Transfer of Sensory Branches of Radial Nerve in Hand Surgery

1993 ◽  
Vol 18 (3) ◽  
pp. 409-409
Author(s):  
R. Matloubi
Keyword(s):  
Radial Nerve ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
War Injuries ◽  
Irreparable Damage

Transfer of sensory branches of the radial nerve to sensory branches of the ulnar or median nerves has been carried out to restore sensitivity to the digits in patients suffering from severe, longstanding and irreparable damage to the median or ulnar nerves, due to war injuries. The author describes the two surgical techniques in detail and reports the results obtained.

Transfer of Sensory Branches of Radial Nerve in Hand Surgery

1988 ◽  
Vol 13 (1) ◽  
pp. 92-95
Author(s):  
R. MATLOUBI
Keyword(s):  
Radial Nerve ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
War Injuries ◽  
Irreparable Damage

Transfer of sensory branches of the radial nerve to sensory branches of the ulnar or median nerves has been carried out to restore sensitivity to the digits in patients suffering from severe, longstanding and irreparable damage to the median or ulnar nerves, due to war injuries. The author describes the two surgical techniques in detail and reports the results obtained.

Transfer of Sensory Nerves in Hand Surgery

1984 ◽  
Vol 9 (1) ◽  
pp. 46-49 ◽  
Author(s):  
P. BEDESCHI ◽  
L. CELLI ◽  
A. BALLI
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Sensory Nerves ◽  
Dorsal Rami

The transfer of sensitive dorsal rami of the ulnar nerve (two cases) and of two sensitive dorsal rami of the radial nerve (five cases) was accomplished in order to restore the sensitivity of the first three finger tips in patients suffering from serious and longstanding inveterate lesions of the median nerve. The Authors describe the two surgical techniques in detail and, according to the satisfactory results obtained, specify the indications and advantages of this operation.

scholarly journals Topographical, anatomical and neurosurgical aspects of "end-to-side" nerve repair

2021 ◽  
Vol 23 (1) ◽  
pp. 121-128
Author(s):  
A. Y. Nisht ◽  
Nikolay F. Fomin ◽  
Vladimir P. Orlov
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Lateral Surface ◽  
Peripheral Nerves ◽  
Radial Nerve ◽  
Surgical Techniques ◽  
Nerve Fibers ◽  
Individual Variability ◽  
Motor Branch ◽  
Deep Branch

The article presents the results of a comprehensive anatomical and experimental study of individual variability in the structure and topography of motor branches of peripheral nerves in relation to the justification of methods for selective reinnervation of tissues by the "end-to-side" neurorrhaphy. It was found that relatively longer branches of peripheral nerves with a small number of connecting inter-arm collaterals characteristic of narrow and long limbs create conditions for less traumatic mobilization of motor branches. In cases with relatively wide and short extremities mobilization of peripheral nerves is complicated by the presence of a large number of collateral branches and intra-trunk connections, which are often damaged when separate bundles that make up the mobilized branches of the donor or recipient nerve are isolated from the main nerve trunk. It has been shown that potential recipient nerves should be motor branches of peripheral nerves, the preservation of which is of fundamental importance for the function of the corresponding segment of the limb. To create conditions conducive to selective reinnervation of functionally significant muscle groups of the upper limb, we have developed, justified from anatomical positions, and tested in an experiment on anatomical material methods for connecting the distal motor branches of peripheral nerves by the "end-to-side" neurorrhaphy. The main idea of accelerated recovery of the thumb opposition in injuries of the median nerve is to reinnervate the muscles of the elevation of the I finger due to nerve fibers that are part of the deep branch of the ulnar nerve. For this purpose, surgical techniques have been developed for connecting the recurrent motor branch of the damaged median nerve mobilized at the level of the wrist with the edges of a surgically formed perineurium defect on the lateral surface of the bundles that make up the deep branch of the ulnar nerve. In another clinical situation, in patients with radial nerve injuries, for the muscle reinnervation, а method is proposed for neurotisation of the deep motor branch of the radial nerve by the end-to-side suture to the lateral surface of the median nerve. We assume that performing the "end-to-side" nerve suture at the level of the base of the hand in the cases of proximal damage to the median nerve will reduce the time of reinnervation of the muscles of the thumb elevation by 400450 days. Transposition of the deep branch of the damaged at the proximal level radial nerve with "end-to-side" neurorrhaphy to the median nerve by 250300 days (based on the total length of the shoulder and forearm, which is about 50 cm and the rate of regeneration of nerve fibers 1 mm per day). Accordingly, with higher injuries (brachial plexus), the gain in the time of reinnervation of the distal segments will be even greater. In our opinion, the results can be used as a basis for further clinical research on the development of methods for selective tissue reinnervation in cases with isolated injuries of the peripheral nerves.

