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https://www.readbyqxmd.com/read/28606622/reconstruction-of-combined-thumb-amputation-at-the-metacarpal-base-level-and-index-amputation-at-the-metacarpal-level-with-pollicization-and-bilateral-double-toe-composite-transfer
#1
Zhenglin Chi, Da Jiang Song, Lin Tian, Fu Hua Hu, Xiao Fang Shen, Harvey Chim
BACKGROUND: This study aimed to describe the technique and report our experience with the reconstruction of combined proximal thumb amputations at the metacarpal base level and index finger amputation at the metacarpal level with pollicization and bilateral double toe composite transfer. METHODS: The technique consists of pollicization of the remnant index ray. Then a contralateral composite medial great toe pulp and vascularized second toe proximal interphalangeal joint flap are harvested to reconstruct the metacarpophalangeal joint of the thumb...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28601599/innervated-dorsoradial-perforator-free-flap-a-reliable-supermicrosurgery-fingertip-reconstruction-technique
#2
Dajiang Song, Georgios Pafitanis, Peng Yang, Mitsunaga Narushima, Zan Li, Linfeng Liu, Zengtao Wang
INTRODUCTION: This study demonstrates the use of a modified free innervated DRAP flap utilizing the supermicrosurgery technique for fingertip reconstruction. MATERIALS AND METHODS: From January 2010 to February 2014, 20 cases of fingertip reconstruction were performed using a short pedicle mini innervated transverse DRAP flap. The patients demographics, the mechanism of injury, the defect size and anatomical location, the source of pedicle vessels, the recipient vessels, the nerve branch used for innervation, the follow-up and sensation outcomes are reported...
May 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28598001/3d-printing-technology-in-planning-thumb-reconstructions-with-second-toe-transplant
#3
Cheng-Wu Zang, Jian-Lei Zhang, Ze-Zu Meng, Lin-Feng Liu, Wen-Zhi Zhang, Yong-Xiang Chen, Rui Cong
OBJECTIVE: To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. METHODS: Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28570448/free-lateral-digital-flap-for-reconstruction-of-the-fingers
#4
Hidehiko Yoshimatsu, Takuya Iida, Akitatsu Hayashi, Takafumi Saito
BACKGROUND: The region between the proximal interphalangeal (PIP) and the metacarpophalangeal (MP) creases has greater laxity than other regions in the fingers, allowing for primary closure of the donor site. We postulated if we could consistently locate perforators from the region between the PIP and the MP crease on the radial side of the middle and ring fingers, on which a scar would be less conspicuous than one on the radial side of the index finger, these regions would be ideal donor sites for digital reconstruction using very small flaps...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28499664/stemi-with-fluctuating-closing-of-lad-and-cx-do-not-concentrate-on-the-finger
#5
Mario Sadaba, Asier Subinas, Jose Ramón Rumoroso
Case report of the male with an anterior STEMI to whom a primary PCI is performed. The angiogram shows a fluctuating close of the LAD and Cx than when an OCT is performed does not clearly see any pathological findings but when the IVUS is performed, it is clearly seen as a coronary haematoma at the LM, LAD and Cx. Stent at the LM-LAD and proximal Cx are implanted with final good result. After exchanging the guiding catheter for a diagnostic catheter to visualize the RCA, there is an aortic flap; the coronary haematoma was coming from an ascending aortic dissection...
March 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28481465/risk-factors-for-pedicled-flap-necrosis-in-hand-soft-tissue-reconstruction-a-multivariate-logistic-regression-analysis
#6
Xu Gong, Jianli Cui, Ziping Jiang, Laijin Lu, Xiucun Li
BACKGROUND: Few clinical retrospective studies have reported the risk factors of pedicled flap necrosis in hand soft tissue reconstruction. The aim of this study was to identify non-technical risk factors associated with pedicled flap perioperative necrosis in hand soft tissue reconstruction via a multivariate logistic regression analysis. METHODS: For patients with hand soft tissue reconstruction, we carefully reviewed hospital records and identified 163 patients who met the inclusion criteria...
