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Plast Reconstr Surg Glob Open 2022 Jun 20;10(6):e4387. Epub 2022 Jun 20.

the Departments of Orthopedics and Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.

Major limb amputation is a devastating potential outcome of trauma, tumor, or disease. Much has been written about the physical, functional, economic, and psychological consequences of major limb loss. In contradistinction, considerably less has been written concerning the consequences of "minor" limb loss, specifically single partial digit amputations. Read More

J Plast Reconstr Aesthet Surg 2022 May 2. Epub 2022 May 2.

Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.

Radial artery superficial palmar branch harvesting is technically challenging, especially for inexperienced hand surgeons. The short pedicle and a damaged recipient digital artery require proximal digital artery dissection and relatively long pedicles. Herein, we describe a facilitated flap elevation technique and its application in various cases. Read More

J Plast Surg Hand Surg 2022 Jun 20:1-7. Epub 2022 Jun 20.

Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, P.R. China.

Reconstruction of degloving injury or amputation of distal thumb with no indication of replantation has always been a challenging problem for hand surgeons. In this study, a reverse homodigital dorsal wraparound flap innervated by the dorsal digital nerve was devised to repair degloving injury or amputation of distal thumb in 20 consecutive cases. In nine cases of thumb amputation, we skeletonized the phalanxes of the amputated part as a free cortical bone with Kirschner wires. Read More

Hand Surg Rehabil 2022 Jun 11. Epub 2022 Jun 11.

Oncological Orthopedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy; Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy. Electronic address:

Reconstruction is very important to ensure good function and quality of life after bone tumor resection. For metacarpals and phalanges, amputation and toe transfer are the gold-standard indications; nevertheless, allograft reconstruction must also be taken into account. Unfortunately, because of its inert biological behavior, it undergoes progressive resorption, with frequent fracture. Read More

J Orthop 2022 Jul-Aug;32:36-42. Epub 2022 May 6.

Levin Center for 3D Printing and Surgical Innovation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Background: Primary bone sarcomas are associated with critically sized bone defects and require complete resection with negative margins. Recent advancements in health care have pioneered novel approaches such as the implementation of 3D surgical technologies. This study presents oncological and functional outcomes following tumor resections of long bones with the use of customized 3D-printed Patient Specific Instruments (PSIs). Read More

Int J Low Extrem Wounds 2022 May 18:15347346221102643. Epub 2022 May 18.

60259Department of Systems Medicine, 9318University of Rome "Tor Vergata", Rome, Italy.

Diabetic foot osteomyelitis (DFO) is a clinical problem with high risk of amputation. The treatment of DFO is still an unsolved challenge. Surgical therapy, antibiotic therapy or conservative treatment are still debated for the timing and the consequences. Read More

Am J Case Rep 2022 May 11;23:e936359. Epub 2022 May 11.

Medical Department of Urgo Medical, Barcelona, Spain.

BACKGROUND Healico© is an innovative smartphone application designed to assist healthcare professionals in managing wounds in their daily practice. The application records all clinical information of the wound, facilitating its monitoring, and may lead to the selection of the best treatment for the patient. In addition, the application allows secure data sharing among healthcare professionals. Read More

Arthritis Res Ther 2022 05 10;24(1):103. Epub 2022 May 10.

Department of Medicine, The University of Melbourne at St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.

Background: To describe the epidemiology, determinants and survival impact of gastric antral vascular ectasia (GAVE) in systemic sclerosis (SSc).

Methods: Consecutive SSc patients prospectively enrolled in the Australian Scleroderma Cohort Study (ASCS) were included. Univariable and multivariable logistic regression were used to determine the associations of GAVE with clinical manifestations and serological parameters. Read More

Plast Reconstr Surg 2022 07 10;150(1):105-116. Epub 2022 May 10.

From the Division of Plastic Surgery, Department of Surgery, University of Washington; and Division of Plastic Surgery, Department of Surgery, University of Michigan.

Background: Artery-only replantation may be necessary in circumstances when venous repair cannot be performed due to their size or vessel injury. Venous congestion of the replanted part is inevitable. A systematic review was performed to identify techniques for mitigating congestion and analyze the outcomes of those techniques. Read More

Orthop Surg 2022 Jun 7;14(6):1019-1033. Epub 2022 May 7.

Unit of Lecco, CNR ICMATE, National Research Council, Lecco, Italy.

Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of treatment. Unfortunately, microsurgical options and transplantation procedures are not possible for patients who present contraindications or refuse to undergo transplantation from the toe (e. Read More

Br J Radiol 2022 Jul 12;95(1135):20211203. Epub 2022 May 12.

Department of Medical Imaging, University Hospital Heraklion, University of Crete Medical School, Heraklion, Greece.

