scholarly journals Replantation fingertip without venous anastomoses in children

2021 ◽  
Vol 24 (2) ◽  
pp. 7-14
Author(s):  
A. V. Alexandrov ◽  
A. A. Smirnov ◽  
P. V. Goncharuk ◽  
A. N. Evdokimov
Keyword(s):  
Clinical Case ◽  
Venous Congestion ◽  
Fingertip Amputation ◽  
Right Hand ◽  
Operative Care ◽  
Golden Standard ◽  
Principles Of Treatment ◽  
Mechanism Of Trauma ◽  
Type Of Injury ◽  
Hand Replantation

Objective. Traumatic complete and partial finger amputations are rare in comparison with adults. There are significant differences between mechanism of trauma, principles of treatment children with this type of injury in comparison with adults.Clinical case. A 15-years old child suffered from injury by axe, which caused the traumatic fingertip amputation of III and IV digits of his right hand. Replantation of both amputated parts was performed. Arteries and nerves were repaired with no veins anastomosed. As a result - survival of replanted parts.Discussion. A submillimeter diameter of vessels and potential venous congestion are basic problems that a surgeon deal with when perform the replantation of fingertips. Respectively, a difficulty in post-operative care of patient appears.Conclusion. Replantation of amputated part of finger is a golden standard of treatment of children with a described type of injury. The correct deliverance of amputated parts, the shortest time of ischemia as possible, a qualitive operation and post-operative care play an important role in successful survival of the replanted segments.

scholarly journals Outcome of Early Motion Protocol for Total Hand Replantation: 1- and 2-Year Postoperative Results

2019 ◽  
Vol 12 (S 01) ◽  
pp. S70-S74
Author(s):  
Lucas M. Harrison ◽  
Spencer R. Anderson ◽  
Sunishka M. Wimalawansa
Keyword(s):  
External Fixation ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Postoperative Management ◽  
Active Motion ◽  
Early Motion ◽  
Right Hand ◽  
Rehabilitation Protocols ◽  
Hand Amputation ◽  
Hand Replantation

Abstract Introduction We review the benefits of early motion protocols following replantation of a total right hand amputation at 1 and 2 years after replantation, and provide recommendations for postoperative management. Materials and Methods Replantation of the entire right hand in zone-4 was performed and supported by rigid external fixation spanning the forearm and hand. An early active “place-and-hold” motion protocol was initiated within the first 3 postoperative days. Metacarpophalangeal joint extensors were tethered by the pins, limiting full excursion. This resulted in stiffness and extensor adhesions that required a staged extensor tenolysis; however, all joints remained supple. The early motion protocol prevented the need for significant flexor tenolysis and joint releases. Results Early motion rehabilitation protocols can produce very successful results in complex replantation. The enhanced stability afforded by external fixation of the wrist allowed us to perform aggressive early rehabilitation. Conclusion This case highlights the benefits of early active motion (limiting the need for complex joint and flexor tendon releases) and demonstrates the degree of extensor adhesions caused by even minor extensor tendon tethering. This aggressive rehabilitation approach can produce excellent range of motion, and likely limit the need for secondary tenolysis and joint release procedures.

scholarly journals Hand replantation after traumatic amputation in a general surgical hospital

2019 ◽  
Vol 178 (4) ◽  
pp. 69-71
Author(s):  
A. N. Plekhanov ◽  
V. A. Shagdurov ◽  
E. N. Shabaeva ◽  
R. D. Garmaev ◽  
N. B. Mansheev
Keyword(s):  
Blood Loss ◽  
Hemorrhagic Shock ◽  
Effective Treatment ◽  
Postoperative Period ◽  
Acute Blood Loss ◽  
Traumatic Amputation ◽  
Active Monitoring ◽  
Right Hand ◽  
The Right ◽  
Hand Replantation

The authors described the case of replantation of the right hand in the men of 28 years after a traumatic amputation. This injury was accompanied by damage to the main vessels, which could lead to acute blood loss, hemorrhagic shock and death. The complication after surgery in the form of suppuration of the wound and its effective treatment was shown. This clinical example demonstrated the possibility of limb replantation in traumatic amputations not only in specialized clinics, but also in General surgical hospitals. The basis of the success of the results of the operation was the phasing in the treatment, active monitoring of the replanted limb in order to early identifying possible complications in the postoperative period.

scholarly journals Report of a human accident caused by Conus regius (Gastropoda, Conidae)

