1,588 results match your criteria Digital Amputations


Fingertip Injuries and Amputations: A Review of the Literature.

Cureus 2020 May 26;12(5):e8291. Epub 2020 May 26.

Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA.

The fingertip is defined as the part of the digit distal to the insertion of the extensor and flexor tendons on the distal phalanx. Devastating injuries to the hand occur every year that lead fingertip amputations in thousands of people. The highest incidence rates are usually seen in children less than five years old and in adults over the age of 65. Read More

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http://dx.doi.org/10.7759/cureus.8291DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317129PMC

Three-dimensional printing in prosthetics: Method for managing rapid limb volume change.

Prosthet Orthot Int 2020 Jun 25:309364620934340. Epub 2020 Jun 25.

Minneapolis VA Health Care System, Minneapolis, MN, USA.

Background And Aim: During post-amputation recovery or rapid body mass change, residual limb volume can change quickly, requiring frequent adjustments or replacement of the socket to maintain fit. The aim of this pilot test was to evaluate the feasibility of using a three-dimensional-printed insert to extend the service life of a prosthetic socket after substantial residual limb volume loss.

Technique: One research subject with a well-fitting transtibial prosthetic socket had an oversized socket fabricated to simulate substantial limb volume loss. Read More

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http://dx.doi.org/10.1177/0309364620934340DOI Listing

Acral Lentiginous Melanoma: Do Surgical Approach and Sentinel Lymph Node Biopsy Matter?

Plast Reconstr Surg Glob Open 2020 Mar 25;8(3):e2698. Epub 2020 Mar 25.

Division of Surgical Oncology, Department of Surgery, Oregon Health & Science University, Portland, Ore.

Management of acral lentiginous melanoma (ALM) remains controversial. Traditionally, ALM was managed with digit amputation (DA), resulting in significant morbidity, but recent evidence has advocated for digit sparing management. Furthermore, the significance of nodal metastasis for ALM is not well reported. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253243PMC

Two-Tongued Cross-Finger Filet Flap Distal Digit Reconstructions Using Spare Parts After Multiple Distal Digital Amputations.

Eplasty 2020 31;20:ic11. Epub 2020 May 31.

Division of Plastic & Reconstructive Surgery, Department of Surgery, Lehigh Valley Health Network, Allentown, Pa.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270325PMC

Leech Therapy Following Digital Replantation and Revascularization.

J Hand Surg Am 2020 Jul 31;45(7):638-643. Epub 2020 May 31.

Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address:

Venous congestion after digital replantation or revascularization threatens digit survival in the immediate postoperative period. External bloodletting, including leech therapy, provides a central role in salvage of the congested finger. Although there have been previous studies describing the initiation of leech therapy for digits experiencing venous insufficiency, few published articles and no consensus guidelines have discussed the weaning of leeches in the postoperative period. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.03.026DOI Listing
July 2020
1.655 Impact Factor

Digital Subtraction Angiography Prior to an Amputation for Critical Limb Ischemia (CLI): An Expert Recommendation Statement From the CLI Global Society to Optimize Limb Salvage.

J Endovasc Ther 2020 May 29:1526602820928590. Epub 2020 May 29.

Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, FL, USA.

Despite recent guideline updates on peripheral artery disease (PAD) and critical limb ischemia (CLI) treatment, the optimal treatment for CLI is still being debated. As a result, care is inconsistent, with many CLI patients undergoing an amputation prior to what many consider to be mandatory: consultation with an interdisciplinary specialty care team and a comprehensive imaging assessment. More importantly, quality imaging is critical in CLI patients with below-the-knee disease. Read More

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http://dx.doi.org/10.1177/1526602820928590DOI Listing
May 2020
3.353 Impact Factor

Acral vascular syndrome during an immune checkpoint inhibitor.

BMJ Case Rep 2020 May 17;13(5). Epub 2020 May 17.

Department of Medical Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA.

