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Hand replantation

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https://www.readbyqxmd.com/read/28762452/eight-years-of-clinical-experience-with-digit-replantation-demographic-characteristics-and-outcomes
#1
Melike Oruç, Koray Gürsoy, Kadri Özer, Özlem Çolak, Yüksel Kankaya, Nezih Sungur, Gürhan Mustafa Ulusoy, Uğur Koçer
BACKGROUND: Despite surgical and technical advances in microsurgery, it is still difficult to obtain satisfactory results after replantation of finger amputation. The aim of the present study was to discuss some of the many factors that can affect the success rate of replantation. METHODS: A retrospective analysis of 60 patients with 85 finger replantations was performed. Revascularizations and replantations proximal to the metacarpophalangeal joint were excluded...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28664706/neuromarkers-of-post-traumatic-stress-disorder-ptsd-in-a-patient-after-bilateral-hand-amputation-erp-case-study
#2
Anna Chrapusta, Juri D Kropotov, Maria Pąchalska
<b>Introduction</b>. There is a lack in the worldwide literature of reports on the Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in patients after bilateral hand amputation The aim of this study was to test a hypothesis regarding developing Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation with the use of Event Related Potentials (ERPs). On the basis of previous research, the amplitudes of P3 ERP components elicited in the cued GO/NOGO tasks have been chosen as candidates for neuromarkers of PTSD...
June 8, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28619683/functional-assessment-and-quality-of-life-in-patients-following-replantation-of-the-distal-half-of-the-forearm-except-fingers-a-review-of-11-cases
#3
U Assouline, D Feuvrier, D Lepage, Y Tropet, L Obert, J Pauchot
The aims of this study were to evaluate the function and quality of life in patients who have undergone replantation of the hand or forearm. We carried out a retrospective single-center study of cases performed between 1977 and 2015. Our hospital's database was searched for patients who underwent replantation of the distal half of the forearm and hand (except the fingers). The evaluation included sensitivity, joint mobility, strength and quality of life. Conventional functional scores were used. Seventeen replantation cases were identified...
June 12, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28564653/skin-perfusion-changes-within-12-h-after-axillary-plexus-block
#4
Andrea Wenger, Amro Amr, Hans-Eberhard Schaller, Jens Rothenberger
BACKGROUND/PURPOSE: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified. METHODS: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed. RESULTS: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control...
June 1, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28527851/intentional-replantation-of-an-avulsed-immature-permanent-incisor-a-case-report
#5
Claudio Maniglia-Ferreira, Fabio de Almeida Gomes, Marcelo de Morais Vitoriano
This case report discusses the successful endodontic treatment of an open apex maxillary right permanent central incisor that had been avulsed and incorrectly replanted in a 7-year-old patient. The tooth was carefully re-extracted followed by cleaning of the alveolar socket and immediate replantation. However, pulp necrosis was diagnosed, and regenerative endodontic treatment was performed. The root canal system was disinfected by passive ultrasonic irrigation with 2.5% sodium hypochlorite. At the first visit, the tooth was repositioned and immobilized with an appropriate semirigid splint...
May 17, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28507872/multiple-level-replantation-in-elderly-patients-risk-versus-benefit
#6
Rafael G Jakubietz, Michael G Jakubietz, Rainer H Meffert, Karsten Schmidt
Multiple-level amputations of the upper extremity represent a surgical challenge generally only attempted in young patients. This case demonstrates a successful replantation in an elderly woman. The postoperative course was complicated by disseminated intravascular coagulopathy most likely due to inadequate resuscitation. Hand trauma is often underestimated in its general severity. Upper extremity amputations need to be handled similar to polytraumatized patients.