2009 ◽  
Vol 42 (4) ◽  
pp. 446-448 ◽  
Author(s):  
Vidal Haddad Junior ◽  
Marcus Coltro ◽  
Luiz Ricardo L. Simone
Keyword(s):  
Clinical Case ◽  
Human Beings ◽  
Fatal Accidents ◽  
First Report ◽  
Right Hand ◽  
The Right

Conus regius is a venomous mollusc in the Conidae family, which includes species responsible for severe or even fatal accidents affecting human beings. This is the first report on a clinical case involving this species. It consisted a puncture in the right hand of a diver who presented paresthesia and movement difficulty in the whole limb. The manifestations disappeared after around twelve hours, without sequelae.

OSTEOCUTANEOUS VY FLAP TO PRESERVE LENGTH IN CORONAL OBLIQUE FINGERTIP AMPUTATION

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 297-299 ◽  
Author(s):  
Tun Lin Foo ◽  
M. Arul
Keyword(s):  
Clinical Case ◽  
Flap Reconstruction ◽  
Shape Distortion ◽  
Fingertip Amputation ◽  
Technical Details

Radial or ulnar oblique amputations treated by nailbed levelling and local digital flap reconstruction can result in significantly shortened fingertip, narrowed pulp and nail shape distortion. A VY type flap containing bone, sterile matrix, and skin was conceptualised to restore nail and pulp contour for coronal oblique amputations. Technical details and a clinical case are discussed.

scholarly journals TOXIN-INDUCED ACUTE KIDNEYINJURY. CLINICAL OBSERVA

2021 ◽  
Vol 11 (1) ◽  
pp. 63-65
Author(s):  
Liubov Popova
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Liver Injury ◽  
Replacement Therapy ◽  
Clinical Case ◽  
Alcohol Intoxication ◽  
Kidney Injury ◽  
Disease Development ◽  
Principles Of Treatment ◽  
Adequate Management

The article presents a clinical case of toxininduced acute kidney injury. The authors analyzed the cause of the event, revealed the pathogenesis of toxin injury of the kidneys, and described the main principles of treatment. The authors used this clinical case to show the importance of timely renal replacement therapy and the influence of comorbid pathology on disease development. The onset of acute kidney injury in patients with surrogate alcohol intoxication manifested as combined kidney and liver injury was described. The article may be of interest to doctors of all specialties, especially for therapists and surgeons who are the first to reveal acute kidney injury and their choice of adequate management ultimately determines the outcome.

scholarly journals The Case of Amyloidosis in Cardiological Practice

Kardiologiia ◽  
2019 ◽  
Vol 59 (1) ◽  
pp. 93-96
Author(s):  
Z. M. Galeeva ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
L. A. Galimzyanova ◽  
A. Y. Rafikov ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Cardiac Amyloidosis ◽  
Clinical Case ◽  
Principles Of Treatment ◽  
The Subject ◽  
Criteria For Diagnosis

In this article we present brief overview of the subject of amyloidosis and involvement of the cardiovascular system, the criteria for diagnosis, principles of treatment, and the clinical case of cardiac amyloidosis.

BEZOAR IN THE PRACTICE OF GENERAL PRACTITIONER AND PEDIATRICIAN: CLINICAL CASE – RAPUNZEL SYNDROME

2021 ◽  
Author(s):  
M. V. Dubkovska ◽  
T. M. Khimenko ◽  
O. V. Fedorenko ◽  
O. V. Kochkarov
Keyword(s):  
Weight Loss ◽  
Clinical Case ◽  
Fruits And Vegetables ◽  
Clinical Symptoms ◽  
Careful Examination ◽  
Rapunzel Syndrome ◽  
Endoscopic Method ◽  
Golden Standard ◽  
Exotic Fruits

