FINGERTIP REPLANTATIONS: IMPORTANCE OF VENOUS ANASTOMOSIS AND THE CLINICAL RESULTS

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 1-6 ◽  
Author(s):  
Takaaki Hasuo ◽  
Genzaburo Nishi ◽  
Daiji Tsuchiya ◽  
Takanobu Otsuka
Keyword(s):  
Survival Rate ◽  
Nerve Repair ◽  
Venous Drainage ◽  
Clinical Results ◽  
High Survival ◽  
Venous Anastomosis ◽  
Nail Deformity ◽  
Sensory Recovery ◽  
Distal Interphalangeal ◽  
Protective Sensation

Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

Artery-Only Fingertip Replantation Distal to the Lunula: A Retrospective Analysis of Clinical Results

2021 ◽  
Vol 26 (03) ◽  
pp. 417-424
Author(s):  
Yasunori Kaneshiro ◽  
Koichi Yano ◽  
Seungho Hyun ◽  
Hideki Sakanaka ◽  
Noriaki Hidaka
Keyword(s):  
Survival Rate ◽  
Anticoagulation Therapy ◽  
Clinical Results ◽  
Venous Anastomosis ◽  
Active Motion ◽  
Normal Side ◽  
Amputation Level ◽  
Fingertip Amputation ◽  
Sensory Recovery ◽  
The Mean

Background: Both arterial and venous repair are crucial for optimal results in digital replantation. However, anastomosis of veins becomes challenging in very distal fingertip amputation. This study aimed to report the clinical results of an artery-only replantation without vein repair for a distal fingertip amputation and to analyze the survival rate and clinical outcomes based on the amputation level. Methods: We performed a retrospective review of 47 digits in 38 patients who had undergone fingertip replantation with a mean follow-up period of 12 months. All patients had complete fingertip amputation distal to the lunula. Only one central artery repair distal to the arch was performed. All patients received the postoperative protocol including external bleeding and anticoagulation therapy. Results: By Ishilawa’s classification, 12 digits in subzone I, and 35 digits in subzone II. 31 of the 47 fingertip replantations (66%) were successful, and a significantly higher survival rate was observed in subzone I than in subzone II. The mean total active motion of surviving digits was 86% of normal side. The mean grip strength was 82% of normal side. The sensory recovery according to modified Highet and Saunders’ classification was S4, S3+, S3, and S2 in fingers 19, 2, 5 and 3, respectively. Conclusions: 66% of survival rate was achieved in fingertip replantation distal to lunula which including large number of crushing/avulsion injury. The result of comparison for the survival rate based on amputation level, a significantly higher survival rate was observed in subzone I compared to subzone II. Therefore, the artery-only fingertip replantation had a better indication for distal amputation, and an aggressive attempt for venous anastomosis or drainage, including a secondary surgery for proximal amputation could be attributed to a higher success rate.

Long-term clinical outcome after epineural coaptation of digital nerves

2015 ◽  
Vol 41 (2) ◽  
pp. 148-154 ◽  
Author(s):  
R. M. Fakin ◽  
M. Calcagni ◽  
H. J. Klein ◽  
P. Giovanoli
Keyword(s):  
Clinical Outcome ◽  
Nerve Repair ◽  
Contralateral Side ◽  
Mean Value ◽  
Level Of Evidence ◽  
Pressure Threshold ◽  
Sensory Recovery ◽  
Protective Sensation ◽  
Level Of Experience

This study evaluates the long-term clinical outcome and complication rate after digital nerve repair in adults and aims to identify possible prognostic factors of sensory recovery. End-to-end epineural coaptation was performed under magnification. A total of 93 coapted digital nerves were clinically evaluated with a mean follow-up of 3.5 years (range 1–6 years). The mean two-point discrimination was 10.6 mm (versus 4.4 mm for the contralateral side). Cutaneous pressure threshold tested with Semmes–Weinstein monofilaments showed a mean value of 2.7 (versus 2.2 for the contralateral side). Only 2% of our patients developed painful neuromas. None of our patients recovered normal functional sensibility, however, recovery of protective sensation contributed to a high reported level of satisfaction. No correlation was observed between the sensory outcome and age, smoking, mechanism of injury, lesion to or anastomosis of a digital artery, or time of immobilization. The only identified predictor of the result was the surgeon’s level of experience. This highlights the importance of adequate training and practice in the surgical repair of smaller peripheral nerves. Level of evidence: IV

scholarly journals Short (6 mm) and Regular Dental Implants in the Posterior Maxilla–7-Years Follow-up Study

