Joint Reconstruction Following Trauma: Comparison of Microsurgical Transfer and Conventional Methods: A Report of 61 Cases

1986 ◽  
Vol 11 (3) ◽  
pp. 388-393
Author(s):  
G. FOUCHER ◽  
P. HOANG ◽  
N. CITRON ◽  
M. MERLE ◽  
M. DURY
Keyword(s):  
Hand Surgery ◽  
Difficult Problem ◽  
Range Of Movement ◽  
Joint Reconstruction ◽  
Interpositional Arthroplasty ◽  
Conventional Methods ◽  
Transfer 21 ◽  
Second Toe

Joint reconstruction at the metacarpophalangeal or proximal interphalangeal levels remains a difficult problem in hand surgery. The authors reviewed sixty-one joints reconstructed acutely or electively allowing to compare Swanson spacer (30 joints), interpositional arthroplasty (4), non vascularized joint transfer (5) and vascularized joint transfer (21). Among these, two different techniques have been used: island compound transfer from a finger bank (10) and free vascularized transfer from the second toe (10) or from a non replantable finger (1). It is not worth while comparing different techniques applied to different indications. The only point which can be stressed is the better average range of movement of metacarpophalangeal reconstruction compared to that obtained at the proximal interphalangeal level.

scholarly journals ANQUILOSE DE ATM EM PACIENTE PEDIÁTRICO: RELATO DE CASO

2019 ◽  
Author(s):  
Rodrigo Figueiredo de Brito Resende
Keyword(s):  
Correct Diagnosis ◽  
Facial Asymmetry ◽  
Radiographic Evaluation ◽  
Autogenous Bone ◽  
Mandibular Growth ◽  
Tmj Ankylosis ◽  
Joint Reconstruction ◽  
Interpositional Arthroplasty ◽  
Mandibular Retrusion ◽  
Costochondral Graft

RESUMO: A anquilose da ATM caracteriza-se pela substituição dos tecidos articulares por tecido ósseo ou fibro-ósseo, gerando uma união entre os componentes ósseos da articulação, tal alteração gera comprometimento da função articular. A anquilose da ATM quando ocorre na infância pode prejudicar o crescimento mandibular, causando posteriormente uma assimetria facial severa entre outros. Sua etiopatogenia é variável, desde traumas até reações a injeções intra-capsulares de medicamentos.O correto diagnóstico só é obtido por meio de avaliação clínica e radiográfica, incluindo tomografia computadorizada e reconstruções em 3D-TC. Há diferentes modalidades cirúrgicas para seu tratamento, artroplastia em GAP, Artroplastia Interposicional utilizando-se da interposição de um material biológico ou não, e a reconstrução conjunta da ATM, com enxertia de osso autógeno ou prótese articular total, todas preconizando ressecção agressiva da massa anômala fibrosa e/ou óssea.O presente trabalho visa relatar cirurgia de remoção de massa anquilótica óssea em ATM  no serviço de CTBMF do HFSE do RJ. Paciente do sexo feminino, 7 anos, melanoderma, AMI de 15mm, acesso Al-Kayat, ressecção de massa anquilótica óssea, coronoidectomia bilateral, revestimento com aba miofascial de temporal, enxerto autógeno costocondral. Paciente evoluiu com AMI de 35mm e acompanhamento de 2 anos. Demonstrando eficácia e previsibilidade do tratamento escolhido, segundo protocolo Kaban.Palavras-chaves: Anquilose de ATM; Enxerto Costocondral; ArtroplastiaInterposicional; Protocolo Kaban                                                                 ABSTRACT: TMJ ankylosis is characterized by the replacement of the joint tissues by bone or fibro-osseous tissue, generating a union between the bone components of the joint, such alteration causes compromised joint function. TMJ ankylosis when it occurs in childhood may impair mandibular growth, causing severe facial asymmetry and mandibular retrusion, difficulty in phonation, among others. Its etiopathogenesis varies from traumas to reactions to intra-capsular injections of medications. Correct diagnosis is only obtained through clinical and radiographic evaluation, including computed tomography and 3DCT reconstructions. There are different surgical modalities for its treatment, GAP arthroplasty, Interpositional arthroplasty using the interposition of a biological material or not, and the joint reconstruction of TMJ, with autogenous bone excision or total joint prosthesis, all of which advocate aggressive resection of the anomalous mass fibrosis and / or bone. The present study aims to report bone ankylosis mass removal surgery in TMJ in the CTBMF service of the HFSE of RJ. Female patient, 7 years old, melanoderma, 15 mm AMI, general anesthesia, Al-Kayat access, bone ankylotic mass resection, bilateral coronoidectomy, temporal myofascial flap coating, autochondral costochondral graft. Patient evolved with 35mm AMI and 2 year post-operative follow-up. Demonstrating effectiveness and predictability of the treatment chosen, according to Kaban protocol. Keywords: TMJ ankylosis; Costochondral Graft, Interpositional Arthroplasty;Kaban Protocol                                                                 

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

Immediate Free Vascularized Joint Transfer from Second Toe to Index Finger Proximal Interphalangeal Joint: A Case Report

1985 ◽  
Vol 10 (1) ◽  
pp. 85-89 ◽  
Author(s):  
T. M. TSAI ◽  
R. SINGER ◽  
E. ELLIOTT ◽  
H. KLEIN
Keyword(s):  
Index Finger ◽  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Severe Injuries ◽  
Immediate Reconstruction ◽  
Joint Reconstruction ◽  
Results Of Treatment ◽  
Second Toe

The results of treatment of severe injuries to the proximal interphalangeal joint are unsatisfactory. The methods of joint reconstruction are discussed, including fusion, implant arthroplasty, perichondrial grafting and vascularized joint transfer. A patient is presented with a severe crush injury to the dorsum of the index finger with loss of skin and extensor tendon and proximal interphalangeal joint disruption. Immediate reconstruction of the finger is described using a composite free flap of skin, extensor tendon and proximal interphalangeal joint from the second toe. Follow-up at two years is described, demonstrating proximal interphalangeal motion and finger function.