Lower limb peripheral arterial disease (PAD) characterizes the impairment of blood flow to extremities caused by arterial stenoses or occlusions. Evaluation of PAD is based on clinical examination, calculation of ankle-brachial index and imaging studies such as ultrasound, CT, MRI and digital subtraction angiography. These modalities provide significant information about location, extension and severity of macrovasular lesions in lower extremity arterial system. Read More

Vascular 2022 May 1:17085381221097310. Epub 2022 May 1.

Department of Radiology, 21727University of Chicago, Chicago, IL, USA.

Objectives: This study aims to report the technical results of below-the-elbow arterial revascularization in patients with critical hand ischemia.

Methods: We retrospectively identified upper extremity critical limb ischemia patients treated with below-the-elbow arterial intervention between 2013 and 2017. Patient demographics, comorbidities, and procedural data were reviewed and technical success was evaluated. Read More

Indian J Plast Surg 2022 Feb 21;55(1):115-116. Epub 2022 Feb 21.

Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.

J Hand Surg Glob Online 2021 Sep 28;3(5):298-301. Epub 2021 Jul 28.

Indiana University School of Medicine, Division of Plastic Surgery, Indianapolis, IN.

We present a unique case of side-to-side metacarpal fusion for reconstruction after an isolated gunshot wound to the right hand of a 19-year-old woman. There was a traumatic segmental loss of the proximal right second metacarpal base with considerable comminution of the trapezium and trapezoid. Reconstructive options were limited because of the destruction of the distal carpus and carpometacarpal (CMC) joint. Read More

J Hand Surg Glob Online 2021 Jul 27;3(4):215-217. Epub 2021 Apr 27.

Department of Orthopedics, St. Joseph's Regional Medical Center, Paterson, NJ.

The use of epinephrine-containing digital nerve blocks has been shown to be safe in recent literature, challenging the historical fear of complications arising from irreversible ischemia. We present a rare case of digital tip necrosis following the injection of lidocaine-containing epinephrine for the purpose of wart removal using cryotherapy, ultimately requiring amputation. Read More

JPRAS Open 2022 Jun 8;32:111-115. Epub 2022 Mar 8.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Different approaches to fingertip reconstructions are reported for cases in which microsurgical replantation is impossible. This report presents two cases of bipedicled digital artery perforator adiposal flaps for fingertip reconstruction after traumatic amputations. Adiposal flaps, including the radial and ulnar digital artery perforator vessels proximal to the distal interphalangeal joint, were elevated and turned to cover the fingertip defect. Read More

Clin Case Rep 2022 Mar 17;10(3):e05618. Epub 2022 Mar 17.

Department of Neonatology KK Women's and Children's Hospital Singapore City Singapore.

The amniotic band comprises disrupted amnion strands causing entrapment or entanglement of various fetal parts resulting in a spectrum of anomalies from digital band constriction or amputation to severe craniofacial/visceral defects and even fetal demise. We present a newborn infant with a rare, isolated ring constriction of the penis. Read More

Children (Basel) 2022 Mar 16;9(3). Epub 2022 Mar 16.

Department of Computer Science, Escuela Politécnica Superior, Universidad Autónoma de Madrid, Francisco Tomás y Valiente, 11. Campus de Cantoblanco, 28049 Madrid, Spain.

In the medical context, designing and developing myoelectric prostheses has made it possible for patients to regain mobility lost due to amputations; however, their use requires intensive training. Serious games through multi-touch devices can serve as a complement to the activities carried out during face-to-face sessions with occupational therapists and physiotherapists, as a useful resource to engage patients, especially children, and make them enjoy training. In this paper, we describe our work to support the training of myoelectric prostheses through digital serious games. Read More

Bioengineering (Basel) 2022 Feb 22;9(3). Epub 2022 Feb 22.

Instituto Superior de Engenharia do Porto, 1161257 Porto, Portugal.

Diabetic peripheral neuropathy is a major complication of diabetes mellitus, and it is the leading cause of foot ulceration and amputations. The Semmes-Weinstein monofilament examination (SWME) is a widely used, low-cost, evidence-based tool for predicting the prognosis of diabetic foot patients. The examination can be quick, but due to the high prevalence of the disease, many healthcare professionals can be assigned to this task several days per month. Read More

Hand (N Y) 2022 Mar 21:15589447221081863. Epub 2022 Mar 21.

Yotsuya Medical Cube, Tokyo, Japan.

Background: This study aimed to compare the outcomes of reverse digital artery island flap (RDAIF) in primary and secondary reconstruction after failed replantation or composite graft method.

Methods: This study retrospectively analyzed 42 patients that underwent RDAIF (18 primary and 24 secondary). Preoperative details (demographics, injury details, and waiting days) and postoperative outcomes (active arc of proximal interphalangeal [PIP] and distal interphalangeal (DIP) joints, extension loss of PIP, flexion arc of metacarpophalangeal joint, total active motion, flap sensation, the presence of numbness, Tinel's sign and cold intolerance) were evaluated. Read More

J Am Podiatr Med Assoc 2021 Dec 15;111(6). Epub 2021 Dec 15.

