3,279 results match your criteria Hand Injury Soft Tissue


Externally Supported Extra-Anatomical Venous Bypass to Treat Upper Limb Ischemia With Shoulder Prosthetic Infection.

Ann Vasc Surg 2020 Jul 9. Epub 2020 Jul 9.

Vascular Surgery Division, University Campus Bio-Medico, Rome, Italy.

To report a case of acute arm ischemia and prosthetic shoulder infection treated by extra-anatomical great saphenous vein graft with external vascular scaffolding. A 65 years-old man with multiple surgical interventions for soft tissue sarcoma of right shoulder, local radiotherapy with residual brachial plexus neuropraxia, was referred to our attention for signs of arm ischemia. Two weeks before, patient was submitted to prosthetic shoulder replacement complicated with prosthetic infection. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.07.002DOI Listing

Bipolar Disruption of the Lateral Ulnar Collateral Ligament of the Elbow: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0335

1Department of Orthopaedics, Italian Hospital of Buenos Aires, Buenos Aires, Argentina 2Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi," Buenos Aires, Argentina 3Division of Hand, Upper Extremity, and Microvascular Surgery, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.

Case: The lateral ulnar collateral ligament (LUCL) is one of the primary stabilizers of the elbow. Disruption typically occurs from the humeral origin and may be because of an elbow dislocation or fracture/dislocation. If not identified and properly managed, posterolateral rotatory instability may result from LUCL insufficiency. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00335DOI Listing

Injectable ECM hydrogel for delivery of BMSCs enabled full-thickness meniscus repair in an orthotopic rat model.

Bioact Mater 2020 Dec 30;5(4):871-879. Epub 2020 Jun 30.

Center for Materials Synthetic Biology, CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.

Meniscal injuries have poor intrinsic healing capability and are associated with the development of osteoarthritis. Decellularized meniscus extracellular matrix (mECM) has been suggested to be efficacious for the repair of meniscus defect. However, main efforts to date have been focused on the concentration, crosslinking density and anatomical region dependence of the mECM hydrogels on regulation of proliferation and differentiation of adult mesenchymal stem cells (MSCs) 2D or 3D culture. Read More

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http://dx.doi.org/10.1016/j.bioactmat.2020.06.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332471PMC
December 2020

The role of biceps loading and muscle activation on radial head stability in anterior Monteggia injuries: An in vitro biomechanical study.

J Hand Ther 2020 Jun 26. Epub 2020 Jun 26.

Roth-McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada; Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada.

Introduction: Little evidence-based information is available to direct the optimal rehabilitation of patients with anterior Monteggia injuries.

Purpose Of The Study: The aims of this biomechanical investigation were to (1) quantify the effect of biceps loading and (2) to compare the effect of simulated active and passive elbow flexion on radial head stability in anterior Monteggia injuries.

Study Design: In vitro biomechanical study. Read More

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http://dx.doi.org/10.1016/j.jht.2020.03.012DOI Listing

Injuries associated with electronic nicotine delivery systems: a systematic review.

J Trauma Acute Care Surg 2020 Jun 24. Epub 2020 Jun 24.

Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.

Background: Since its introduction on the market in 2007, the number of reports on injuries caused by the overheating, ignition or explosion of electronic nicotine delivery systems (ENDS) has increased significantly. These injuries appear to have different causes, the most important one being lithium-ion battery overheating to the point of ignition or explosion.

Methods: A literature search for all relevant studies concerning ENDS related traumatic injuries of all kinds was conducted, according to the PRISMA protocol. Read More

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http://dx.doi.org/10.1097/TA.0000000000002834DOI Listing

Upper limb extravasation of cytotoxic drugs: results of the saline washout technique in children.

J Child Orthop 2020 Jun;14(3):230-235

Department of Pediatric Orthopaedics and Pediatric Hand Emergencies, Robert Debré Hospital, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris University, Paris, France.