Acute infections of the hand

2013 ◽  
Vol 6 (11) ◽  
pp. 688-693 ◽  
Author(s):  
James Warbrick-Smith ◽  
James Smith
Keyword(s):  
Secondary Care ◽  
Functional Outcomes ◽  
Care Setting ◽  
Primary Care Setting ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Inappropriate Therapy ◽  
Permanent Disability ◽  
Common Presentation ◽  
Acute Infections

Hand infections are a common presentation to primary and secondary care. Early diagnosis and appropriate management can often produce good functional outcomes, whereas delayed or inappropriate therapy risks permanent disability, amputation and in extreme cases mortality. It can be challenging to know which patients can be treated in the primary care setting and which require referral to a local hand surgery service, plastic surgery or orthopaedics as dictated by local availability. There are two main aims for this article. The first is to provide a framework for the assessment of hand infections and common principles of management. The second is to describe the most common acute infections and clearly indicate which should be referred to secondary care and how urgently this should occur. We deliberately do not describe the intricacies of surgical techniques.

scholarly journals Surgical techniques for reconstruction of the hypoplastic thumb

2018 ◽  
Vol 44 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Konrad Mende ◽  
José Annelie Suurmeijer ◽  
Michael Alan Tonkin
Keyword(s):  
Soft Tissues ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Metacarpophalangeal Joint ◽  
Surgical Decision ◽  
Surgical Options ◽  
Hypoplastic Thumb ◽  
Operative Findings ◽  
Operative Assessment ◽  
Surgical Decision Making

The reconstruction of a congenital hypoplastic thumb usually involves release of a tight first web space, metacarpophalangeal joint stabilization, reconstruction of intrinsic muscle function, and extrinsic tendon reconstruction, as appropriate. Numerous surgical options and combinations are available, but the approaches vary among surgeons who work in the field of congenital hand surgery and the empirical evidence that allows for evaluation of the results of techniques is scarce. Both the pre-operative assessment and intra-operative findings of all thumb elements – bone, joints, and soft tissues – should be considered in the surgical decision-making and eventually define the methods of reconstruction. This article summarizes the different reconstructive options.

scholarly journals Hand Surgery in Japan

2021 ◽  
Vol 13 (01) ◽  
pp. 42-48
Author(s):  
Yoshitaka Minamikawa ◽  
Emiko Horii ◽  
Yoshitaka Hamada
Keyword(s):  
Tendon Repair ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Wrist Arthroscopy ◽  
External Fixators ◽  
Health Care Information ◽  
Flexor Tendon Repair ◽  
Joint Replacements ◽  
Care Information ◽  
Significant Achievement

AbstractJapan has faced the most challenging times in the past. Through precise diligence by stalwarts and doyens of initial hand surgeons, it led an incredible path for the most significant moments of hand surgery. This article describes the early phase of development of Japanese Society for Surgery of the hand, substantial and innovative contributions from surgeons. A noteworthy and significant achievement in the hand surgery is microsurgery and its utilities for all hand-related diseases. The first replantation of the thumb, toe transfers and wrap-around flaps are the effective surgical techniques developed and imparted to the fellow hand surgeons worldwide. We had a particular interest in congenital hand surgery and developed a modification of congenital hand classifications and introduced many surgical techniques. Besides, we grew ourselves refining more in hand and microsurgery, innovating flexor tendon repair, peripheral nerve surgeries, wrist arthroscopy, joint replacements, external fixators, and implant arthroplasty for rheumatoid hand. We share our health care information, insurance working model and hand surgery training schedule in Japan.