Immune checkpoint inhibitors, including antiprogrammed death cell protein 1 (anti-PD-1) and anti cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), have been associated with a range of autoimmune-related side effects since their introduction in cancer treatment. Small vessel digital necrosis, referred to as the acral vascular syndrome, is a rare but serious complication that can result in loss of digits. Here we present a case report of acral vascular syndrome and review possible aetiologies. Read More

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http://dx.doi.org/10.1136/bcr-2019-233463DOI Listing

Coexistence of antiphospholipid syndrome and cryoglobulinemia in a patient with rheumatoid arthritis.

Clin Rheumatol 2020 May 9. Epub 2020 May 9.

Rheumatology Department, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.

We present here a case of severe digital necrosis in a patient with long-standing rheumatoid arthritis (RA). The concomitant presence of two autoimmune conditions such as cryoglobulinemia and antiphospholipid syndrome (APS) were diagnosed. To best of our knowledge, this is the first case of the coexistence of RA, cryoglobulinemia, and APS in a single patient. Read More

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http://dx.doi.org/10.1007/s10067-020-05127-yDOI Listing

Molten metal high pressure injection injury of the hand.

Hand Surg Rehabil 2020 May 7. Epub 2020 May 7.

Orthopedic Department, HaEmek Medical Center, Yitshak Rabin Boulevard 21, 1834111 Afula, Israel; Faculty of Medicine, Technion, 3200003 Haifa, Israel. Electronic address:

The second case of high temperature molten metal, high-pressure injection injury of the hand is reported here. Like in the previous case, there was an innocent-looking entry point with deep thermal injury to the flexor tendons and the digital nerves that appeared a few days after the injury and lead to finger amputation. LEVEL OF EVIDENCE: 5. Read More

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http://dx.doi.org/10.1016/j.hansur.2020.03.007DOI Listing

Aggressive digital papillary adenocarcinoma and sentinel node biopsy: A case report and literature review.

JPRAS Open 2020 Jun 12;24:43-46. Epub 2020 Mar 12.

Department of Plastic Surgery, St George's Hospital, UK.

Aggressive digital papillary adenocarcinomas (ADPA) are malignant tumours of the sweat gland. Due to the high tendency to recur and metastasise, wide local resection of the lesion is recommended. However, there are a limited number of cases reporting the use of sentinel node biopsy in the management of ADPA, thus its effectiveness remains unclear. Read More

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http://dx.doi.org/10.1016/j.jpra.2020.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195495PMC

Digital Hand Embolization as a Complication of Substance Abuse.

J Invasive Cardiol 2020 May;32(5):E135

Beaumont Hospital Dearborn, 18101 Oakwood Blvd, Dearborn, MI 48124 USA.

Intra-arterial injection of recreational substances and drugs is less well described in the literature. It carries a risk for hand ischemia and embolization to the hand digits and ultimately amputation. Read More

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Vascular Injuries in Intravenous Drug Addicts-A Single-Center Experience.

Ann Vasc Surg 2020 Apr 23. Epub 2020 Apr 23.

Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia.

Background: Infected false aneurysms (IFA) caused by intravenous drug abuse are uncommon but challenging lesions. The best approach for the surgical management of this condition is still unknown. The aim is to present a single-center 14-year experience in the IFA treatment in intravenous drug abusers, thus providing additional data regarding the treatment options and outcome in these patients. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.02.041DOI Listing

Low molecular weight heparin for prevention of microvascular occlusion in digital replantation.

Cochrane Database Syst Rev 2020 04 17;4:CD009894. Epub 2020 Apr 17.

Chang Gung University, College of Medicine, Taoyuan, Taiwan.

Background: The success of digital replantation is highly dependent on the patency of the repaired vessels after microvascular anastomosis. Antithrombotic agents are frequently used for preventing vascular occlusion. Low molecular weight heparin (LMWH) has been reported to be as effective as unfractionated heparin (UFH) in peripheral vascular surgery, but with fewer adverse effects. Read More

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http://dx.doi.org/10.1002/14651858.CD009894.pub3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164413PMC

Definitive External Fixation for Anterior Stabilization of Combat-related Pelvic Ring Injuries, With or Without Sacroiliac Fixation.

Clin Orthop Relat Res 2020 Apr;478(4):779-789

B. W. Hoyt, A. E. Lundy, R. L. Purcell, C. J. Harrington, W. T. Gordon, Uniformed Services University-Walter Reed National Military Medical Center Department of Surgery, Bethesda, MD, USA.

