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https://www.readbyqxmd.com/read/28537409/-ureterointestinal-anastomosis-in-urinary-diversion-current-opinion
#1
J Doležel
Uretero-intestinal anastomosis (UIA) is one of the most critical points for the occurrence of severe complications of intestinal urinary diversion. Perfection of the current techniques and development of new UIA methods are motivated by the effort to reduce both early and late post-surgical complications. The necessity of using antireflux UIA, especially with an orthotopic neobladder, is controversial: according to some authors, antireflux UIA of any type generally increases, in comparison with reflux UIA, the risk of obstruction that endangers renal function more than the urine reflux itself...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28530627/-laparoscopic-treatment-of-retroperitoneal-fibrosis
#2
Carlos Hernández Fernández, David Subirá Rios, Mercedes Moralejo Gárate, Elena Rodríguez Fernández, Jorge Caño Velasco, Felipe Herranz Amo
Retroperitoneal fibrosis is a disease that may condition a severe involvement of various organs, mainly upper urinary tract, even causing renal insufficiency. It was first described by Albarran in 1905 and it is also known as Ormonds disease. The correct diagnosis includes, in many cases, the performance of one or more tests: CT scan, MRI, renal scan, etc. It is often necessary the insertion of double J catheters on percutaneous nephrostomy tubes with the aim to preserve renal function. Initial treatment is medical, based on corticoids, and , less frequent, immunosuppressive or chemotherapy drugs...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#3
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28507861/absence-of-ulnar-artery-inflow-detected-by-allen-s-test-prior-to-radial-forearm-free-flap
#4
Benjamin A Taylor, Faisal Alzahrani, Eric Levi, S Mark Taylor, Matthew H Rigby, Jonathan Trites, Robert D Hart
Radial forearm free flaps are commonly used for soft-tissue reconstruction after resection of head and neck cancer. It is perfused by the radial artery, leaving the ulnar artery for perfusion of the hand and digits. The absence of distal ulnar artery and associated superficial palmar arch, however, has not been reported in cadaveric dissection. We report a case of unilateral ulnar artery flow absence, detected by Allen's test, during preoperative preparation for a radial forearm free flap. Based on the simplicity, safety, and ease, we recommend Allen's test to be performed preoperatively on every patient for whom such a flap is a consideration...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507354/the-bilobed-flap-a-better-option-for-soft-tissue-release-in-the-management-of-radial-club-hand
#5
Uzair Ahmed Qazi, Ishtiaq Ur Rehman Orakzai, Mamoon Rashid
OBJECTIVE: To establish that the bilobed flap as soft tissue release component for the radial club hand is superior to the z-plasty technique in type III and IV radial club hands. METHODS: This study was conducted at the Shifa International Hospital, Islamabad, Pakistan, from 2009 to 2015, and comprised patients with radial club hands operated by a single consultant plastic surgeon. Soft tissue release was performed at 08 months. The extremity was then casted for 08 weeks and kept in a long-arm cast for 3 to 6 months...
May 2017: JPMA. the Journal of the Pakistan Medical Association
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/28464581/-effects-of-vacuum-sealing-drainage-technique-in-acute-and-chronic-suppurative-tenosynovitis-of-hand
#7
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
#8
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/28423439/-reliable-flaps-for-congenitally-malformed-hands
#9
H Piza-Katzer, A Wenger
Congenital hand malformations are rare, but hand function and aesthetics cannot be improved by surgery in every affected child. However, whenever this is possible, it is important to create an individual surgical plan for each child. Growth has to be taken into account in the accurate planning of incisions and local flaps. Just because it is technically possible, not every flap should be used in the malformed child's hand. In the following article, we present a collection of reliable flaps in the surgery of the congenitally malformed hand...
February 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28392088/single-stage-treatment-of-osteomyelitis-for-digital-salvage-by-using-an-antibiotic-eluting-methylmethacrylate-joint-spanning-spacer
#10
REVIEW
Victoria L Aimé, John T Kidwell, Leland H Webb
Osteomyelitis of the digit is a challenging problem that can result in amputation. We describe 13 cases of osteomyelitis involving bones of the hand managed with a novel technique. We reviewed records of 12 patients (13 digits) who had joint-spanning, antibiotic-eluting (tobramycin or vancomycin), methylmethacrylate spacers placed as definitive, single-stage treatment for digital osteomyelitis. The primary outcome was digit salvage. Secondary outcomes were infection eradication (no recurrence at 3 months) and spacer removal...