Purpose: Extravasation of cytotoxic vesicant drugs is a surgical emergency (within six hours) since this incident can lead to severe skin and soft-tissue damage. Outcomes after the saline washout procedure have been extensively described in adults, but rarely in children. The aim of this study was to evaluate the outcome of early saline washout procedure for upper limb cytotoxic drug extravasation in children. Read More

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http://dx.doi.org/10.1302/1863-2548.14.200020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302410PMC

[Application of membrane induced by antibiotic loaded bone cement in skin grafting for tendon exposed wound healing].

Zhongguo Gu Shang 2020 Jun;33(6):564-6

Department of Orthopaedics, 906 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Ningbo 314050, Zhejiang, China.

Objective: To evaluate the effects of membrane induced by antibiotic-loaded bone cement in skin grafting for tendon exposed wound healing.

Methods: A total of 10 traumatic patients with tendon exposed wound were admitted to our department between February 2016 and December 2018, including 6 males and 4 females, with a mean age of 34.6 years old (ranged, 19 to 43 years old), and treatment duration ranged from 2 to 6 months. Read More

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http://dx.doi.org/10.12200/j.issn.1003-0034.2020.06.015DOI Listing

One bone forearm with vascularized fibular graft. Clinical experience and literature review.

Injury 2020 Jun 15. Epub 2020 Jun 15.

Department of Orthopaedic and Traumatology, Hand and Microsurgery Unit, Orthopaedic and Trauma Center,AOU Cittàdella Salute e dellaScienza di Torino, via Zuretti 29, 10126, Turin, Italy.

One-Bone-Forearm (OBF) is a procedure in which the proximal stump of the ulna is fixed to the distal stump of the radius. Historically, the indications for OBF have been represented by forearm instability due to trauma, infection, tumor resection, and congenital deformities with severe radius and ulna bone loss. When major bone loss prevents direct fixation between ulna and radius a Vascularized Fibular Bone Graft (VFBG) may allow forearm bone reconstruction and fixation. Read More

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http://dx.doi.org/10.1016/j.injury.2020.06.018DOI Listing

Biomechanical analysis of simultaneous distal and proximal radio-ulnar joint instability.

Clin Biomech (Bristol, Avon) 2020 Jun 7;78:105074. Epub 2020 Jun 7.

Department of Orthopedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.

Background: Simultaneous dislocation of the proximal and distal radio-ulnar joints without bony injuries has been reported, but the mechanism remains unclear. We investigated concurrent proximal and distal radio-ulnar joint instability after sequential sectioning of the annular ligament, triangular fibrocartilage complex, and quadrate ligament.

Methods: We performed this biomechanical study with six fresh-frozen cadaveric upper extremities. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.105074DOI Listing

Surgical and Nonsurgical Pediatric Hand Fractures: A Cohort Study.

Plast Reconstr Surg Glob Open 2020 Mar 25;8(3):e2703. Epub 2020 Mar 25.

Section of Plastic Surgery, Department of Surgery, University of Calgary.

Pediatric hand fractures are common and approximately 10% require surgery.

Methods: This retrospective cohort study reports on hand fractures in a large pediatric population and identifies the characteristics and patterns of fractures that required surgical correction. A χ analysis was done to evaluate the association between individual fracture variables and surgery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253283PMC

A Novel Surgical Technique for Resuspension of Digital Pulp Tissue after Degloving Injuries.

Plast Reconstr Surg Glob Open 2019 Dec 26;7(12):e2600. Epub 2019 Dec 26.

Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, Wis.

Adherence of pulp tissue to the underlying distal phalanx is required for fundamental actions including grip, proprioception, and fine motor skills. Disruption of the fibrous septa causes sliding between the distal phalanx and overlying soft tissues, hindering basic hand function. The authors present a novel surgical technique in which the fibrous pulp septa are resuspended to the distal phalanx with bone anchors and sclerosing agents after a closed degloving injury. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288873PMC
December 2019

Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction.

J Orthop Surg Res 2020 Jun 11;15(1):216. Epub 2020 Jun 11.

Department of Gynecology, Xuzhou Maternal & Child Health Care Hospital, Xuzhou, 221009, Jiangsu, China.

Objectives: This paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients.