Background: Combat-related pelvic ring injuries frequently lead to placement of a temporizing external fixation device for early resuscitation and transport. These injuries are commonly complicated by concomitant polytrauma and extensive soft-tissue injuries, which may preclude early internal fixation and lead to prolonged use of external fixation. To date, few studies have reported on the outcomes of definitive external fixation for combat-related pelvic ring injuries. Read More

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http://dx.doi.org/10.1097/CORR.0000000000000961DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282593PMC

Optimization of the homodigital antegrade island flap for fingertip reconstruction: New dissection sequence based on cadaver study findings.

Orthop Traumatol Surg Res 2020 Apr 18;106(2):335-339. Epub 2020 Mar 18.

Institut Européen de la Main, Hôpital Kirchberg Medical Training Center, 9, rue Edward Steichen, 2540 Luxembourg, Luxembourg.

Introduction: The homodigital antegrade island flap pedicled on the proper palmar digital artery is very useful for covering fingertip defects. However, it has its drawbacks, such as the risk of stiffness due to retractile scars and the need for extensive dissection with long-lasting dysesthesia in some cases. In clinical studies, expanding the skin paddle with V-shaped incisions increases the flap's advancement. Read More

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http://dx.doi.org/10.1016/j.otsr.2020.01.002DOI Listing

Carbon dioxide-angiography for patients with peripheral arterial disease at risk of contrast-induced nephropathy.

World J Cardiol 2020 Feb;12(2):76-90

Department of Cardiology, Heart, Vascular and Leg Center, Bakersfield, CA 93309, United States.

Patients with peripheral arterial disease (PAD) and critical limb ischemia are at risk for limb amputation and require urgent management to restore blood flow. Patients with PAD often have several comorbidities, including chronic kidney disease, diabetes mellitus, and hypertension. Diagnostic and interventional angiography using iodinated contrast agents provides excellent image resolution but can be associated with contrast-induced nephropathy (CIN). Read More

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http://dx.doi.org/10.4330/wjc.v12.i2.76DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061263PMC
February 2020

Prevention of symptomatic neuroma in traumatic digital amputation: A RAND/UCLA appropriateness method consensus study.

Injury 2020 Mar 9. Epub 2020 Mar 9.

Hand Surgery and Reconstructive Microsurgery Department. ASST Gaetano Pini - CTO, P.zza A. Ferrari 1, 20122 Milan, Italy. Electronic address:

Introduction: The appearance of a symptomatic neuroma following finger amputation is a devastating consequence for patient's quality of life. It could be cause of chronic neuropathic pain. The prevention of neuroma formation is a challenging effort for hand surgeons. Read More

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http://dx.doi.org/10.1016/j.injury.2020.03.018DOI Listing

Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review.

Diabetes Metab Res Rev 2020 03;36 Suppl 1:e3277

Bristol Centre for Surgical Research, University of Bristol, Bristol, UK.

The accurate identification of peripheral artery disease (PAD) in patients with diabetes and foot ulceration is important, in order to inform timely management and to plan intervention including revascularisation. A variety of non-invasive tests are available to diagnose PAD at the bedside, but there is no consensus as to the most useful test, or the accuracy of these bedside investigations when compared to reference imaging tests such as magnetic resonance angiography, computed tomography angiography, digital subtraction angiography or colour duplex ultrasound. Members of the International Working Group of the Diabetic Foot updated our previous systematic review, to include all eligible studies published between 1980 and 2018. Read More

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http://dx.doi.org/10.1002/dmrr.3277DOI Listing

Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2019 update).

Diabetes Metab Res Rev 2020 03;36 Suppl 1:e3274

School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.

The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the use of offloading interventions to promote the healing of foot ulcers in people with diabetes and updates the previous IWGDF guideline. We followed the GRADE methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical-scientific literature, and to write recommendations and their rationale. Read More

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http://dx.doi.org/10.1002/dmrr.3274DOI Listing

Mangled finger salvage using cross-finger revascularization.

J Orthop Surg Res 2020 Mar 11;15(1):104. Epub 2020 Mar 11.