2021 ◽  
Vol 10 (5) ◽  
pp. 940
Author(s):  
Jakub Hadzik ◽  
Paweł Kubasiewicz-Ross ◽  
Izabela Nawrot-Hadzik ◽  
Tomasz Gedrange ◽  
Artur Pitułaj ◽  
...  
Keyword(s):  
Survival Rate ◽  
Dental Implants ◽  
Clinical Results ◽  
Implant Survival ◽  
Implant Survival Rate ◽  
Short Implants ◽  
Posterior Maxilla ◽  
Patient Reported ◽  
Bone Level

Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11–13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery.

High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children.

1991 ◽  
Vol 9 (1) ◽  
pp. 123-132 ◽  
Author(s):  
C Patte ◽  
T Philip ◽  
C Rodary ◽  
J M Zucker ◽  
H Behrendt ◽  
...  
Keyword(s):  
Survival Rate ◽  
B Cell ◽  
Pediatric Oncology ◽  
Stage Iv ◽  
High Dose ◽  
High Survival ◽  
Advanced Stage ◽  
High Survival Rate ◽  
Cns Involvement

From April 1984 to December 1987, the French Pediatric Oncology Society (SFOP) organized a randomized trial for advanced-stage B-cell lymphoma without CNS involvement to study the possibility of reducing the length of treatment to 4 months. After receiving the same three intensive six-drug induction courses based on high-dose fractionated cyclophosphamide, high-dose methotrexate (HD MTX), and cytarabine in continuous infusion, patients were evaluated for remission. Those who achieved complete remission (CR) were randomized between a long arm (five additional courses with two additional drugs; 16 weeks of treatment) and a short arm (two additional courses; 5 weeks). For patients in partial remission (PR), intensification of treatment was indicated. Two hundred sixteen patients were registered: 15 stage II nasopharyngeal and extensive facial tumors, 167 stage III, and 34 stage IV, 20 of the latter having more than 25% blast cells in bone marrow. The primary sites of involvement were abdomen in 172, head and neck in 30, thorax in two, and other sites in 12. One hundred sixty-seven patients are alive in first CR with a minimum follow-up of 18 months; four are lost to follow-up. Eight patients died from initial treatment failure, 14 died from toxicity or deaths unrelated to tumor or treatment, and 27 relapsed. The event-free survival (EFS), with a median follow-up of 38 months, is 78% (SE 3) for all the patients, 73% (SE 11) for the stage II patients, 80% (SE 3) for the stage III patients, and 68% (SE 8) for the stage IV and acute lymphoblastic leukemia (ALL) patients. One hundred sixty-six patients were randomized: 82 in the short arm and 84 in the long arm. EFS is, respectively, 89% and 87%. Statistical analysis confirms equivalence of both treatment arms with regard to EFS. Moreover, morbidity was lower in the short arm. This study confirms the high survival rate obtained in the previous LMB 0281 study without radiotherapy or debulking surgery and demonstrates the effectiveness of short treatment.

scholarly journals Survival Rate of 1008 Short Dental Implants with 21 Months of Average Follow-Up: A Retrospective Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3943
Author(s):  
João Caramês ◽  
Ana Catarina Pinto ◽  
Gonçalo Caramês ◽  
Helena Francisco ◽  
Joana Fialho ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Survival Rate ◽  
Dental Implants ◽  
Cox Regression ◽  
Survival Rates ◽  
High Survival ◽  
Implant Survival ◽  
Posterior Maxilla ◽  
Clinical Records

This retrospective study evaluated the survival rate of short, sandblasted acid-etched surfaced implants with 6 and 8 mm lengths with at least 120 days of follow-up. Data concerning patient, implant and surgery characteristics were retrieved from clinical records. Sandblasted and acid-etched (SLA)-surfaced tissue-level 6 mm (TL6) or 8 mm (TL8) implants or bone-level tapered 8 mm (BLT8) implants were used. Absolute and relative frequency distributions were calculated for qualitative variables and mean values and standard deviations for quantitative variables. A Cox regression model was performed to verify whether type, length and/or width influence the implant survival. The cumulative implant survival rate was assessed by time-to-event analyses (Kaplan–Meier estimator). In all, 513 patients with a mean age of 58.00 ± 12.44 years received 1008 dental implants with a mean follow-up of 21.57 ± 10.77 months. Most implants (78.17%) presented a 4.1 mm diameter, and the most frequent indication was a partially edentulous arch (44.15%). The most frequent locations were the posterior mandible (53.97%) and the posterior maxilla (31.55%). No significant differences were found in survival rates between groups of type, length and width of implant with the cumulative rate being 97.7% ± 0.5%. Within the limitations of this study, the evaluated short implants are a predictable option with high survival rates during the follow-up without statistical differences between the appraised types, lengths and widths.