Systemic lupus erythematosus is an autoimmune disorder that affects several organs and systems in the human body. Digital gangrene is known to be a rare and severe complication of systemic lupus erythematosus that could lead to amputation. We report a case of an adolescent who presented with an autoimmune disorder and multiple comorbidities and developed gangrenous toes. Read More

Hand (N Y) 2022 Mar 14:15589447221082160. Epub 2022 Mar 14.

Washington University School of Medicine, St. Louis, MO, USA.

Background: Diabetes is a well-established risk factor for severe digital infection, and patients are more likely to require digital amputation for adequate source control. This study aims to identify factors predictive of digital amputation compared with preservation in patients with diabetes who present with surgically treated finger infections.

Methods: Current Procedural Terminology (CPT) and International Classification of Diseases Versions 9 and 10 (ICD-9/10) databases from a single academic medical center were queried to identify patients with type 1 or type 2 diabetes mellitus who underwent surgical treatment in the operating room for treatment of a digital infection from 2010 to 2020. Read More

Case Rep Vasc Med 2022 2;2022:8963753. Epub 2022 Mar 2.

University of Twente, Faculty of Behavioral, Management and Social Sciences, Department Psychology, Health and Technology, Enschede, Netherlands.

Background: Non-Hodgkin lymphomas (NHLs) comprise a group of haematologic malignancies with different histologic subtypes. The clinical picture varies from indolent to aggressive presentation and nodal (lymphadenopathy) to extranodal (central nervous system, gastrointestinal, cutaneous plaque, or ulcer) involvement. Digital gangrene is seldom reported. Read More

J Hand Surg Eur Vol 2022 May 13;47(5):546-548. Epub 2022 Mar 13.

Hand Surgery and Reconstructive Microsurgery Department, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy.

Acta Chir Orthop Traumatol Cech 2022 ;89(1):81-84

Interní oddělení Strahov, Všeobecná fakultní nemocnice v Praze.

Upper limb ischemia in patients with chronic kidney disease treated by haemodialysis is a known complication, but fortunately its progression into gangrene is not frequent. Ischemia occurs in 3.7-5% of dialysis patients, in dependence on the type of vascular access. Read More

BMC Surg 2022 Mar 3;22(1):79. Epub 2022 Mar 3.

Laboratory of Digital Medicine, Wuxi People's Hospital, Nanjing Medical University, Wuxi, 214023, China.

Purpose: The aim of this study is to investigate the outcome of these limb-threatening injuries through external fixation treatment and to discuss the case of patients' functional recovery after external fixation.

Methods: Demographics, surgical treatment and outcomes in 88 patients with lower leg arterial injuries treated by external fixation at two trauma centers from 2009 to 2018 were reviewed. The primary outcome was the rate of successful lower leg salvage, while secondary outcomes were complications and functional recovery. Read More

J Am Podiatr Med Assoc 2022 Feb 25:1-42. Epub 2022 Feb 25.

‡Podiatry Department, Faculty of Health Sciences, University of Malta.

People suffering from diabetes are at risk of developing foot ulcerations, which, if left untreated, could also lead to amputation. Monitoring of the foot temperature can help in the prevention of these foot complications, and various studies have shown that elevated temperatures may be indicative of ulceration. Over the years there have been various devices that were designed for foot temperature monitoring, both for clinical and home use. Read More

Bull Hosp Jt Dis (2013) 2022 Mar;80(1):31-36

The first digital replantation was performed over 50 years ago, and soon after surgeons in countries around the world were finding great success in their outcomes. The initial wave of success, however, has been followed by somewhat disappointing results in the United States in recent years. The steadily declining number of attempts at replantation and diminishing viability rates can be attributed to several factors, many of which can be addressed with centralization of care and the modification of our own indications and contraindications. Read More

J Hand Ther 2022 Apr-Jun;35(2):289-298. Epub 2022 Feb 25.

The University of Derby, Derby, United Kingdom.

STUDY DESIGN": Qualitative research design using interpretative phenomenological analysis (IPA) to interpret users' experiences with digital prostheses.

Background: Digital prostheses are rarely used, and little is known about the experiences of traumatic finger amputees with digital prostheses. When advising patients regarding digital prostheses, it is crucial for professionals to understand users experiences of wearing a digital prosthesis and the meaning attached to wearing a digital prosthesis. Read More

BMJ Open 2022 Feb 21;12(2):e051981. Epub 2022 Feb 21.

Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Brazil.

Introduction: Type 2 diabetes can lead to gait abnormalities, including a longer stance phase, shorter steps and improper foot pressure distribution. Quantitative data from objective methods for evaluating gait patterns are accurate and cost-effective. In addition, it can also help predictive methods to forecast complications and develop early strategies to guide treatments. Read More