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.

Background: Mangled finger with impaired arteria digitalis communis remains to be a challenge for replantation surgery due to the limited amount of tissue to work with.

Methods: Out of 554 hands with total finger amputations treated by replantation of finger/fingers from July 2012 to June 2018, there were 7 cases of damaged arteria digitalis communis, all of which were replanted by anastomosing distal adjacent radial/ulnar digital artery to distal end of ulnar/radial digital artery of amputation finger, and 2 veins were anastomosed for each finger. A skin pedicle was made by suturing both dorsal and palmar skin of adjacent fingers, and detachment was performed 4 weeks postoperatively. Read More

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http://dx.doi.org/10.1186/s13018-020-01621-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066790PMC

The unilateral perforator V-Y flap for fingertip reconstruction-a versatile technique.

JPRAS Open 2020 Mar 5;23:1-7. Epub 2019 Nov 5.

Department of Plastic Surgery, Royal London Hospital, Barts Health NHS Trust, London.

Fingertip amputations are a very common form of injury seen in the emergency departments. Various techniques have been described for the management of these injuries including simple dressings, skin grafts, homodigital, heterodigital and regional flaps and also free flaps. We present our experience with 10 cases of unilateral V-Y flaps raised on a perforator vessel and advanced in a modified fashion to cover the entire tip with a single flap. Read More

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http://dx.doi.org/10.1016/j.jpra.2019.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061637PMC

Intramedullary fixation with bioabsorbable and osteoconductive hydroxyapatite/poly-L-lactide threaded pin in digital replantation.

J Plast Surg Hand Surg 2020 Jun 10;54(3):177-181. Epub 2020 Mar 10.

Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, Matsudo, Japan.

In digital replantation, Kirschner wire (K-wire) fixation has commonly been used for osteosynthesis. On the other hand, K-wires are often obtrusive because of protrusion from the replanted digit. We describe a case series treated using hydroxyapatite/poly-L-lactide (HPLLA) threaded pins, which are not only bioabsorbable, but also osteoconductive, for osteosynthesis in crushed amputation or comminuted fracture, including distal phalanx amputation. Read More

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http://dx.doi.org/10.1080/2000656X.2020.1738239DOI Listing

Usefulness of avulsed fingertip skin for reconstruction after digital amputation.

Case Reports Plast Surg Hand Surg 2020 31;7(1):23-29. Epub 2020 Jan 31.

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

We present four cases of fingertip amputation treated with local flap where the avulsed fingertip skin could be effectively utilized for these donor sites. The avulsed finger skin may be utilized even when replantation is not possible. This approach may serve as a new treatment option after fingertip amputation. Read More

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http://dx.doi.org/10.1080/23320885.2020.1719843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033701PMC
January 2020

Comparison of traditional vascular reconstruction with covered stent in the treatment of subclavian artery injury.

Chin J Traumatol 2020 Feb 18;23(1):25-28. Epub 2020 Jan 18.

Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.

Purpose: To explore the significance of traditional vascular reconstruction and covered stent for limb salvage after subclavian artery injury.

Methods: Patients with subclavian artery injury admitted to Beijing Jishuitan Hospital from January 2010 to December 2018 were retrospectively analyzed. All the injuries have been confirmed by intraoperative exploration, computed tomography angiography or digital subtraction angiography. Read More

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http://dx.doi.org/10.1016/j.cjtee.2019.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049638PMC
February 2020

Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients.

Acta Orthop 2020 Jun 14;91(3):326-330. Epub 2020 Feb 14.

Department of Orthopaedic Surgery, Horsens Regional Hospital, Denmark.

Background and purpose - Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment option for Dupuytren contracture, which has gained momentum worldwide in recent years. However, evidence regarding safety and severe complications associated with PNF is sparse. Thus, we evaluated safety of a specific PNF method in the largest cohort reported in literature. Read More

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http://dx.doi.org/10.1080/17453674.2020.1726057DOI Listing

Squamous Cell Carcinoma of the Hand: A Retrospective Study in Immunosuppressed and Immunocompetent Individuals.

Dermatol Surg 2020 Feb 4. Epub 2020 Feb 4.

Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.