Sensory Recovery After Nerve Repair

HAND ◽  
1970 ◽  
Vol 2 (1) ◽  
pp. 7-9 ◽  
Author(s):  
W. McQUILLAN
Keyword(s):  
Nerve Repair ◽  
Sensory Recovery

scholarly journals High survival rate of a critically endangered species, the Azores Bullfinch Pyrrhula murina, as a contribution to population recovery

2010 ◽  
Vol 151 (3) ◽  
pp. 627-636 ◽  
Author(s):  
David Monticelli ◽  
Ricardo Ceia ◽  
Ruben Heleno ◽  
Hugo Laborda ◽  
Sergio Timóteo ◽  
...  
Keyword(s):  
Survival Rate ◽  
Endangered Species ◽  
Critically Endangered ◽  
High Survival ◽  
Population Recovery ◽  
High Survival Rate ◽  
Critically Endangered Species

scholarly journals Repeat hepatectomy for recurrent colorectal liver metastases is associated with a high survival rate

HPB ◽  
2011 ◽  
Vol 13 (11) ◽  
pp. 774-782 ◽  
Author(s):  
Andreas Andreou ◽  
Antoine Brouquet ◽  
Eddie K. Abdalla ◽  
Thomas A. Aloia ◽  
Steven A. Curley ◽  
...  
Keyword(s):  
Survival Rate ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Repeat Hepatectomy ◽  
High Survival ◽  
High Survival Rate

Postburn Nailfold Retraction: A Reconstructive Technique

1986 ◽  
Vol 11 (3) ◽  
pp. 385-387
Author(s):  
R. C. K. NGIM ◽  
K. SOIN
Keyword(s):  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Transposition Flap ◽  
Left Thumb ◽  
Nail Deformity ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Reconstructive Technique

Postburn nailfold retraction often results in nail deformity and loss of distal interphalangeal joint flexion. A technique of reconstruction of the nailfold using a proximally based transposition flap is described in a patient with postburn nailfold retraction of the left thumb, index and middle fingers.

scholarly journals Metformin-Associated Lactic Acidosis Undergoing Renal Replacement Therapy in Intensive Care Units: A Five-Million Population-Based Study in the North-West of Italy

2017 ◽  
Vol 44 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Filippo Mariano ◽  
Marco Pozzato ◽  
Paola Inguaggiato ◽  
Cesare Guarena ◽  
Ernesto Turello ◽  
...  
Keyword(s):  
Intensive Care ◽  
Survival Rate ◽  
Renal Replacement Therapy ◽  
Lactic Acidosis ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
High Efficiency ◽  
Journal Club ◽  
Large Population ◽  
High Survival

Background: Metformin-associated lactic acidosis (MALA) is a severe complication of drug administration with significant morbidity and mortality. So far no study in large population areas have examined the incidence, clinical profile and outcome of acute kidney injury (AKI)-MALA patients admitted in intensive care units (ICUs) and treated by renal replacement therapy (MALA-RRT). Methods: Retrospective analysis over a 6-year period (2010-2015) in Piedmont and Aosta Valley regions (5,305,940 inhabitants, 141,174 diabetics treated with metformin) of all MALA-RRT cases. Results: One hundred and seventeen cases of AKI-MALA-RRT were observed (12.04/100,000 metformin treated diabetics, 1.45% of all RRT-ICU patients). Survival rate was 78.3%. The average duration of RRT was 4.0 days at mean dialysis effluent of 977 mL/kg/day. At admission most patients were dehydrated, and experienced shock and oliguria. Conclusion: Our data showed that MALA-RRT is a common complication, needing more prevention. Adopted policy of early, extended, continuous and high efficiency dialysis could contribute to an observed high survival rate. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=471917.

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