Epidemiology and Surgical Management of Abdominal War Injuries in Sarajevo: State Hospital of Sarajevo Experience

1994 ◽  
Vol 9 (S1) ◽  
pp. S29-S34 ◽  
Author(s):  
Branko Vujovic ◽  
Damir Mazlagic
Keyword(s):  
Mortality Rate ◽  
Significant Proportion ◽  
Surgical Techniques ◽  
Exploratory Laparotomy ◽  
Multiple Organ ◽  
War Injuries ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Organ Systems ◽  
Record Review

AbstractBackground:In war, abdominal injuries constitute a significant proportion of the total injuries. These injuries are associated with high mortality and their treatment poses dianostic, surgical, and therapeutic dilemmas. This article presents the epidemiology of abdominal war injuries during the siege of Sarajevo, and briefly describes the surgical techniques and therapeutic practices used in their treatment.Methods:A retrospective medical record review was performed of 273 war casualties with trauma to visceral and vascular structures in the abdomen inflicted during a 7.5 month period in 1992.Results:Most patients underwent exploratory laparotomy. Six percent had negative laparotomies, and there were no deaths in this group. In 18.3%, injuries were limited to one organ system, while 81.7% sustained combined injuries to multiple-organ systems. The crude mortality rate was 26.0%. Mortality rate excluding deaths within 24 hours of injury was 10.3%. Injuries were caused by metal fragments from artillery shrapnel, mortar and contact mines, or hand grenades. Because of a shortage of colostomy bags, resections of the colon with primary end-to-end anastomoses rather than colostomy were performed in 72% of the cases.Conclusions:Mortality was highest in those victims with four or more injured organ systems (81.3%) or with major vascular injuries (64.7%). The primary cause of death within the first 24 hours was prolonged hemorrhagic shock.

scholarly journals Current Concepts in Reconstruction of Hand Function in Tetraplegia

2008 ◽  
Vol 97 (4) ◽  
pp. 341-346 ◽  
Author(s):  
J. Fridén ◽  
C. Reinholdt
Keyword(s):  
Upper Extremity ◽  
Hand Function ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Muscle Contractions ◽  
The Past ◽  
Recent Developments ◽  
Common Observation ◽  
Further Development ◽  
Active Training

Several recent developments in the field of reconstructive hand surgery in tetraplegia have created a foundation for further refinements of both surgical techniques and postoperative training strategies to improve the outcome of restoration of upper extremity functions. A remarkable means of improving function is the immediate activation of transferred muscle after surgery. Early active training of new motors not only prevents the formation of adhesions but facilitates the voluntary recruitment of motors powering new functions before swelling and immobilization-induced stiffness restrain muscle contractions. A common observation internationally over the past years is that the number of incomplete tetraplegics increases. This shift towards more incomplete injuries with spasticity as a common feature in addition to the paralysis has expanded and changed the spectrum of surgeries in this group of patients and also emphasizes the need for a revisit and further development of the different strategies for reconstruction of hand function.

Flexor Tendon Injuries

2018 ◽  
Author(s):  
Chao Long ◽  
Lisa C Moody ◽  
Paige M Fox ◽  
James Chang
Keyword(s):  
Flexor Tendon ◽  
Hand Function ◽  
Adhesion Formation ◽  
Tendon Repair ◽  
Surgical Techniques ◽  
Hand Surgery ◽  
Tendon Injuries ◽  
Pulley System ◽  
Rehabilitation Protocols ◽  
Flexor Tendon Injuries

Flexor tendon injuries are common hand injuries that can significantly affect hand function. Treatment of these injuries requires a thorough understanding of the intricate anatomy and biomechanics of flexor tendons. The goals of reconstruction include restoration of tendon continuity, preservation and reconstruction of the pulley system, maximizing tendon gliding, and minimizing adhesion formation. Surgical treatment, in conjunction with postoperative hand therapy, provides enhanced function. This review provides the surgeon with the relevant anatomy, pearls of clinical evaluation, necessary investigative studies, management algorithms, surgical techniques, rehabilitation protocols, and approaches to common complications. It ends with a discussion of basic and translational research currently being undertaken to address the challenges posed by flexor tendon injuries and how this research can potentially advance patient care.   This review contains 16 figures, 5 tables and 55 references Key words: flexor tendon, flexor tendon injuries, flexor tendon reconstruction, flexor tendon repair, hand, hand surgery, injury, surgical technique, tendons

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