Background: Cutaneous squamous cell carcinoma (SCC) of the hand presents a treatment challenge because of the anatomical complexity of this location. Immunosuppressed patients are disproportionately affected by cutaneous SCC. Existing data on SCC of the hand are primarily presented in the orthopedic literature, and may thus be affected by referral bias. Read More

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http://dx.doi.org/10.1097/DSS.0000000000002336DOI Listing
February 2020

What Interventional Radiologists Need to Know About Managing Severe Frostbite: A Meta-Analysis of Thrombolytic Therapy.

AJR Am J Roentgenol 2020 04 5;214(4):930-937. Epub 2020 Feb 5.

Department of Radiology, Boston Medical Center, 820 Harrison Ave, FGH Bldg, 3rd Fl, Boston, MA 02118.

The purpose of this study is to review the various techniques and clinical management paradigms using tissue plasminogen activator (tPA) to treat severe frostbite injuries, which are relevant to the interventional radiologist. A literature search yielded 157 citations, which were manually screened for inclusion criteria of case reports, case series, cohort studies, and randomized prospective studies that reported the use of tPA to treat severe frostbite injuries, of which 16 qualified for review. Data extracted from the studies included authors, journal, year of publication, initial assessment and management of severe frostbite injuries, inclusion and exclusion criteria for tPA therapy, treatment and control group size, different imaging modalities used in evaluation of severe frostbite injuries, tPA treatment protocols, outcomes, and side effects or complications. Read More

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http://dx.doi.org/10.2214/AJR.19.21592DOI Listing

[Tenoarthrolysis after flexor tendon injuries].

Unfallchirurg 2020 Feb;123(2):104-113

Klinik für Handchirurgie, Rhön-Klinikum Campus Bad Neustadt, Von Guttenbergstr. 11, 97616, Bad Neustadt an der Saale, Deutschland.

Normal function of the fingers and thumb depends on properly gliding flexor tendons and a free range of motion of the involved joints. This normal gliding function may be inhibited by adhesions due to damage of the tendon, tendon sheath and adjacent tissue. When digital function is still limited despite a long-term course of hand therapy and there are no signs of further improvement, surgical intervention should be considered. Read More

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http://dx.doi.org/10.1007/s00113-020-00778-7DOI Listing
February 2020

An Unusual Case of Periosteal Glomus Tumor at the Metacarpal Base Presenting as Type II CRPS: Case Report.

Authors:
Dean W Smith

Hand (N Y) 2020 Jan 27:1558944719895618. Epub 2020 Jan 27.

The University of Texas Health Science Center at Houston, USA.

An unusual case involving a middle-aged male with a 9-year history of presumptive chronic regional pain syndrome (CRPS) and ulnar neuropathy was referred for failure in treatment. On presentation, the patient was requesting an amputation of his arm. However, work-up uncovered a periosteal extra-digital glomus tumor on the base of the small finger metacarpal. Read More

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http://dx.doi.org/10.1177/1558944719895618DOI Listing
January 2020

A rare case of a digital papillary carcinoma of the hand with secondary conservative management.

J Surg Case Rep 2020 Jan 20;2020(1):rjz403. Epub 2020 Jan 20.

Hand and Wrist Unit, Chelsea and Westminster Hospital, London SW10 9NH, UK.

A digital papillary carcinoma (DPC) is a cancer of the sweat glands which develops on the digits of the hands and feet. With an incidence of 0.08 per 1 000 000 people/year, it is often initially misdiagnosed as a simple ganglion although it has a significant risk of metastasis. Read More

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http://dx.doi.org/10.1093/jscr/rjz403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970341PMC
January 2020

Experimental Validation of an ITAP Numerical Model and the Effect of Implant Stem Stiffness on Bone Strain Energy.

Ann Biomed Eng 2020 Apr 23;48(4):1382-1395. Epub 2020 Jan 23.

Centre for Biomedical Engineering, Institute of Orthopaedics and Musculo-Skeletal Science, University College London, Stanmore, HA7 4LP, UK.