April 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28392073/combined-multi-lobed-flaps-a-series-of-39-extensive-hand-and-multi-digit-injuries-one-staged-reconstructions-using-modified-designs-of-alt-dpa-and-chimeric-linking-flaps
#11
Liang Tang, Georgios Pafitanis, Peng Yang, Zan Li, Ming Jia, Isao Koshima, Dajiang Song, Zhenglin Chi
INTRODUCTION: The use of multiple small flaps linked in a "chain-linked" flap microanastomosed chimeric system is recommended in distal hand and digital defects reconstruction. The aim of this study is to demonstrates our experience utilizing microsurgical fabrication, multi-lobed and linking combined flaps for the reconstruction of hand degloving injuries with complex multidigit soft tissue defects. METHODS: Microanastomosed chimeric flap systems using ALT and DPA modified designed flaps were combined in five selections to cover extensive soft tissue defects involving the hands and multiple digits of 39 patients (M:F - 36:3) from October 2009 to February 2013...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28383404/progressive-fingertip-necrosis-after-nail-avulsion-injury-in-a-patient-with-ulnar-artery-hypoplasia-a-case-report
#12
Yeon Jin Jeong, Seong Hyuk Park, Jun Yong Lee
RATIONALE: Slowly progressive hand ischemia is mostly associated with medical illness such as vasculitis, and in patients with smoking history, Buerger disease is often considered first. However, despite the very low incidence of vascular anatomical anomalies, they can lead to hand ischemia. And if there is no consideration for them, proper treatment cannot be selected. PATIENT CONCERNS: A 42-year-old male smoker presented with a slowly progressing 5th fingertip necrosis following blunt trauma...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28370473/-half-folded-pedicled-scapular-bone-flap-for-nonunion-after-humeral-neck-fracture-a-case-report
#13
Gen Matsumae, Makoto Motomiya, Naoya Watanabe, Norimasa Iwasaki
Treatment of a nonunion of the proximal humerus remains a challenge because of the small proximal fragment and poor central cancellous bone stock of the humeral head. In this report, we describe our experience using a "half-folded" pedicled scapular bone flap with an anatomical locking plate to treat an atrophic nonunion of the proximal humerus in a 64-year-old right-handed woman. The patient had fallen and experienced a common humeral neck fracture 2.5 years previously. During the operation, we elevated the pedicled scapular bone flap, which measured 8...
March 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28366791/restoration-of-basic-hand-function-following-devastating-hand-injuries-using-a-microsurgically-fabricated-chimeric-iliac-osteocutaneous-flap
#14
Zhao Hui Pan, Ping Ping Jiang, Shan Xue, Hongfei Li, Jian Li Wang
Reconstruction following devastating hand injuries, with amputations of the thumb plus multiple digits, is challenging. Double flap or combined flap transfers may be options in such cases. Between 2012 and 2014, 6 patients underwent hand reconstruction following devastating injuries with amputations of the thumb and multiple digits. Sensate anterolateral thigh free flaps and superficial circumflex iliac artery osteocutaneous flaps were microsurgically fabricated as sequential chimeric flaps. Basic hand function, including pulp-to-palm distance, pinch strength, sensation recovery and modified DASH scores, were evaluated...
June 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#15
REVIEW
Mauricio De la Garza, Michael Sauerbier, Germann Günter, Curtis L Cetrulo, Reuben A Bueno, Robert C Russell, Michael W Neumeister
Improvements in critical care and burn victim resuscitation have led to increased survival of burned patients. Initial resuscitation, early excision of burned tissues, prevention of burn wound sepsis, and wound coverage remain mainstays of care. Many burn wounds require complex reconstruction. This is particularly important in the hand. Coverage of tendons, ligaments, joints, vessels, nerves, and bones of the hand requires healthy vascularized tissue to maintain viability and function. Local flaps or regional flaps may be within the burn zone of injury...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28363299/reconstruction-of-the-adult-and-pediatric-burned-hand
#16
REVIEW
Ryan P Cauley, Lydia A Helliwell, Matthias B Donelan, Kyle R Eberlin
Thermal injuries of the hand can have a great impact on function. Initial treatment should focus on the prevention of contracture through the use of tissue-sparing techniques and optimized occupational therapy. Surgical intervention should follow the standard reconstructive ladder and can involve several techniques from simple to complex including minimally invasive techniques, such as laser and steroid injection, contracture release and skin grafting, and local tissue rearrangement and regional flaps as well as distant pedicled and free flaps...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28363298/postburn-contractures-of-the-hand
#17
REVIEW
Matthew Brown, Kevin C Chung
Postburn contractures are a common occurrence after severe burn injuries. It is important to understand the pathologic condition and anatomy of specific postburn deformities in order to provide comprehensive surgical care. Postburn contractures can result in a flexion contracture, boutonniere deformity, burn syndactyly, metacarpophalangeal extension contracture, wrist contracture, or claw hand. A patient evaluation is performed before proceeding to the operating room. Surgery sequences require proper incision design, release of the skin, and deeper contracted structures and coverage with an appropriate flap or graft...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28359638/indications-and-predictors-for-reconstructive-surgery-after-hand-burns
#18
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/28344538/surgical-excision-of-mycosis-fungoides-using-thumb-sparing-reconstruction
#19
Giancarlo McEvenue, Ashley Kim, Paul Binhammer
Background: The differential for soft tissue tumors of the hand and upper limb is broad. Hematologic malignancy remains quite low on the differential for soft tissue tumors involving the hand, and there is little in the literature describing surgical management of such cutaneous manifestations. When the tumor is large or involves the thumb, careful consideration of reconstructive options is required. Methods: We present a rare case of an aggressively enlarging mycosis fungoides, a cutaneous T-cell lymphoma tumor, involving the thumb...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344527/reverse-radial-forearm-flap-to-provide-arterial-inflow-to-a-toe-transfer
#20
Joohak Kim, Alfred P Yoon, Neil F Jones
Background: Toe-to-thumb transfer has become the gold standard for thumb reconstruction, but in badly mutilated hands, additional soft tissue coverage may be required or a suitable recipient artery may not be available. There are only 3 case reports describing the successful use of a reverse radial forearm flap for coverage of a soft tissue defect around the thumb as well as providing arterial inflow for a toe transfer, performed either simultaneously or secondarily. Methods: A single surgeon's experience of all toe-to-hand transfers performed in conjunction with a reverse radial forearm flap between 1995 and 2014 was reviewed, including patient demographics, type of toe transfer and vascular pedicle, whether immediate or secondary, follow-up, and complications...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
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