Methods: A total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative computed tomographic angiography (CTA) and color Doppler sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense, and two-point discrimination recovery results. Read More

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http://dx.doi.org/10.1186/s13018-020-01733-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291421PMC

Percutaneous Tenodermodesis for Mallet Fingers: An Office-based Procedure.

Tech Hand Up Extrem Surg 2020 Jun 9. Epub 2020 Jun 9.

Christine M Kleinert Institute for Hand and Microsurgery, Louisville, KY.

Mallet fingers are injuries to the extensor tendon at the distal interphalangeal (DIP) joint and can present as a bony avulsion or as a soft tissue injury. Nonbony mallet fingers are frequently splinted in extension between 6 and 8 weeks. If splinted correctly, most results are good with a mean DIP joint extension lag between 5 and 10 degrees. Read More

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http://dx.doi.org/10.1097/BTH.0000000000000298DOI Listing

Adipose tissue and the vascularization of biomaterials: stem cells, microvascular fragments and nanofat-a review.

Cytotherapy 2020 Jun 2. Epub 2020 Jun 2.

Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland. Electronic address:

Tissue defects in the human body after trauma and injury require precise reconstruction to regain function. Hence, there is a great demand for clinically translatable approaches with materials that are both biocompatible and biodegradable. They should also be able to adequately integrate within the tissue through sufficient vascularization. Read More

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http://dx.doi.org/10.1016/j.jcyt.2020.03.433DOI Listing

Safety and Efficacy of Prophylactic Closed Incision Negative Pressure Therapy after Acute Fracture Surgery.

Injury 2020 May 23. Epub 2020 May 23.

Department of Orthopaedics, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung City, 813, Taiwan, ROC; Department of Orthopaedics, National Defense Medical Center, 161, Section 6, Minquan E Rd, Neihu District, Taipei City, Taiwan 114 Taipei city, Taiwan Republic of China. Electronic address:

Introduction: Soft tissue swelling after acute fracture surgery is a challenge which may increase wound dehiscence, delay early range of motion, and increase infection rate postoperatively. This study investigates closed incision negative pressure therapy (ciNPT) using wide-range cover over the incision site and the peripheral swelling trauma zone to promote early active motion and to mitigate joint stiffness, bulla formation, and tendon adhesion.

Methods: Twenty-nine patients were enrolled between January 2018 and December 2018. Read More

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http://dx.doi.org/10.1016/j.injury.2020.05.032DOI Listing

Dorsal fracture-dislocation of the radiocarpal joint: a new classification and implications in surgical treatment.

J Hand Surg Eur Vol 2020 Jun 3:1753193420926801. Epub 2020 Jun 3.

Surgery and Reconstructive Microsurgery Unit of the Hand, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Dorsal dislocations and fracture-dislocations of the radiocarpal joint are a spectrum of pathology involving both the bony and ligamentous structures that stabilize the radiocarpal joint. We retrospectively reviewed 63 dorsal radiocarpal dislocations treated in our Institute in order to propose a new classification and define surgical treatment. Preoperative CT-scan findings together with clinical and radiological outcomes were recorded. Read More

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http://dx.doi.org/10.1177/1753193420926801DOI Listing

Impact of the COronaVIrus Disease 2019 lockdown on hand and upper limb emergencies: experience of a referred university trauma hand centre in Paris, France.

Int Orthop 2020 Jun 2. Epub 2020 Jun 2.

Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 rue Leblanc, 75015, Paris, France.

Purpose: The lockdown imposed in France to cope with the COronaVIrus Disease 2019 (COVID-19) outbreak has led to major changes in the lifestyle of French citizens. The aim of our study was to study its impact on activity related to emergencies in hand and upper limb trauma in comparison to the same reference period in 2019.

Material And Methods: All consecutive patients consulting for upper limb injury requiring urgent care at Georges-Pompidou European Hospital (HEGP), France, during the lockdown period (case group) and the equivalent period in 2019 (control group) were included. Read More

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http://dx.doi.org/10.1007/s00264-020-04654-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264483PMC

A foreign body in the blood vessel: A diagnostic and therapeutic dilemma.

Am J Emerg Med 2020 Apr 17. Epub 2020 Apr 17.