The Intraosseous Transcutaneous Amputation Prosthesis (ITAP) offers transfemoral amputees an ambulatory method potentially reducing soft tissue complications seen with socket and stump devices. This study validated a finite element (in silico) model based on an ITAP design and investigated implant stem stiffness influence on periprosthetic femoral bone strain. Results showed good agreement in the validation of the in silico model against the in vitro results using uniaxial strain gauges and Digital Image Correlation (DIC). Read More

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http://dx.doi.org/10.1007/s10439-020-02456-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089889PMC

Peripheral Gangrene as the Initial Presentation of Systemic Lupus Erythematosus in Emergency Department.

Cureus 2020 Jan 15;12(1):e6667. Epub 2020 Jan 15.

Emergency Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Systemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disease. Among the cutaneous manifestations of SLE, digital gangrene is considered to be very rare. This complication, which may lead to severe ischemic necrosis and amputation, is suggested to be the result of poor perfusion that is usually caused by vasculitis, vasospasm, thromboembolism, or atherosclerosis. Read More

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http://dx.doi.org/10.7759/cureus.6667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964793PMC
January 2020

Evaluation of the influence of cyclic loading on a laser sintered transtibial prosthetic socket using Digital Image Correlation (DIC).

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:5382-5385

People with a transtibial amputation worldwide rely on their prosthetic socket to regain their mobility. Patient comfort is largely affected by the weight and strength of these prosthetic sockets. The use of additive manufacturing could give the prosthetist a range of new design possibilities when designing a prosthetic socket. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856544DOI Listing

Internally Fabricated Chimera Anterolateral Thigh-Amputate Flaps for Metachronous Reconstruction.

Plast Reconstr Surg Glob Open 2019 Nov 14;7(11):e2508. Epub 2019 Nov 14.

Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.

The chimera flap is a versatile and exciting tissue composition for the reconstruction of complex tissue defects.

Methods: Here, we present 2 cases of internally fabricated anterolateral thigh (ALT)-amputate chimera flaps for metachronous transfer.

Results: A 22-year-old man (case 1) developed extended soft tissue necrosis in both legs following meningococcal septicemia. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002508DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908347PMC
November 2019

Composite grafts for fingertip amputations: A systematic review protocol.

Int J Surg Protoc 2019 23;16:1-4. Epub 2019 May 23.

Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom.

Background: There is much debate in the hand surgery literature as to the management of fingertip amputations. Much research continues to be published in this area. Methods of reattachment include microsurgical and non-microsurgical (composite graft) replantation. Read More

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http://dx.doi.org/10.1016/j.isjp.2019.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921220PMC

Botulinum Toxin A Salvage of Ischemic Hand Trauma.

Plast Reconstr Surg 2020 01;145(1):161-164

Albuquerque, N.M. From the Division of Plastic, Reconstructive and Burn Surgery, University of New Mexico.

Posttraumatic hand injuries from crush injury, infusion, or iatrogenic vascular cannulation can cause ischemic finger damage that can progress to necrosis and digital amputation. Botulinum toxin type A (Botox) improves blood flow in chronic vasospastic disorders of the hand. Botox's efficacy in salvaging ischemic loss in digits in acute traumatic and iatrogenic injury has not been previously reported. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006379DOI Listing
January 2020

The results of the treatment of hand - Outcomes of the treatment of hand degloving injuries with greater omentum flaps.

Pol Przegl Chir 2019 Oct;91(6):20-27

Klinika Chirurgii Ogólnej i Chirurgii Ręki, Pomorski Uniwersytet Medyczny w Szczecinie.

Degloving injury consists in tearing out the soft-tissue integument from skeleton of the hand, with accompanied nerves and vessels. The whole hand degloving has bad reputation and one of worst prognosis, even worse than total hand amputation. The range of possible salvage procedures in these cases is limited and their outcomes are unsatisfactory. Read More

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http://dx.doi.org/10.5604/01.3001.0013.5495DOI Listing
October 2019

Surgical Reconstruction of the Metatarsal Pad Using Nonweight-Bearing Surfaces of the Footpads in a Dog.

J Am Anim Hosp Assoc 2020 Jan/Feb;56(1):e56101

From the Department of Veterinary Surgery, Konkuk Veterinary Medical Teaching Hospital, Konkuk University, Seoul, South Korea.