May 8, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28470032/pedicled-unipolar-latissimus-dorsi-flap-for-reconstruction-of-finger-extensor
#7
Mitsuhiko Takahashi, Tokio Kasai, Naohito Hibino, Seiji Ishii, Tadashi Mitsuhashi
We describe the use of a pedicled unipolar latissimus dorsi flap to restore finger extension. The patient had large defects in the radial nerve and extensor musculature. A long-tailed, 50-cm-long flap was prepared, which enabled the end of the flap to be sutured to the extensor digitorum.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/28464581/-effects-of-vacuum-sealing-drainage-technique-in-acute-and-chronic-suppurative-tenosynovitis-of-hand
#8
H Wang, F Xia, D M Xing, D Ren, W Feng, Y Chen, Z H Xiao, Z M Zhao
Objective: To investigate the effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand. Methods: A total of 9 cases acute and chronic suppurative tenosynovitis patients from January 2013 to April 2015 in Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were retrospectively reviewed. There were 6 males and 3 females, aging from 27 to 65 years, the average age was 55 years. There were 3 cases of index finger, 3 cases of middle finger, 2 cases of ring finger, 1 case include three fingers...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28444647/-partial-fasciectomy-and-options-of-reconstruction-using-local-flaps-in-cases-of-dupuytren-s-disease
#9
N Spindler, C Josten, S Langer
Aim: Partial fasciectomy in cases of grade III-IV Dupuytren's contracture and coverage of the defect with local flaps. Indication: Dupuytren's contracture is a progressive disease of the hand associated with the formation of fascial cords, which may result in flexion and adduction contractures of the fingers leading up to complete dysfunction of the hands. Method: If several fingers are affected, partial fasciectomy is the gold standard in the treatment of Dupuytren's contracture. Ideally, the fingers reach the neutral position after the fibres causing the contracture are resected and arthrolysis is performed as needed...
April 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28434834/the-zitelli-bilobed-flap-on-skin-coverage-after-mucous-cyst-excision-a-retrospective-cohort-of-33-cases
#10
Isidro Jiménez, Pedro J Delgado, Ricardo Kaempf de Oliveira
PURPOSE: To study the time to wound healing and recurrence rate achieved in the treatment of distal interphalangeal joint mucous cysts using the Zitelli modified bilobed flap. METHODS: We surgically treated 33 patients from January 2006 to June 2015. We assessed demographic data, comorbidities, location and size of the cyst, time to wound healing, and complications. RESULTS: The most affected finger was the right middle finger. All flaps survived and wounds healed in 14 days on average...
April 20, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28372640/fingertip-and-thumb-tip-wounds-changing-algorithms-for-sensation-aesthetics-and-function
#11
REVIEW
Günter Germann, Klaus D Rudolf, Scott L Levin, Manuel Hrabowski
Management of fingertip and thumb tip injuries has recently undergone substantial changes. The time-proven traditional armamentarium of local flaps has been expanded and replaced by a wide variety of flaps. Simultaneous with the development of new flaps, the conservative treatment of fingertip and thumb tip injuries with semiocclusive dressings has also become a more acceptable treatment for these injuries. The excellent results with respect to restoring contour, sensibility of the pulp, and aesthetics of the finger justify this more tedious and time-consuming treatment of fingertip and thumb tip injuries...
April 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28372639/single-stage-separation-of-3-and-4-finger-incomplete-simple-syndactyly-with-contiguous-gull-wing-flaps-a-technique-to-minimize-or-avoid-skin-grafting
#12
Xiaofei Tian, Jun Xiao, Tianwu Li, Wei Chen, Qiu Lin, Harvey Chim
PURPOSE: Staged separation of 3- and 4-finger syndactyly is commonly performed owing to concerns about vascular supply to the central digit and availability of flap skin. We performed single-stage separation of patients with incomplete syndactyly of multiple digits with adjacent contiguous dorsal gullwing flaps and avoided skin grafts in the majority of cases. METHODS: Seventy-four webs of 31 patients with more than 2-finger incomplete syndactyly were included. Median age at surgical separation was 12 months (range, 5-123 months)...