Department of Orthopaedics, the Second Affiliated Hospital of Anhui Medical University, Hefei 230000, China. Electronic address:

Foreign body(FB) in soft tissue is a common injury in trauma, but it is rare for FB to enter the blood vessel. Typical causes of intravascular FB include iatrogenic and non-iatrogenic factors.A 65-year-old Chinese worker's left hand was hit by two colliding metal blocks while operating a machine tool. Read More

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http://dx.doi.org/10.1016/j.ajem.2020.04.047DOI Listing

Pre-transplant management and sensitisation in vascularised composite allotransplantation: A systematic review.

J Plast Reconstr Aesthet Surg 2020 May 19. Epub 2020 May 19.

Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. Electronic address:

Introduction: Vascularised composite allotransplantation (VCA) permits like-for-like reconstruction following extensive soft tissue injuries. The initial management of extensive soft tissue injury can lead to the development of anti-HLA antibodies through injury-related factors, transfusion and cadaveric grafting. The role of antibody-mediated rejection, donor-specific antibody formation and graft rejection in the context of VCA remains unclear. Read More

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http://dx.doi.org/10.1016/j.bjps.2020.05.010DOI Listing

Role, Management, and Outcome of Free Flap Reconstruction for Acute Full-Thickness Burns in Hands.

Ann Plast Surg 2020 May 27. Epub 2020 May 27.

From the Department of Hand, Plastic and Reconstructive Surgery, Microsurgery-Burn Center, BG Trauma Center Ludwigshafen/Rhine, Hand and Plastic Surgery, University Heidelberg, Ludwigshafen, Germany.

Introduction: Severe thermal trauma to the hand can result in major impairment and reduced function due to defective healing or even extremity loss. Full-thickness injuries frequently incur exposure of tendons or bone and require an early and stable coverage with soft tissue transplants to allow for rapid induction of exercise and to preserve structures and hand function. Free tissue transfer to the hand after thermal trauma is a rare indication, and safety, management, and outcome of free flap surgery for severe acute burn injuries to the hand remains underreported. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002412DOI Listing

A new sequential animal model for infection-related non-unions with segmental bone defect.

BMC Musculoskelet Disord 2020 May 27;21(1):329. Epub 2020 May 27.

Unfallklinik Ludwigshafen, Klinik für Unfallchirurgie und Orthopädie, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.

Background: The treatment of fracture-related infections (FRI) is still a challenge for orthopedic surgeons. The prevalence of FRI is particularly high in open fractures with extensive soft-tissue damage. This study aimed to develop a new two-step animal model for non-unions with segmental bone defects, which could be used to evaluate new innovative bone substitutes to improve the therapeutic options in humans with FRI and bone defects. Read More

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http://dx.doi.org/10.1186/s12891-020-03355-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254709PMC

Indications and interventions of damage control orthopedic surgeries: an expert opinion survey.

Eur J Trauma Emerg Surg 2020 May 26. Epub 2020 May 26.

Department of Trauma, University of Zurich, UniversitätsSpital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

Objectives: The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.

Background: The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO). Read More

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http://dx.doi.org/10.1007/s00068-020-01386-1DOI Listing

Calvaria critical-size defects in rats using piezoelectric equipment: a comparison with the classic trephine.

Injury 2020 Jul 13;51(7):1509-1514. Epub 2020 May 13.

Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA.

Calvarial critical-size defects in rats are used to study regeneration of both craniofacial bone and long-bones. For decades, the trephine technique has been used with no notable refinements in the procedure. The use of piezoelectric surgical equipment has increased in human clinical oral and maxillofacial surgery, neurosurgery, traumatology, and orthopedics, because the devices are easy to handle, and can cut bone without damaging sensitive soft tissues such as blood vessels, nerves, and membranes. Read More

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http://dx.doi.org/10.1016/j.injury.2020.04.041DOI Listing

Functional evaluation following emergency arthroplasty of the proximal interphalangeal joint for complex fractures with silicone implant.

Hand Surg Rehabil 2020 May 19. Epub 2020 May 19.

