2,847 results match your criteria Thumb Reconstruction


Compact off-axis holographic slide microscope: design guidelines.

Biomed Opt Express 2020 May 14;11(5):2511-2532. Epub 2020 Apr 14.

Institute of Applied Sciences and Intelligent Systems "E. Caianiello", Italian National Research Council (ISASI-CNR), Via Campi Flegrei 34, 80078, Pozzuoli (Napoli), Italy.

Holographic microscopes are emerging as suitable tools for diagnostics and environmental monitoring, providing high-throughput, label-free, quantitative imaging capabilities through small and compact devices. In-line holographic microscopes can be realized at contained costs, trading off complexity in the phase retrieval process and being limited to sparse samples. Here we present a 3D printed, cost effective and field portable off-axis holographic microscope based on the concept of holographic microfluidic slide. Read More

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http://dx.doi.org/10.1364/BOE.11.002511DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249844PMC

Reconstruction of a distal index fingertip in a patient with thumb polydactyly: a case report.

J Hand Surg Eur Vol 2020 Jun 3:1753193420927585. Epub 2020 Jun 3.

Department of Orthopedic Surgery, The Fourth Affiliated Hospital of Kunming Medical University, Yunnan Province, China.

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http://dx.doi.org/10.1177/1753193420927585DOI Listing

Thumb Carpometacarpal Arthritis: Prognostic Indicators and Timing of Further Intervention Following Corticosteroid Injection.

J Hand Surg Am 2020 May 22. Epub 2020 May 22.

Division of Hand and Upper Extremity Surgery, Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Purpose: Corticosteroid injections are commonly used to treat thumb carpometacarpal arthritis in adults. We aimed to define the timing of surgery following an initial corticosteroid injection and identify patient-specific factors that influence the likelihood of repeat injection or surgery.

Methods: We performed a retrospective analysis of all patients who underwent a first-time corticosteroid injection for carpometacarpal arthritis between 2009 and 2017. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.03.025DOI Listing

Thumb lengthening using a three-dimensional half-ring distraction frame.

Hand Surg Rehabil 2020 May 6. Epub 2020 May 6.

The hand surgery department, Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Qiaoxi District, Shijiazhuang, 050051 Hebei, China. Electronic address:

The purpose of this study was to evaluate the use of a three-dimensional half-ring distraction frame for thumb phalangeal lengthening. From February 2009 to March 2015, 23 patients (23 thumbs) with thumb loss were treated with a half-ring distraction frame. Active movements of the metacarpophalangeal (MCP) joint were measured with a goniometer. Read More

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http://dx.doi.org/10.1016/j.hansur.2020.04.006DOI Listing

Pronator Quadratus to Extensor Carpi Radialis Brevis Nerve Transfer in C5-C7 or C5-C8 Brachial Plexus Injuries for Independent Wrist Extension.

Indian J Plast Surg 2020 Mar 22;53(1):36-41. Epub 2020 Apr 22.

Department of Orthopedics, Aswan University, Aswan, Egypt.

Patients with lesions affecting C7 and C8 roots (in addition to C56) demonstrate loss of independent wrist dorsiflexion in addition to loss of shoulder abduction and elbow flexion. Traditionally, this deficit has been addressed using tendon transfers after useful function at the shoulder and elbow has been restored by primary nerve surgery. Confidence with nerve transfer techniques has prompted attempts to replace this method by incorporating procedures for wrist dorsiflexion in the primary operation itself. Read More

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http://dx.doi.org/10.1055/s-0040-1708114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192692PMC

Comparison of reverse dorsoradial flap for thumb reconstruction: narrow pedicle versus wide pedicle.

Arch Orthop Trauma Surg 2020 May 4. Epub 2020 May 4.

Department of Orthopedics, Gansu Provincial Hospital of TCM, Lanzhou, 730000, Gansu, China.

Introduction: The reverse homodigital dorsoradial flap remains a useful alternative for covering thumb defects. However, the description of pedicle width of dorsoradial flap is not clear. The aim of this study was to compare the results of narrow pedicle with wide pedicle in dorsoradial flaps and describe our experience with the thumb reconstruction. Read More

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http://dx.doi.org/10.1007/s00402-020-03467-7DOI Listing

Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report.

J Neurol Surg A Cent Eur Neurosurg 2020 May 3. Epub 2020 May 3.