Aneurysmal Bone Cysts in the Hand Treated by Free Non-Vascular Transfer of Metatarsal or Proximal Phalanx from the Foot

1993 ◽  
Vol 18 (6) ◽  
pp. 736-741 ◽  
Author(s):  
G. S. RAO ◽  
P. KEOGH ◽  
H. WEBSTER ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Donor Site ◽  
Bone Cyst ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Joint Reconstruction ◽  
Articular Surfaces ◽  
Aneurysmal Bone Cysts ◽  
And Function ◽  
Second Toe

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

scholarly journals Examining the Hand in the Video Consultation

2021 ◽  
Author(s):  
Kristian Welle ◽  
Stefan Täger ◽  
Roslind Karolina Hackenberg ◽  
Alexander Markowetz ◽  
Frank Alexander Schildberg ◽  
...  
Keyword(s):  
Patient Care ◽  
Medical History ◽  
Motor Skills ◽  
Hand Surgery ◽  
Online Video ◽  
Direct Examination ◽  
Range Of Movement ◽  
Function Tests ◽  
Video Consultation ◽  
And Function

Abstract Background Video consultations could support patient care in hand surgery during social distancing in the COVID-19 era. According to the literature, images of hand and fingers can support telediagnosis in hand emergencies. We present this feasibility study on online video consultation in hand surgery. Methods A structured examination was designed to query the medical history and examine motor skills, sensitivity, strength and function tests of the hand. Thirty examinations on both hands were carried out by online video consultation, then in direct contact and compared with each other. Results With 4560 evaluated range of movement of the hand and finger joints, there was a high correlation between the measurement methods of R = 0.995 (p < 0.0001, confidence interval 0.9946 – 0.9954). In the video-based examination, 84.6% of the measured values showed a deviation of less than 5° compared to the direct examination, 92.8% less than 10° deviation. Good accordance was also found in the patientʼs medical history. An estimating examination of sensitivity, function and strength during video examination is feasible with simple auxiliary aids. Deficits are evident in the detection of scars, in function tests and the absence of haptic findings. Conclusion Online video consultation allows hand examination with sufficient documentation of hand and finger movements (range of motion) and proper evaluation of symptoms. It cannot replace direct examination but complement patient care in hand surgery even beyond the current COVID-19 pandemic.

A Comparison of Immediate and Staged Reconstruction of the Dorsum of the Hand

1996 ◽  
Vol 21 (2) ◽  
pp. 216-221 ◽  
Author(s):  
M. SUNDINE ◽  
L. R. SCHEKER
Keyword(s):  
Difficult Problem ◽  
Range Of Movement ◽  
Immediate Reconstruction ◽  
Traditional Treatment ◽  
Dorsal Hand ◽  
Hand Defects ◽  
Subcutaneous Tissues ◽  
Returning To Work ◽  
Primary Bone ◽  
Staged Reconstruction

The treatment of complex dorsal hand lesions involving skin and subcutaneous tissues, extensor tendons, and bone remains a difficult problem for reconstructive surgeons. Traditional treatment of these defects uses staged reconstruction, first obtaining soft tissue cover and then performing bone and tendon grafts. The purpose of this study was to compare a series of seven patients who underwent staged reconstruction with seven patients who had immediate reconstruction involving primary bone and tendon grafting. All procedures were performed to correct similar severe dorsal hand defects. Patients with immediate reconstruction had a significantly faster return to maximum range of movement (ROM) (214 days compared to 630 days, P = 0.002), significantly fewer operations (2.1 compared to 5.9, P = 0.002) and a greater chance of returning to work (86% compared to 48.2%, P = 0.3) than patients with staged reconstruction.

Simultaneous Toe-to-Hand Transfer and Lower Extremity Amputations for Severe Upper and Lower Limb Defects: The Use of Spare Parts

2002 ◽  
Vol 27 (3) ◽  
pp. 219-223 ◽  
Author(s):  
J. CHANG ◽  
N. F. JONES
Keyword(s):  
Lower Extremity ◽  
Hand Function ◽  
Hand Surgery ◽  
Spare Parts ◽  
Lower Extremity Amputation ◽  
Great Toe ◽  
Lower Extremity Function ◽  
Knee Amputation ◽  
Extremity Amputation ◽  
Second Toe

From 1995 to 2000, five microvascular toe-to-hand transfers were performed in three children who were simultaneously undergoing lower extremity amputations. Their ages at time of transfer ranged from 4 to 10 years and the types of lower extremity amputation included toe amputation, foot amputation and through-knee amputation. The resulting toe-to-hand transfers included three great toe-to-thumb transfers and one combined great and second toe-to-hand transfer. The toe-to-hand transfers were all successful and all the lower extremity amputations healed without complications. In all cases, improved hand function and lower extremity function was noted by the families. These unique cases represent the ultimate use of spare parts in congenital hand surgery.

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