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https://www.readbyqxmd.com/read/28423439/-reliable-flaps-for-congenitally-malformed-hands
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
March 21, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#7
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
#8
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
#9
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
#10
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/28344538/surgical-excision-of-mycosis-fungoides-using-thumb-sparing-reconstruction
#11
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
#12
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
https://www.readbyqxmd.com/read/28341070/severe-hand-injuries-from-fireworks-injury-patterns-%C3%A2-outcomes-and-fireworks-types
#13
Brinkley K Sandvall, Kari A Keys, Jeffrey B Friedrich
PURPOSE: The purpose of this study was to characterize injury patterns and outcomes of fireworks-related hand injuries and determine if there was an association with certain fireworks types. METHODS: A retrospective cohort study was conducted on patients treated at a trauma center between 2005 and 2015. A total of 105 patients sustaining operative hand injuries due to fireworks were identified. Medical records were reviewed to identify injury patterns, treatment outcomes, and fireworks types...
March 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#14
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/28340660/severe-crush-injury-to-the-forearm-and-hand-the-role-of-microsurgery
#15
REVIEW
Francisco Del Piñal, Esteban Urrutia, Maciej Klich
The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Digital defects often require the use of complete or subtotal toe transfer to avoid amputation and restore function to the hand...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340659/exploring-new-frontiers-of-microsurgery-from-anatomy-to-clinical-methods
#16
REVIEW
Zeng Tao Wang, You Mao Zheng, Lei Zhu, Li Wen Hao, Ya Bin Zhang, Chao Chen, Li Feng Xia, Lin Feng Liu
This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340658/a-global-view-of-digital-replantation-and-revascularization
#17
REVIEW
Jin Bo Tang, Zeng Tao Wang, Jing Chen, Jason Wong
Survival rates of digital replantation vary in different regions and countries, and Asian surgeons see more challenging cases and have developed some unique methods. Replantation of multiple digits in one or both hands can follow a structure-by-structure method or a digit-by-digit method. For replanting all 10 digits, 3 or 4 teams should be organized. Flow-through flaps, often venous flaps, can be taken from the distal forearm or lower extremity to repair defects of soft tissues and arteries. A pedicled digital artery flap from the adjacent digit can also repair tissue defects and supply blood to the replanted digit...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28293513/the-number-of-perforators-included-in-reversed-flow-posterior-interosseous-artery-flap-does-it-affect-the-incidence-of-venous-congestion
#18
Khaled A Reyad, Ayman A Shaker, Amir S Elbarbary, Mohamed A Sayed, Mohamed A Elghareeb
BACKGROUND: The purpose of this study is to decrease the incidence of venous congestion occurring in the reversed flow posterior interosseous artery flap used for coverage of hand defects. METHODS: This may be achieved by studying the incidence of venous congestion in flaps including only 1 perforator and comparing the results with others including more than 1 perforator both in small and large sized flaps. RESULTS: This study showed that inclusion of only 1 perforator in the flap decreased the incidence of venous congestion with complete flap loss in flaps to 5%...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28291749/proteolysis-of-truncated-hemolysin-a-yields-a-stable-dimerization-interface
#19
Walter R P Novak, Basudeb Bhattacharyya, Daniel P Grilley, Todd M Weaver
Wild-type and variant forms of HpmA265 (truncated hemolysin A) from Proteus mirabilis reveal a right-handed, parallel β-helix capped and flanked by segments of antiparallel β-strands. The low-salt crystal structures form a dimeric structure via the implementation of on-edge main-chain hydrogen bonds donated by residues 243-263 of adjacent monomers. Surprisingly, in the high-salt structures of two variants, Y134A and Q125A-Y134A, a new dimeric interface is formed via main-chain hydrogen bonds donated by residues 203-215 of adjacent monomers, and a previously unobserved tetramer is formed...
March 1, 2017: Acta Crystallographica. Section F, Structural Biology Communications
https://www.readbyqxmd.com/read/28289889/finger-reconstruction-using-induced-membrane-technique-and-ulnar-pedicled-forearm-flap-a-case-report
#20
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
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