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http://dx.doi.org/10.5326/JAAHA-MS-6834DOI Listing
December 2019

Targeted Muscle Reinnervation in the Hand: Treatment and Prevention of Pain After Ray Amputation.

J Hand Surg Am 2019 Dec 6. Epub 2019 Dec 6.

Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address:

Targeted muscle reinnervation (TMR), originally developed as an experimental technique for prosthetic control, has been shown to be safe and effective for the treatment and prevention of postamputation pain. Targeted muscle reinnervation involves coaptation of residual nerve ends to nearby motor nerve branches of healthy but expendable muscles proximal to an amputation. It has been shown to prevent and reduce residual limb pain and phantom limb pain after major upper and lower extremity amputation. Read More

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http://dx.doi.org/10.1016/j.jhsa.2019.10.020DOI Listing
December 2019

A New Technique in Tamai Zone 1 Reconstruction: Reverse Dorsal Terminal Vein Flap (Hat Flap).

J Hand Microsurg 2019 Dec 4;11(3):140-145. Epub 2019 Apr 4.

Konya Numuna Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Konya, Turkey.

The aim of this study was to determine usability of the reverse dorsal terminal vein flap (hat flap) in the reconstruction of Tamai zone 1 defects. A total of 31 patients with fingertip amputation in Tamai zone 1 defect in the finger operated upon between 2014 and 2016 were included in this study. Flaps were designed from the proximal end of the nail bed to the middle phalanx according to the defect size. Read More

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http://dx.doi.org/10.1055/s-0039-1683949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894948PMC
December 2019

Presentation, treatment and outcome of long-bone fractures in pet rabbits (Oryctolagus cuniculus).

J Small Anim Pract 2020 Jan 28;61(1):46-50. Epub 2019 Nov 28.

Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, Scotland.

Objectives: To describe the incidence, aetiology, characteristics, assessment, management and outcome of long-bone fractures in rabbits presenting to a single institution.

Materials And Methods: Medical records of pet rabbits diagnosed with long-bone fractures over a 12-year period were analysed. Patient signalment, fracture aetiology, fracture location, fracture description, time from fracture occurrence to veterinary presentation, fixation method, postoperative complications, clinical outcome and follow-up were recorded. Read More

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http://dx.doi.org/10.1111/jsap.13087DOI Listing
January 2020

A Novel Method of Treatment of Macrodactyly with Digital Nerve Resection and Nerve Allograft.

Plast Reconstr Surg Glob Open 2019 Oct 29;7(10):e2483. Epub 2019 Oct 29.

Department of Orthopedic Surgery, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, Calif.

Macrodactyly is a rare and debilitating pediatric hand anomaly that has historically been treated with amputation. Recent advances in our understanding of macrodactyly have increasingly implicated the digital nerve as the underlying cause of the condition. In addition, much progress has been made toward digital salvage in treating macrodactyly. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846287PMC
October 2019
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Fingertip reconstruction by palmar bipedicular island flap in long fingers (modified neurovascular Tranquilli-Leali flap): A dual-center study.

Hand Surg Rehabil 2020 Feb 15;39(1):59-64. Epub 2019 Nov 15.

Hand, upper limb and peripheral nerve service, Department of orthopedic surgery, Teaching European Hospital Georges Pompidou, Paris Descartes University, Sorbonne Paris Cité université, AP-HP, 20, rue Leblanc, 75908 Paris cedex 15, France.

When bone is exposed, fingertip defects may require a flap procedure. Many types are available, with little consensus about which one is best. But each one has its own disadvantages: esthetic (claw nail deformity), neurological (sensory disorders) or functional (stiffness). Read More

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http://dx.doi.org/10.1016/j.hansur.2019.11.003DOI Listing
February 2020

Practical Tips to Improve Efficiency and Success in Upper Limb Replantation.

Authors:
Sang Hyun Woo

Plast Reconstr Surg 2019 11;144(5):878e-911e

Daegu, Republic of Korea From the W Institute for Hand and Reconstructive Microsurgery and the Department of Plastic and Reconstructive Surgery, W General Hospital.