Service Chirurgie orthopédique, traumatologie, Chirurgie plastique et Chirurgie de la main, Centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France. Electronic address:

The proximal interphalangeal (PIP) joint is particularly vulnerable to trauma. In comminuted fractures, arthroplasty with a silicone implant is a treatment option that may be controversial in an emergency setting. This joint destruction is usually accompanied by soft tissue injuries (skin and tendon damage, devascularization) making the reconstruction all the more complex. Read More

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http://dx.doi.org/10.1016/j.hansur.2020.05.003DOI Listing

Distant myonecrosis by atraumatic infection in a patient with metastatic breast cancer.

IDCases 2020 5;20:e00784. Epub 2020 May 5.

Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.

is an anaerobic, gram-positive bacillus known to cause myonecrosis, also known as gas gangrene, a life-threatening necrotizing soft tissue infection. Though it accounts for just 1 % of all infections attributable to spp., is a highly virulent and aggressive pathogen. Read More

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http://dx.doi.org/10.1016/j.idcr.2020.e00784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218154PMC

Platelet-rich plasma therapy in the treatment of diseases associated with orthopedic injuries.

Tissue Eng Part B Rev 2020 May 7. Epub 2020 May 7.

Chinese PLA General Hospital, 104607, Institute of Orthopedics, Beijing, Beijing, China;

PRP is an autologous platelet concentrate prepared from the whole blood that is activated to release growth factors and cytokines and has been shown to have the potential capacity to reduce inflammation and improve tissue anabolism for regeneration.The use of platelet-rich plasma (PRP) provides a potential for repair due to its abundant growth factors and cytokines, which are key in initiating and modulating regenerative microenvironments for soft and hard tissues. Among outpatient, orthopedic injuries are common and include bone defects, ligament injury, enthesopathy, musculoskeletal injury, peripheral nerve injury, chronic nonhealing wounds, articular cartilage lesions and osteoarthritis, which are caused by trauma, sport-related or orther types of trauma or tumor resection. Read More

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http://dx.doi.org/10.1089/ten.TEB.2019.0292DOI Listing

[Effect of free medial plantar perforator flap in repairing deep burn wound on palm with the assistance of three dimensional computed tomography angiography].

Zhonghua Shao Shang Za Zhi 2020 Apr;36(4):323-326

Department of Burns and Plastic Surgery, Dezhou People's Hospital, Dezhou 253045, China.

To explore the effect of free medial plantar perforator flap in repairing deep burn wound on palm with assistance of three dimensional computed tomography angiography (CTA). From March 2015 to January 2018, 11 patients with deep burn wounds of palm were admitted to the Department of Burns and Plastic Surgery of Yidu Central Hospital of Weifang City, including 6 males and 5 females, aged 19-53 years. The wound area after debridement was 3. Read More

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http://dx.doi.org/10.3760/cma.j.cn501120-20190308-00091DOI Listing

Split-Thickness Nail Bed Flap Graft in the Management of Distal Partial Defect of the Nail Bed Combined With Soft Tissue.

J Hand Surg Am 2020 Apr 13. Epub 2020 Apr 13.

Department of Microsurgery and Hand Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen Guangdong Province, People's Republic of China. Electronic address:

Purpose: We report a surgical procedure for the management of nail bed injuries combined with soft tissue defects.

Methods: We reviewed the records of patients with a nail bed injury combined with a soft tissue defect, who were surgically treated at our hospital from 2015 through 2018. According to the Allen classification, 5 patients were characterized as type 2 and 3 were characterized as type 3. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.02.018DOI Listing

The Subaxial Cervical Pedicle Screw for Cervical Spine Diseases: The Review of Technical Developments and Complication Avoidance.

Neurol Med Chir (Tokyo) 2020 May 15;60(5):231-243. Epub 2020 Apr 15.

Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine.

This study aimed to review information on the subaxial cervical pedicle screw (CPS) including recent anatomical considerations, entry points, placement techniques, accuracy, learning curve, and complications. Relevant literatures were reviewed, and the authors' experiences were summarized. The CPS is used for reconstruction of unstable cervical spine and achieves superior biomechanical stability compared to other fixation techniques. Read More

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http://dx.doi.org/10.2176/nmc.ra.2019-0189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246229PMC

Fingertip Reconstruction Using a Lateral Flap Based on the Distal Transverse Arch of the Digital Artery.