Introduction. Bezoar is a cluster of foreign, inedible or difficult to digest objects in the digestive tract (especially in the stomach). Depending on the composition, there are: phytobezoars, trichobezoars, pharmacobezoars, lactobezoars. Patients may not have any symptoms for years, and their appearance is associated with an bezoar size enlargment, then there is abdominal pain, bloating, nausea and vomiting, a feeling of rapid satiety, anorexia and weight loss. The small bowel obstruction is the often cause of acute surgical pathology in the case of bezoar. It is important to pay attention to the peculiarities of the patient’s behavior, halitosis, spotted alopecia. The purpose of this publication was to raise the awareness of pediatricians and general practitioners in the diagnosis and management of patients with bezoars. The article presents a review of the literature and the clinical case of trichobezoar (Rapunzel syndrome) in a 14-year-old girl. Conclusions. Bezoar, regardless of its nature, disrupts the function of the gastrointestinal tract and can cause acute surgical complications patients of all ages. General practitionersn and pediatricians, taking into account the risk factors and clinical symptoms, may suspect bezoar formation in the early stages. In pediatric practice at the stage of primary diagnostic search, ultrasound can be recommended as a less invasive, but quite informative method. The “golden standard” for verification and treatment of uncomplicated forms of bezoar is the endoscopic method, regardless of age. Phytobezoars are less common in our region, but the processes of globalization, migration and increase in the diet of exotic fruits and vegetables may actualize this pathology. Adolescents, mostly girls who have long-term dyspeptic symptoms, alopecia, weight loss, especially if it occurs against the background of difficult social circumstances or pre-existing psychiatric disorders, are at risk of developing trichobezoar, so they need careful examination and consultation with a psychiatrist.

scholarly journals High-Energy Transsyndesmotic Ankle Fracture Dislocation: A Case Report and Systematic Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yinshuan Deng ◽  
Chenhui Dong ◽  
Xiaojie Yang ◽  
Rui Liu ◽  
Feiyi Hou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
Ankle Fracture ◽  
Clinical Case ◽  
High Energy ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
Ovid Medline ◽  
Type Of Injury

High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.

scholarly journals SPINAL DURAL ARTERIOVENOUS FISTULA: CLINICAL CASE AND LITERATURE REVIEW

2018 ◽  
Vol 25 (2) ◽  
pp. 75-82
Author(s):  
R. A. Gapeshin ◽  
A. A. Yakovlev ◽  
A. G. Smochilin ◽  
A. V. Gavrichenko ◽  
M. S. Pushkaryov
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Case ◽  
Dural Arteriovenous Fistula ◽  
Screening Method ◽  
Magnetic Resonance Tomography ◽  
Spinal Angiography ◽  
Spinal Dural Arteriovenous Fistula ◽  
Initial Symptoms ◽  
Golden Standard ◽  
Neurological Exam

Spinal dural arteriovenous fistula (SDAVF) is a rare disease, however, with nonspecific initial symptoms, like back pain, parestesias, gait imbalance, weakness and numbness in extremities. Para- or tetraparesis, disturbance of deep sensation and pelvic organs functions may develop during the course of disease. There isn’t any specific laboratory tests. So, the diagnostics of dural fistulas is complex. The main screening method is magnetic resonance tomography (MRI), which may suspect or reveal dural fistula. Spinal angiography is a «golden standard» in diagnostics. Options of treatment include microsurgical separation or endovascular embolisation of fistula. The article presents a clinical case of SDAVF in thoracic region of spine. Related to complains, neurological exam and MRI data, the vascular mass was suspected and spinal angiography was per-formed to confirm the presence of SDAVF. After surgical treatment the patient was observed to rehabilitation course, which had improved his status. In sum, appropriate diagnostics, surgical intervention and rehabilitation are the main factors related to successful treatment of patients with SDAVF.

scholarly journals Dislocation of the penis: a rare case of genital trauma

2021 ◽  
Vol 9 (4) ◽  
pp. 127-132
Author(s):  
V. A. Dudarev ◽  
V. Yu. Startsev ◽  
A. N. Khaustov ◽  
A. A. Koshmelev
Keyword(s):  
Medical Care ◽  
Rare Case ◽  
Clinical Case ◽  
Occurrence Frequency ◽  
Urinary Leakage ◽  
Joint Area ◽  
Traumatic Dislocation ◽  
Late Treatment ◽  
Genital Trauma ◽  
Type Of Injury

Traumatic dislocation of the penis is one of the rarest types of genital trauma. This type of injury is accompanied by a violation of the integrity of the skin and the penile ligamentous apparatus, with the dislocation of the penis into the scrotum under the skin of the thigh, or the area of the pubic joint. The low occurrence frequency of such injuries and the small number of observations described in the literature entails the absence of generally accepted treatment tactics for this category of patients. The article describes a clinical case of successfully treated traumatic dislocation of the penis with penile transposition into the pubic joint area and the formation of subcutaneous urinary leakage after late treatment of the patient for medical care.

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