Learning Objectives: After reading this article, participant should be able to: 1. Describe the technique of replantation for very distal amputation of the digit and salvage procedures for venous drainage. 2. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006134DOI Listing
November 2019

Comparison Between Interwoven Nitinol and Drug Eluting Stents for Endovascular Treatment of Femoropopliteal Artery Disease.

Eur J Vasc Endovasc Surg 2019 Dec 25;58(6):865-873. Epub 2019 Oct 25.

Division of Angiology, Swiss Cardiovascular Centre, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Objectives: Information on performance of different stent platforms in endovascular revascularisation of femoropopliteal lesions is controversial and scarce.

Methods: Interwoven nitinol (INS, Supera) were compared with drug eluting (DES, Zilver PTx) stents with primary intervention for femoropopliteal lesions. The primary endpoint was time to clinically driven target lesion revascularisation (CD-TLR) within 12 months. Read More

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http://dx.doi.org/10.1016/j.ejvs.2019.09.002DOI Listing
December 2019

Sepsis-induced digital ischaemia in a professional pianist, in the absence of vasopressors.

BMJ Case Rep 2019 Oct 25;12(10). Epub 2019 Oct 25.

Intensive Care, Barwon Health, Geelong, Victoria, Australia.

Peripheral limb ischaemia and gangrene are devastating complications of pneumococcal sepsis. We report a 43-year-old professional pianist who presented with early sepsis and rapid development of this syndrome. No vasopressor medication was ever administered. Read More

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http://dx.doi.org/10.1136/bcr-2019-229659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827789PMC
October 2019
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[Artificial intelligence in plastic surgery : Current developments and perspectives].

Chirurg 2020 Mar;91(3):211-215

Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Pettenkoferstr. 8a, 80336, München, Deutschland.

Background: Artificial intelligence (AI) has long been established in various parts of everyday life due to the instrumentalization of machines and robotics in industry, autonomous vehicles and the rapid development of computer-based systems.

Objective: Demonstration of current developments and perspectives of AI in plastic surgery.

Material And Methods: Evaluation of statistics, press releases and original articles from journals and discussion of reviews. Read More

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http://dx.doi.org/10.1007/s00104-019-01052-2DOI Listing

Midterm Outcomes of Drug-Coated Balloon Angioplasty in Femoropopliteal Lesions in a Daily Practice Cohort.

Ann Vasc Surg 2020 Apr 18;64:188-197. Epub 2019 Oct 18.

Department of Vascular Surgery, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, the Netherlands.

Background: Most previous drug-coated balloon (DCB) angioplasty studies used strict inclusion and exclusion criteria and therefore might not be representative for daily practice. This study was performed to evaluate the midterm outcomes of DCB angioplasty in femoropopliteal artery disease and to identify risk factors for restenosis.

Materials And Methods: All patients treated with DCB angioplasty between January 2015 and September 2016 were included. Read More

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http://dx.doi.org/10.1016/j.avsg.2019.09.032DOI Listing
April 2020
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Relocation Nerve Grafting: A Technique for Management of Symptomatic Digital Neuromas.

J Hand Microsurg 2019 Oct 4;11(Suppl 1):S50-S52. Epub 2019 Jan 4.

Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, United States.

Digital neuromas are a common problem following amputation, often severely impairing hand function. Surgical treatment of terminal digital nerve neuroma is challenging because of the lack of surrounding soft tissue in the hand. To help tackle this problem, we describe a novel technique, "relocation nerve grafting," to relocate the nerve ends into the interosseous muscles at the midcarpal level. Read More

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http://dx.doi.org/10.1055/s-0038-1677320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791802PMC
October 2019

[Acral melanoma in a patient with hereditary keratoderma of the palms and soles (mal de Meleda): A chance association?]

Ann Dermatol Venereol 2019 Nov 30;146(11):730-736. Epub 2019 Sep 30.

Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefeux, 750101 Paris, France.

Introduction: Development of acral malignant melanoma in Mal de Meleda is highly unusual. As far as we could ascertain, to date, only 10 previous cases have been published. Herein, we report a new case. Read More

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http://dx.doi.org/10.1016/j.annder.2019.08.013DOI Listing
November 2019
1 Read