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.

Primary Extensor Tendon Reconstruction in Dorsal Hand Defects Requiring Free Flaps

1993 ◽  
Vol 18 (5) ◽  
pp. 568-575 ◽  
Author(s):  
L. R. SCHEKER ◽  
S. J. LANGLEY ◽  
D. L. MARTIN ◽  
K. N. JULLIARD
Keyword(s):  
Free Flap ◽  
Extensor Tendon ◽  
Free Flaps ◽  
Tendon Injuries ◽  
Dorsal Hand ◽  
Hand Defects ◽  
Primary Bone ◽  
Tendon Grafts ◽  
Emergency Free Flap ◽  
Extensor Tendon Injuries

This study reports results in nine patients with extensive loss of soft tissue, extensor tendon, and bone, treated with an emergency free flap for skin cover, primary bone grafts, and tendon grafts passed through individual tunnels in the free flap. Four had a good result, four were fair and one poor. Six patients returned to work, two were not working and one was retired. In select patients, emergency reconstruction of severe extensor tendon injuries appears to produce better function, with fewer operations, a shorter hospital stay, minimal complications, and a shorter period of disability.

scholarly journals The use of dorsoradial forearm flap for the treatment of dorsal hand defect

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Perçin Karakol ◽  
Melihcan Sezgiç ◽  
Burak Ergün Tatar ◽  
Caner Gelbal ◽  
Can Uslu
Keyword(s):  
Bone Fractures ◽  
Metacarpal Bone ◽  
Forearm Flap ◽  
Dorsal Hand ◽  
Vital Functions ◽  
Flap Viability ◽  
Hand Defects ◽  
Pedicle Length ◽  
Joint Range ◽  
Hand Defect

Abstract Generally dorsal hand defects are often closed with a flap. Dorsoradial forearm artery flap has generally been used in thumb defects; however, it can also be used in the reconstruction of dorsal hand defects thanks to its wide rotation arc and appropriate pedicle length. In this case report, we presented the outcome of a case where the dorsoradial forearm flap was applied to treat the dorsal hand defect. A 27-year-old patient was admitted to emergency room with trauma on hand. Fixation of metacarpal bone fractures was performed. The dorsoradial forearm flap was elevated and inserted in order to close an opening exposing bones and tendons in the dorsum of hand. There was no complication with flap viability in the postoperative period. Patient’s joint range of motion and vital functions were acceptable. Dorsoradial forearm flap, which is generally used in thumb reconstruction, can also be used in dorsal hand defects.

Reconstructive options for cutaneous dorsal hand defects

2021 ◽  
Author(s):  
Brett C. Neill ◽  
Erin Roberts ◽  
Stanislav N. Tolkachjov
Keyword(s):  
Dorsal Hand ◽  
Hand Defects

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 Venous super-drained posterior interosseous artery flap for dorsal hand defects

Microsurgery ◽  
2018 ◽  
Vol 38 (8) ◽  
pp. 876-881 ◽  
Author(s):  
Erhan Sönmez ◽  
Ersin Aksam ◽  
Mustafa Durgun ◽  
Onder Karaaslan
Keyword(s):  
Posterior Interosseous Artery ◽  
Dorsal Hand ◽  
Hand Defects ◽  
Interosseous Artery ◽  
Posterior Interosseous Artery Flap

Exit-surface wave reconstruction using a focal series

1992 ◽  
Vol 50 (2) ◽  
pp. 988-989
Author(s):  
W.J. de Ruijter ◽  
M.R. McCartney ◽  
David J. Smith ◽  
J.K. Weiss
Keyword(s):  
Surface Wave ◽  
Spherical Aberration ◽  
Data Extraction ◽  
High Sensitivity ◽  
Geometric Distortion ◽  
Variation Method ◽  
Objective Lens ◽  
Immediate Reconstruction ◽  
Exit Surface ◽  
Electron Microscopes

Further advances in resolution enhancement of transmission electron microscopes can be expected from digital processing of image data recorded with slow-scan CCD cameras. Image recording with these new cameras is essential because of their high sensitivity, extreme linearity and negligible geometric distortion. Furthermore, digital image acquisition allows for on-line processing which yields virtually immediate reconstruction results. At present, the most promising techniques for exit-surface wave reconstruction are electron holography and the recently proposed focal variation method. The latter method is based on image processing applied to a series of images recorded at equally spaced defocus.Exit-surface wave reconstruction using the focal variation method as proposed by Van Dyck and Op de Beeck proceeds in two stages. First, the complex image wave is retrieved by data extraction from a parabola situated in three-dimensional Fourier space. Then the objective lens spherical aberration, astigmatism and defocus are corrected by simply dividing the image wave by the wave aberration function calculated with the appropriate objective lens aberration coefficients which yields the exit-surface wave.

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