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28499510/effect-of-policy-change-on-the-use-of-long-distance-transport-and-follow-up-care-for-patients-with-traumatic-finger-amputations
#7
Michael T Nolte, Melissa J Shauver, Kevin C Chung, Aviram M Giladi
PURPOSE: In January 2006, the American College of Emergency Physicians released updated guidelines for air transfer. Digit amputation and near-amputation were no longer an indication for this costly service. We analyzed the effect of this update on the use of air transport and associated care outcomes for finger amputation patients and examined factors involved in providing follow-up care for these patients. METHODS: A retrospective chart review identified all patients treated for traumatic finger amputation between 1995 and 2012 at a major hand trauma referral center...
August 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28413903/digital-revascularization-and-replantation-using-the-wide-awake-hand-surgery-technique
#8
Jkf Wong, C H Lin, N J Chang, H C Chen, Y T Lin, C C Hsu
The use of local anaesthesia and adrenaline for hand surgery is gaining popularity; however, where vascularity is impaired, wide-awake surgery is considered a contraindication. We present our case series of five digital devascularizations and eight amputations that underwent surgery using the 'wide-awake' anaesthetic technique. A temporary digital tourniquet (< 20 min) was used in three cases to identify structures quickly. The anastomoses were performed under local anaesthesia without a tourniquet. All cases had successful re-establishment of blood flow with good perfusion to the digital tips; no cases were re-explored because of vascular crisis...
July 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28340658/a-global-view-of-digital-replantation-and-revascularization
#9
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/28329874/long-term-health-related-quality-of-life-outcomes-in-digital-replantation-versus-revision-amputation
#10
Oren Tessler, Matthew J Bartow, Marie P Tremblay-Champagne, Alex M Lin, Geneviève Landes, Sarah Sebbag, Andreas Nikolis
Background Earlier, digit viability judged the success of digital replantation. Now, utility health-related quality of life (HRQOL) measures can better assess the impact of digital replantation. Methods Overall, 264 digital injury patients were sent a regimen of utility measures: Disabilities of the Arm, Shoulder and Hand (DASH) score, European Quality of Life 5 Dimensions, visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG). Overall, 51 patients responded completely to all of these-36 replantation patients and 15 revision amputation patients...
July 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28251838/is-hyperbaric-oxygen-therapy-indispensable-for-saving-mutilated-hand-injuries
#11
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/28216826/assessment-of-hand-function-after-successful-replantation-of-upper-limb-at-arm
#12
V Koteswara Rao Rayidi, Venkata Bhargava Velde, Narsimha Rao, N Ram Babu, Laxman Sambari
In upper arm replantation, a successful anastomosis guarantees the viability and good quality repair determines the overall function of the hand. There is paucity of successful arm replantation case reports in the literature. This is a case report of a successful arm replantation in a four year child with a near total functional outcome. We have used different scores to assess the functional outcome.
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28187720/long-term-outcome-following-upper-extremity-replantation-after-major-traumatic-amputation
#13
G Mattiassich, F Rittenschober, L Dorninger, J Rois, R Mittermayr, R Ortmaier, M Ponschab, K Katzensteiner, L Larcher
BACKGROUND: Amputations in general and amputations of upper extremities, in particular, have a major impact on patients' lives. There are only a few long-term follow-up reports of patients after macro-replantation. We present our findings in contrast with the existing literature. METHODS: Sixteen patients with traumatic macro-amputation of an upper extremity were eligible for inclusion in this study. Altogether, the patients underwent replantation in 3 institutions between 1983 and 2011...
February 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28179478/magnetic-resonance-spectroscopy-of-current-hand-amputees-reveals-evidence-for-neuronal-level-changes-in-former-sensorimotor-cortex
#14
Carmen M Cirstea, In-Young Choi, Phil Lee, Huiling Peng, Christina L Kaufman, Scott H Frey
Deafferentation is accompanied by large-scale functional reorganization of maps in the primary sensory and motor areas of the hemisphere contralateral to injury. Animal models of deafferentation suggest a variety of cellular-level changes including depression of neuronal metabolism and even neuronal death. Whether similar neuronal changes contribute to patterns of reorganization within the contralateral sensorimotor cortex of chronic human amputees is uncertain. We used functional MRI-guided proton magnetic resonance spectroscopy to test the hypothesis that unilateral deafferentation is associated with lower levels of N-acetylaspartate (NAA, a putative marker of neuronal integrity) in the sensorimotor hand territory located contralateral to the missing hand in chronic amputees (n = 19) compared with the analogous hand territory of age- and sex-matched healthy controls (n = 28)...