April 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365145/the-double-thenar-flap-a-technique-to-reconstruct-2-fingertip-amputations-simultaneously
#13
REVIEW
Daniel B Polatsch, Remy V Rabinovich, Steven Beldner
Fingertip injuries are a common problem. There may be pulp loss and exposed bone. Various techniques have been described to reconstruct function as well as aesthetics; yet it is still unclear which treatment options should be chosen for each specific injury. Evidence-based treatment strategies are limited because there are no prospective randomized clinical trials evaluating one method with another. Fingertip injuries are usually variable in their presentation, and therefore treatment decisions are often dictated by the knowledge and expertise of the treating physician combined with the patient's unique injury...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359638/indications-and-predictors-for-reconstructive-surgery-after-hand-burns
#14
C H van der Vlies, S de Waard, J Hop, M K Nieuwenhuis, E Middelkoop, M E van Baar, P P M van Zuijlen
PURPOSE: The objective of this study was to analyze the prevalence, indications, and type of reconstructive surgery and predictors of the outcomes of reconstructive surgery after hand burns. METHODS: A retrospective cohort study was conducted that included all patients admitted with acute hand burns in the Dutch burn centers from January 1998 through December 2002. The details of reconstruction including frequency, timing, indication, and techniques were collected over a 10-year follow-up period...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359353/guitar-string-suture-to-facilitate-closure-of-a-finger-like-flap-for-reconstruction-of-the-nose
#15
E Querol-Cisneros, P Redondo
INTRODUCTION: The basic principle of a lobed or finger-like transposition flap is that, after covering the defect with the transposed tissue, the donor site is closed primarily. With large defects, a second lobe may be added to the flap if primary closure of the area left by the first lobe is not possible. The flap can often be made to adapt to the defect, but this maneuver, in combination with primary closure of the adjacent tissue, can sometimes produce excessive tension and compromise the blood supply...
March 27, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#16
REVIEW
Bruno Battiston, Davide Ciclamini, Jin Bo Tang
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28289889/finger-reconstruction-using-induced-membrane-technique-and-ulnar-pedicled-forearm-flap-a-case-report
#17
Olivier Herisson, Alain-Charles Masquelet, Levon Doursounian, Alain Sautet, Adeline Cambon-Binder
INTRODUCTION: Injuries referred to as "rollover hands" are associated with multiple and complex lesions of the dorsal aspect of the hand. We present a case of a multitissular reconstruction following a severe injury of the dorsum of the fingers in a 45-year-old woman. MATERIALS AND METHODS: The bone loss reconstruction was performed in two stages using the Masquelet induced membrane technique. In the first stage, a cement spacer was inserted into the phalanx bone defects...
May 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28272123/reconstruction-of-moderate-sized-hand-defects-using-a-superficial-lateral-sural-artery-perforator-flap
#18
Xiao-Qing He, Yue-Liang Zhu, Jia-Zhang Duan, Xi Yang, Fanzhe Feng, Yong-Qing Xu
BACKGROUND: The skin on the lower leg has abundant perforators and, thus, is an excellent donor site for transplant tissue flaps. However, due to vascular variations and body positions, tissue flaps at the posterolateral proximal portion of the lower leg are rarely used for transplantation. This study reports our experience with the use of superficial lateral sural artery perforator (SLSAP) flaps in the repair of moderate-sized hand wounds. METHODS: From March 2012 to April 2015, the hand wounds of 15 patients were planned for repair using a superficial sural artery perforator flap...
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28259275/extended-posterior-interosseous-artery-flap-anatomical-and-clinical-study
#19
Ezequiel Ernesto Zaidenberg, Efrain Farias-Cisneros, Martin Jose Pastrana, Carlos Rodolfo Zaidenberg
PURPOSE: A reverse-flow pedicled flap from the posterior interosseous artery (PIA) has been used to cover defects on the dorsal and volar aspects of the hand. However, the original description of this flap does not reach further than the metacarpophalangeal joints of the 4 ulnar digits. In the present study, we describe a distal variant (type 2) of the PIA flap, which changes the pivot point of the classic variant (type 1) and which can provide full coverage of single or multiple digits in the entire dorsum and palmar surface of the fingers...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28251838/is-hyperbaric-oxygen-therapy-indispensable-for-saving-mutilated-hand-injuries
#20
I-Han Chiang, Yuan-Sheng Tzeng, Shun-Cheng Chang
Mutilated hand injuries are a profound challenge to the plastic surgeon, and such injuries often lead to limb loss and severe functional impairment. Hyperbaric oxygen therapy (HBOT) appears to counteract tissue hypoxia and stimulate acute wound healing. This study was performed to evaluate the efficacy of HBOT as an adjunctive therapy in patients with a mutilated hand injury. Between January 2006 and December 2014, 45 patients with a mutilated hand injury were enrolled. After reconstruction or revascularisation, patients underwent 120 minutes of HBOT with oxygen at 2·5 atmospheres absolute while breathing 100% oxygen...
March 1, 2017: International Wound Journal
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