft tissue defects in the middle and proximal parts of double fingers underwent reconstructive surgery with the double skin paddle arterialized venous flaps. There were 5 males and 1 female with an average age of 33...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
Hongjun Liu, Subhash Regmi, Yanyan He, Ruixing Hou
INTRODUCTION: Thumb tip reconstruction has been a very challenging issue for hand surgeons. Varieties of reconstructive options have been described or modified to obtain satisfactory sensory recovery. However, none has yielded entirely satisfactory results. This study reports a retrospective review of clinical data records of patients treated with a neurovascular island pedicle flap obtained from the medial aspect of the long finger. METHODS: We enrolled 15 patients (9 men and 6 women), who received neurovascular island pedicle flaps for thumb tip amputations between December 2011 and December 2015...
October 2016: Aesthetic Plastic Surgery
Xiao Fang Shen, Jing Yi Mi, Ming Yu Xue, Gang Zhao, Li Qiang, Xiao Zhou, Yong Jun Rui, Harvey Chim
BACKGROUND: The purpose of this article is to report the authors' experience with the use of the modified great toe wraparound flap with preservation of a plantar triangular flap for reconstructing degloving injuries of the thumb and fingers. METHODS: Between 2007 and 2012, 31 patients underwent reconstruction with 37 flaps. Twenty-seven patients underwent reconstruction with 31 flaps for a degloved thumb and fingers, and four patients underwent reconstruction with six flaps for degloved fingers only...
July 2016: Plastic and Reconstructive Surgery
S Dast, L Dessena, N Assaf, E David, C Herlin, R Sinna
Surgical treatment of complete cutaneous ring finger avulsion is a challenge in hand surgery. When replantation of the avulsed fragment is not technically feasible, the surgeon must consider reconstruction of soft tissue. Many surgical techniques have been described. We report a case of complete avulsion of the cutaneous sheath and nail of the fourth finger with preservation of mobility and collateral nerves. The reconstruction of soft tissue was performed by a Colson flap-graft. This simple and reliable technique of reconstruction allowed to obtain a functional and sensitive finger with a satisfactory cosmetic result...
June 22, 2016: Annales de Chirurgie Plastique et Esthétique
Muwei Li, Luo Zhaohui, Hannan Gu, Lifeng Ma, Yanjun Yang, Ziqing Zhang
OBJECTIVE: To discuss the effectiveness of free croin flap in repairing defects of donor after toe or feetissue flap transplantation. METHODS: Between March 2010 and May 2015, 23 cases of defects of donor after toe or feet tissue flap transplantation were repaired with free croin flap and followed up for more than 6 months, and the clinical data were retrospectively analyzed. There were 15 males and 8 females, with an age range from 17 to 52 years (mean, 25.6 years)...
February 2016: Chinese Journal of Reparative and Reconstructive Surgery
Takumi Yamamoto, Hidehiko Yoshimatsu, Kazuki Kikuchi
Dorsal skin defect of the hand/digit requires thin and pliable skin for coverage. The prepuce skin, the second thinnest skin, can be a reconstructive option, but there is no previous report of a free prepuce flap for the reconstruction of the hand/digit. We report the first successful case of a free prepuce flap based on the superficial penile artery perforator (SPAP) for the treatment of dorsal soft tissue defect of the hand/digit. A 68-year-old male presented with a 5 x 3 cm dorsal soft tissue defect of the left index finger with the extensor tendon exposure...
May 21, 2016: Microsurgery
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