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Hand replantation

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https://www.readbyqxmd.com/read/29209634/the-vilkki-procedure-as-an-emergency-treatment-in-an-apocalyptical-hand-injury-a-case-report-and-first-description
#1
Dominique Merky, Katarina Wishart, Urs Hug, Elmar Fritsche
We describe a young man who suffered a severe mutilating injury of the hand and forearm while working as a cheesemaker. He underwent a complex reconstruction of his right adominant hand including a heterotopic thumb replantation into the distal radius and combined with an emergency flow-through anterolateral thigh flap.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/29117833/management-of-the-pediatric-patient-following-upper-extremity-replantation-or-revascularization-a-suggested-protocol
#2
Alec Sundet, Kyros Ipaktchi, Claudia Kunrath, Rodrigo N Banegas
BACKGROUND: Traumatic pediatric amputations of the hand and upper extremity can have long-term financial, psychological, developmental, and functional consequences that readily extend beyond the realm of that which is normally encountered in comparatively injured adults. These factors, along with a paucity of medical comorbidities, have guided a more liberal and aggressive approach to treating pediatric amputations in hopes of optimizing psychosocial, aesthetic, and developmental outcomes...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29117830/in-vitro-evaluation-of-human-hand-tendon-ingrowth-into-a-synthetic-scaffold
#3
Shalimar Abdullah, Fadzlina Mohtar, Nordashima Abdul Shukor, Jamari Sapuan
BACKGROUND: Synthetic scaffold has been used for tissue approximation and reconstructing damaged and torn ligaments. This study explores the ability of tendon ingrowth into a synthetic scaffold in vitro, evaluate growth characteristics, morphology and deposition of collagen matrix into a synthetic scaffold. METHODS: Upper limb tendons were harvested with consent from patients with crush injuries and non-replantable amputations. These tendons (both extensor and flexor) measuring 1 cm are sutured to either side of a 0...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#4
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29036026/a-comparison-of-functional-outcomes-and-therapeutic-costs-single-digit-replantation-versus-revision-amputation
#5
Hongyi Zhu, Bingbo Bao, Xianyou Zheng
BACKGROUND: The functional outcomes and therapeutic costs between digit replantation and revision amputation has remained controversial. METHODS: Total 1023 patients with single digit traumatic amputation or devascularization who received successful digit replantation (failure excluded) or revision amputation from 1 January 2013 to 1 January 2016 were included in this study. All cases were subgrouped based on Tamai level of amputation and injured fingers. The Clinical outcomes were assessed by Michigan hand outcomes questionnaire (MHQ) one year after the initial surgery...
October 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28762452/eight-years-of-clinical-experience-with-digit-replantation-demographic-characteristics-and-outcomes
#6
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
#7
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
#8
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...
September 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28564653/skin-perfusion-changes-within-12-h-after-axillary-plexus-block
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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