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https://www.readbyqxmd.com/read/28372640/fingertip-and-thumb-tip-wounds-changing-algorithms-for-sensation-aesthetics-and-function
#1
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
#2
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
#3
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...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359638/indications-and-predictors-for-reconstructive-surgery-after-hand-burns
#4
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...
March 27, 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
#5
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
#6
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
#7
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...
March 13, 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28242241/neurovascular-advancement-flap-to-release-flexion-contracture-of-the-proximal-interphalangeal-joint
#11
REVIEW
James Tseng, Yu-Te Lin
Various methods have been described to surgically release posttraumatic flexion contracture of the proximal interphalangeal joint. Extension of the distal digit often creates a soft tissue defect on the volar aspect of the finger. Although various flaps and skin grafting have been utilized for coverage of this defect, they can be associated with morbidity. We present our experience with a volar neurovascular advancement flap to achieve soft tissue release in proximal interphalangeal joint flexion contracture...
February 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28216827/distal-phalanx-amputation-with-delayed-presentation-and-successful-reconstruction-with-reposition-and-flap-after-2-weeks
#12
Jefferson Braga-Silva, Renato Franz Matta Ramos, Gabriela Meirelles Marchese, Pedro Salomao Piccinini
Traumatic finger amputations are common, causing significant functional and cosmetic deficits. Microsurgical replantation techniques are the mainstay of treatment for most such injuries although they require adequate conservation of the amputated segment for a successful result. In distal finger amputations, replantation is the procedure of choice, as long as the amputated fragment is viable. If replantation is not an option, reposition + flap using a neurovascular flap can be an efficient option, as this offers improved skin coverage...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28183229/modified-innervated-sensory-cross-finger-flap-in-failed-finger-replantation
#13
S H Lee, S J An, D H Kim, S M Hong, J I Kim
No abstract text is available yet for this article.
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28178151/reconstruction-of-large-area-defect-of-the-nail-bed-by-cross-finger-fascial-flap-combined-with-split-thickness-toe-nail-bed-graft-a-new-surgical-method
#14
Jianyun Yang, Tao Wang, Cong Yu, Yudong Gu, Xiaotian Jia
Fingertip injury commonly results in avulsion of the nail bed. For large area defects of the nail bed with distal phalanx exposure, methods for reconstruction of soft tissue defects are scarcely mentioned in the literature.From May 2014 to January 2016, 6 patients with large area defects of the nail bed with distal phalanx exposure were enrolled. A new surgical method, cross finger fascial flap combined with thin split-thickness toe nail bed graft, was applied in all patients.All the 6 patients were followed-up at least 3 months...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176541/super-kutler-flap-an-alternative-technique-for-reconstruction-of-fingertip-defects
#15
E Arpaci, R E Unlu, S Altun, N M Ertas
The bilateral V-Y flap concept for fingertip reconstruction was first desribed by Kutler. This method has limitations, such as flap size and advancement, therefore larger flap modifications are described to increase the advancement capacity of the flaps. We described a small direct-flow homodigital island flap method, called the 'super Kutler flap', for recontruction of finger pulp defects. In addition, neurorrhaphy was performed between the cut ends of the digital nerves to prevent neuroma formation. This method was used in 10 fingers in patients who had undergone pulp tissue reconstruction of fingertip defects from May 2008 to October 2011...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28160036/-treatment-of-recurrent-dupuytren-s-disease
#16
T Pillukat, L Walle, R Stüber, J Windolf, J van Schoonhoven
BACKGROUND: The tendency of recurrence or progression is a frequent problem in Dupuytren's disease. The management of recurrence is adapted to the individual situation and the patient's needs. In mild cases a non-operative approach is recommended. Revision surgery is reserved for disabling situations with acceptable circulation and sensation in absence of dystrophy. It is complicated by a combined formation of scar tissue and new cords. This increases the risk of soft tissue loss and injuries to the neurovascular bundles, which impair sensation and circulation and may result in loss of the finger...
February 3, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28149255/treatment-of-an-acute-deep-hand-burn-in-a-lowincome-country-with-no-available-microsurgery-a-case-report
#17
K S Amouzou, A El Harti, T E Kouevi-Koko, A Abalo, A Dossim
Deep hand burns usually lead to joint and tendon exposure. A simple skin graft is insufficient to achieve healing. Soft tissue reconstruction represents a surgical challenge that ranges from the simplest to the most complex flaps. In some areas, microsurgery is not technically possible. Choice is then limited to pedicled distant flaps such as the abdominal wall flap-graft. We report a case of an acute burned hand with exposure of metacarpophalangeal joints from the second to the fourth radius as well as proximal inter phalangeal joints from the second to the fifth radius and extensor tendons, treated in the burns and wound care unit of the Sylvanus Olympio Teaching Hospital in Lomé...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28141728/parental-influence-on-a-child-s-autistic-traits
#18
Randall Phelps, Robert Nickel, Debi Eisert, Martin T Stein
Robbie is a 4-year-old boy whose parents are concerned about his speech, social skills, and repetitive behaviors. He has poor articulation; at time, he is difficult to understand. On the other hand, he has a fair vocabulary, and he has good intent to communicate. He is generally able to communicate his needs and wants. He likes to tell his parents about his day.When he begins the day at preschool, Robbie initially stands by himself and watches. He slowly warms up and eventually participates in activities. He engages in parallel play or follows other children...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28099360/aggressive-intramuscular-hemangiomas-in-the-upper-extremity-a-case-report
#19
Hui Lu, Qiang Chen, Hu Yang, Hui Shen
INTRODUCTION: Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us. CLINICAL FINDINGS: This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. On physical examination, the tumor and skin flap complex was seen with a size of 14 cm_12 cm in his right hand, and the multiple postoperative scars were shown on his right hand and forearm...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28065405/fingertip-reconstruction-with-a-posterior-interosseous-artery-perforator-flap-a-minimally-invasive-procedure-for-donor-and-recipient-sites
#20
Satoshi Usami, Mutsumi Okazaki
BACKGROUND: A posterior interosseous artery perforator flap is used for small defects and leaves no functional disturbance at the flap donor site. This report aimed to describe our experience with the transfer of this flap for fingertip defects and the evaluation of postoperative function. METHODS: In total, 11 flaps were used for 13 fingertip reconstructions in 11 patients. Two patients had two finger defects simultaneously covered with one bridge flap, and five flaps were harvested in true perforator flap style...
February 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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