Ann Plast Surg 2020 May;84(5S Suppl 3):S186-S189

Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Purpose: Fingertip defect is more common in emergency hand trauma in the hospital, and most of them are accompanied by defects of the phalanx and nail bed. There are many methods in clinic for the repair of Yamano zone I fingertip injury. This article reports the repair of this type of injury using a lateral flap based on the distal transverse arch of the digital artery. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002370DOI Listing

[Free sensate intercostal artery perforator flap for hand soft tissue reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Apr;34(4):497-500

Department of Oncology Plastic Surgery, Hunan Cancer Hospital, Changsha Hunan, 410008, P.R.China.

Objective: To investigate the effectiveness of free sensate intercostal artery perforator flap for the hand soft tissue reconstruction.

Methods: Between March 2010 and September 2015, 19 cases of hand soft tissue defect were repaired with free sensate intercostal artery perforator flap, including 16 males and 3 females, aged from 18 to 53 years, with an average of 35.2 years. Read More

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http://dx.doi.org/10.7507/1002-1892.201904072DOI Listing

The free vastus lateralis muscle flap. A smart less used flap for soft tissue reconstruction of the weight-bearing foot.

Injury 2020 Mar 25. Epub 2020 Mar 25.

Department for Plastic, Reconstructive and Hand Surgery, Evangelisches Hospital, Oldenburg, Germany.

Background: The lateral circumflex femoral artery one of the most favoured donor-site for a wide array of free flaps including either cutaneous, fascial and muscle components or a combination thereof. Here, we provide evidence on the safe use of the free vastus lateralis muscle flap and its feasibility for optimal soft tissue coverage of the weight-bearing foot.

Methods: Eighteen consecutive patients with soft tissue defects of the heel (n = 3, 16. Read More

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http://dx.doi.org/10.1016/j.injury.2020.03.019DOI Listing

Rapidly Progressive Soft Tissue Infection of the Upper Extremity With Aeromonas veronii biovar sobria.

J Hand Surg Am 2020 Mar 29. Epub 2020 Mar 29.

Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, MA.

Aeromonas veronii, a bacterium found in freshwater, is an unusual pathogen in healthy patients. We present a case report of a rare, aggressive subtype in a young, immunocompetent individual. History of injury in an aquatic environment and culture data are key for identification of the causal agent and should dictate acute clinical management and antibiotic therapy. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.02.003DOI Listing

Factors Associated with Primary and Secondary Amputation following Limb-Threatening Upper Extremity Trauma.

Plast Reconstr Surg 2020 04;145(4):987-999

Boston, Mass.; and Utrecht, The Netherlands From the Department of Orthopaedic Surgery and the Division of Plastic and Reconstructive Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital; and the Department of Surgery, University Medical Center Utrecht.

Background: The aim of this study was to assess the factors associated with primary and secondary amputation in patients with limb-threatening trauma to the upper extremity, describe the incidence of these injuries, and describe the procedures involved in the treatment of these difficult injuries.

Methods: A retrospective study of 49 cases (in 47 patients) with acute limb-threatening trauma of the upper extremity proximal to the carpometacarpal joint level treated with either amputation or limb salvage was performed in two urban level I trauma centers between January of 2001 and January of 2018.

Results: Bivariate analysis demonstrated that cases of primary amputation more frequently had a higher Injury Severity Score, higher Abbreviated Injury Scale score, more proximal fractures, more severe muscle injuries, and a larger number of major nerve injuries. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006644DOI Listing

The Face of War: Maxillofacial Patients in the Syrian Civil War.

J Craniofac Surg 2020 Jul-Aug;31(5):1330-1333

Oral and Maxillofacial Surgery Department, Baruch Padeh Medical Center, Poriya.