April 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28121876/emergency-department-wait-time-and-treatment-of-traumatic-digit-amputation-do-race-and-insurance-matter
#15
Elham Mahmoudi, Peter R Swiatek, Kevin C Chung
BACKGROUND: Little is known about the association between the quality of trauma care and management of nonfatal injuries. The authors used emergency department wait times as a proxy for hospital structure, process, and availability of on-call surgeons with microsurgical skills. They evaluated the association between average hospital emergency department wait times and likelihood of undergoing digit replantation for patients with traumatic amputation digit injuries. The authors hypothesized that hospitals with shorter emergency department wait times were associated with higher odds of replantation...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28029391/off-hour-surgery-among-orthopedic-subspecialties-at-an-urban-quaternary-care-level-1-trauma-center
#16
Amanda Lans, Stein J Janssen, David Ring
PURPOSE: We sought to determine and quantify which subspecialties of orthopedic surgeons are operating off hours in an urban, quaternary-care, level 1 trauma center. MATERIALS AND METHODS: We used our clinical registry to identify 43,211 orthopedic surgeries performed between January 2008 and December 2011. Our outcome measures were the number and proportion of off-hour surgeries performed as well as the number and proportion of off-hours per subspecialty. The denominators were the total number of surgeries and the total number of surgical hours worked per subspecialty...
December 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027844/effect-of-hospital-volume-on-success-of-thumb-replantation
#17
Elham Mahmoudi, Kevin C Chung
PURPOSE: Hospital volume-outcome association has been examined for many high-risk surgical procedures. Little is known about this association for thumb replantation, a complex but essential surgical procedure to restore hand function. We aimed to determine patient and hospital characteristics that are associated with increased probability of replanted thumb survival and to examine volume-outcome association among hospitals that performed thumb replantation. METHODS: We used data from 2008 to 2012 from the National Trauma Data Bank...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28010933/paediatric-fingertip-composite-grafts-do-they-all-go-black
#18
Adrian D Murphy, Cameron P Keating, Anthony Penington, David McCombe, Chris J Coombs
BACKGROUND: Fingertip injuries are amongst the most frequently seen hand injuries in the paediatric population. The present study evaluated the composite graft survival rate in distal digital amputations with respect to injury type, amputation level and time to surgery. METHODS: We performed a retrospective review of patients who underwent composite grafting of fingertip injuries over an 11-year period at a paediatric hospital. All children who underwent non-vascularized replantation of amputated fingertips were included...
February 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27893542/safety-and-suitability-of-finger-replantations-as-a-residency-training-procedure-a-retrospective-cohort-study-with-analysis-of-the-initial-postoperative-outcomes
#19
Dimitra Kotsougiani, Felicitas Ringwald, Caroline A Hundepool, Florian Neubrech, Thomas Kremer, Berthold Bickert, Ulrich Kneser, Christoph Hirche
Finger replantations demand technical excellence in microsurgery and hand trauma care. The objective of this study was to determine whether finger replantations constitute an appropriate and safe procedure for residency training. Additionally, the prognostic risk factors for the need to take a replanted finger back to the operation room and replant failure were analyzed.All patients who underwent finger replantation after complete amputation between 2007 and 2015 were included in a retrospective comparative study...
November 23, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27882250/apical-revascularization-after-delayed-tooth-replantation-an-unusual-case
#20
Marília Pacífico Lucisano, Paulo Nelson-Filho, Lea Assed Bezerra Silva, Raquel Assed Bezerra Silva, Fabricio Kitazono de Carvalho, Alexandra Mussolino de Queiroz
The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed...
2016: Case Reports in Dentistry
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