The type of the armed conflict on the Syrian battle field acquired several types of injuries; including injuries that were caused by explosive, shrapnel and blast injuries.In the current study, the authors conducted an overview of maxillofacial patients, who mainly suffered from ballistic injuries in term of injuries, reconstruction, and management.Overall, 53 maxillofacial Syrian patients were treated. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006321DOI Listing

Survival and Versatility of the Flow-Through Lateral-Thigh Free Flap in Severe Electrical Injuries to the Wrist.

Ann Plast Surg 2020 Mar 19. Epub 2020 Mar 19.

From the Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing.

Background: The hand and wrist are most often in contact with electrical currents and thus most vulnerable to severe electrical burns. The treatment of such severe injury via surgical intervention remains a big challenge because of the vast tissue necrosis and the segmental vascular injury. The flow-through lateral-thigh free flap has been used effectively to resurface these defects and to reconstruct segmental vascular defects. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002355DOI Listing

Reconstruction of a long defect of the median nerve with a free nerve conduit flap.

Arch Plast Surg 2020 Mar 15;47(2):187-193. Epub 2020 Mar 15.

Department of Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti di Ancona, Ancona, Italy.

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. Read More

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http://dx.doi.org/10.5999/aps.2019.00654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093277PMC

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

Ultrasonic Wave Bone Cutting Technique (Piezotome) in Cochlear Implant Surgery by Veria Technique.

Indian J Otolaryngol Head Neck Surg 2020 Mar 28;72(1):66-69. Epub 2019 Sep 28.

ENT Department, Sri Aurobindo Medical College and PG Institute, MR-10, Indore, MP 452001 India.

To study use of ultrasonic wave bone cutting technique (piezotome) in cochlear implant surgery by veria technique. The Piezoelectric device is a bone cutting tool that transmits ultrasonic high frequency vibrations through a metallic tip to selectively cut bone while sparing the surrounding soft tissues. We have used the piezo tools instead of the perforator in over 50 cases of Cochlear Implant by the non mastoidectomy Veria technique [which uses a specially designed hand piece perforator with a guide (Kiratzidisa et al. Read More

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http://dx.doi.org/10.1007/s12070-019-01741-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040105PMC

Current indications for abdominal-based flaps in hand and forearm reconstruction.

Injury 2020 Feb 21. Epub 2020 Feb 21.

Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, United States; Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, United States. Electronic address:

Extensive soft tissue loss or injury of the hand and upper extremity is a challenging reconstructive problem traditionally treated with abdominal-based pedicled flaps. Options for coverage included the groin flap based on the superficial circumflex iliac artery, the Scarpa's fascia flap based on the superficial inferior epigastric artery, and the paraumbilical perforator flap from the deep inferior epigastric artery perforators. Despite the ability to provide consistent and pliable soft tissue coverage with ease of elevation, these flaps have several disadvantages including restriction of mobility, requirement for multiple procedures, bulkiness and patient discomfort. Read More

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http://dx.doi.org/10.1016/j.injury.2020.02.105DOI Listing
February 2020

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015.

Scand J Trauma Resusc Emerg Med 2020 Mar 2;28(1):15. Epub 2020 Mar 2.

Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany.

Background: To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational trauma registry.

Methods: The TraumaRegister DGU® was searched for patients suffering from serious trauma with a Maximum Abbreviated Injury Scale (AIS) ≥ 3 between 2002 and 2015 in Europe. After excluding cases without significant head injury defined by an AIS ≥ 2, groups were built regarding the existence of a concomitant damage to the prechiasmatic optic system comprising globe and optic nerve. Read More

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http://dx.doi.org/10.1186/s13049-020-0712-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052966PMC

[Exploration on the method of aesthetic repair of the donor sites of flaps].

Zhonghua Shao Shang Za Zhi 2020 Feb;36(2):97-105

Department of Burns, Beijing Jishuitan Hosptial, Beijing 100035, China.

To explore the excellent methods for aesthetic repair of the donor sites of flaps. From January 2013 to March 2018, 120 patients (94 males and 26 females, aged from 3 to 60 years) were admitted to the Department of Burns of Beijing Jishuitan Hospital. Wounds areas after debridement or removing scar were ranged from 8. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2020.02.004DOI Listing
February 2020

Outcomes and Management of Peripheral Intravenous Infiltration Injuries.

Hand (N Y) 2020 Feb 28:1558944720906494. Epub 2020 Feb 28.

Vanderbilt University Medical Center, Nashville, TN, USA.

Although intravenous (IV) infiltration is relatively common, data regarding complications and outcomes of this problem remain limited. In addition, there is wide variation in institutional protocols for the management of IV infiltrations. Through retrospective review, we aim to delineate complications and outcomes, and propose an algorithm for the management of these injuries. Read More

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http://dx.doi.org/10.1177/1558944720906494DOI Listing
February 2020

The 'Shoelace Sign': just another simple thumb laceration?

Emerg Med J 2020 Mar;37(3):126-134

Department of Plastic Surgery, St Georges Hospital NHS Trust, London, UK.

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http://dx.doi.org/10.1136/emermed-2019-209050DOI Listing

Sequential propeller flaps in the treatment of post-traumatic soft tissue defects of the lower limb - a case series.

Injury 2020 Feb 15. Epub 2020 Feb 15.

Depatment of Hand and Plastic Surgery, Luzerner Kantonsspital, Spitalstrasse 6000 Luzern 16, Lucerne, Switzerland. Electronic address:

Introduction: Propeller flaps have gained great popularity among reconstructive surgeons; however, the inability to directly close the donor site of large propeller flaps constitutes a well-known limitation of this technique. Skin grafting of the donor area is not always feasible nor desirable. To address large propeller flaps secondary defects, we investigated the use of a second propeller flap harvested from a nearby region of relative skin redundancy to assist the donor site closure generated by the first. Read More

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http://dx.doi.org/10.1016/j.injury.2020.02.031DOI Listing
February 2020

VIDEO: Dynamic Ultrasound Evaluation for Soft-Tissue Injuries of the Extremities: Hand, Wrist, and Ankle.

AJR Am J Roentgenol 2020 04 11;214(4):871. Epub 2020 Feb 11.

Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC H2X 0C1, Canada.

The purpose of this article is to show the sonographic anatomy of the extremities relevant to various ligamentous, tendinous, and articular injuries occurring in the hand, wrist, and ankle. A brief discussion and depiction of the specific elements relevant to the pathophysiologic mechanism of these entities is followed by demonstrations of the dynamic ultrasound techniques that can be used to diagnose these injuries. The schematics and video clips illustrate the normal and pathologic features of these injuries. Read More

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http://dx.doi.org/10.2214/AJR.19.22040DOI Listing
April 2020
2.731 Impact Factor

Lipoconstruct surface topography grating size influences vascularization onset in the dorsal skinfold chamber model.

Acta Biomater 2020 04 8;106:136-144. Epub 2020 Feb 8.

Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, Zurich 8091, Switzerland. Electronic address:

After skin tissue injury or pathological removal, vascularization timing is paramount in graft survival. As full thickness skin grafts often fail to become perfused over larger surfaces, split-thickness grafts are preferred and can be used together with biomaterials, which themselves are non-angiogenic. One way of promoting vascular ingrowth is to "pre-vascularize" an engineered substitute by introducing endothelial cells (ECs). Read More

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http://dx.doi.org/10.1016/j.actbio.2020.01.050DOI Listing

Effect of ulnar angulation and soft tissue sectioning on radial head stability in anterior Monteggia injuries: an in vitro biomechanical study.

J Shoulder Elbow Surg 2020 Jun 8;29(6):1249-1258. Epub 2020 Feb 8.

Roth-McFarlane Hand & Upper Limb Centre, St Joseph's Health Care, London, ON, Canada; Division of Orthopaedic Surgery, Department of Surgery, London, ON, Canada.

Background: Radial head instability continues to be a challenge in the management of anterior Monteggia injuries; however, there is a paucity of literature on the factors that contribute to this instability. The aim of this biomechanical investigation was to examine the effects of ulnar angulation and soft tissue insufficiency on radial head stability in anterior Monteggia injuries.

Methods: Six cadaveric arms were mounted in an elbow motion simulator. Read More

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http://dx.doi.org/10.1016/j.jse.2019.10.025DOI Listing