Division of Neurosurgery, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

High median nerve injuries (HMNIs) are rare lesions involving the upper extremities and affect the median nerve from its origin to the emergence of the anterior interosseous nerve (AIN). Proximal reconstruction has long been considered the gold standard in treating HMNI, but thumb and index flexion and pinch and grip weakness are consistently not recovered. We report the surgical results of a patient affected by an HMNI with partial spontaneous recovery after a gunshot wound. Read More

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http://dx.doi.org/10.1055/s-0039-3400950DOI Listing

Death due to fractal wood burning: an emerging public health problem.

J Burn Care Res 2020 Apr 30. Epub 2020 Apr 30.

Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

The art of pyrography, burning designs in wood, dates back to prehistory. Risks of traditional techniques included cutaneous burns and airway injury. Fractal woodburning is a niche technique utilizing a high-voltage electrical source to burn branched designs into wood. Read More

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http://dx.doi.org/10.1093/jbcr/iraa066DOI Listing

Management of osteoarthritis at the base of the thumb.

Bone Joint J 2020 May;102-B(5):600-605

Nuffield Orthopaedic Centre, Oxford, UK.

Aims: Base of thumb osteoarthritis (BTOA) is a common age-related disease which has a significant negative impact upon quality of life. Our aim was to assess current UK practice in secondary care with regard to the nature of non-surgical treatments, the surgical procedures most commonly performed, and factors influencing the surgical decision-making process.

Methods: Ten consecutive patients undergoing surgery for BTOA between March 2017 and May 2019 were prospectively identified in 15 UK centres. Read More

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http://dx.doi.org/10.1302/0301-620X.102B5.BJJ-2019-1464.R2DOI Listing

Factors affecting sensory recovery after thumb reconstruction using a wrap-around flap.

J Hand Surg Eur Vol 2020 Apr 28:1753193420918760. Epub 2020 Apr 28.

Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan.

This study evaluated factors affecting sensory restoration after thumb reconstruction using a wrap-around flap in 21 thumbs in patients aged 11 to 50 years old. The patients were followed from 12 to 94 months after surgery. Static and moving 2-point discrimination of the reconstructed pulp was measured and analysed using multiple regression analysis. Read More

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http://dx.doi.org/10.1177/1753193420918760DOI Listing

Joint replacement for trapeziometacarpal osteoarthritis: implants and outcomes.

J Hand Surg Eur Vol 2020 Apr 26:1753193420917582. Epub 2020 Apr 26.

University Clinic for Hand, Hip and Knee Surgery, Holstebro Hospital, Holstebro, Denmark.

For thumb carpometacarpal osteoarthritis, trapeziectomy provides generally good results with reduction of pain and restoration of thumb mobility, but shortening of the thumb may at least in theory lead to reduction in grip and pinch strength. Furthermore, instability of the base of the first metacarpal and contact with the scaphoid may occur regardless of the several described techniques with ligament reconstruction and tendon interposition. Thus, for years alternatives to trapeziectomy have been explored and reported with disputable success. Read More

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http://dx.doi.org/10.1177/1753193420917582DOI Listing

Osteocutaneous hemi-fibula flap and index finger transposition for thumb reconstruction: a case report.

J Hand Surg Eur Vol 2020 Apr 19:1753193420917049. Epub 2020 Apr 19.

Department of Microsurgery and Hand Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China.

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http://dx.doi.org/10.1177/1753193420917049DOI Listing

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

Treatment of Severe Ulnar Instability of the MCP Joint Improves Function in LRTI Arthroplasty for Osteoarthritis of the Thumb CMC Joint.

J Wrist Surg 2020 Apr 31;9(2):105-115. Epub 2019 Dec 31.

Practice for Plastic and Hand Surgery, Murnau, Germany.

 Comorbidity in the metacarpophalangeal joint (MCPj) of the thumb, i.e., hyperextension or ulnar collateral instability, could affect the outcome of arthroplasty in the thumb carpometacarpal joint (CMCj). Read More

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http://dx.doi.org/10.1055/s-0039-1697650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112995PMC

Transfer of the Distal Anterior Interosseous Nerve for Thumb Motion Reconstruction in Radial Nerve Paralysis.

J Hand Surg Am 2020 Mar 21. Epub 2020 Mar 21.

Wockhardt Hospital, The Umrao IMSR, Thane, Maharashtra, India.

Purpose: With nerve or tendon surgery, the results of thumb reconstruction to treat radial nerve paralysis are suboptimal. The goals of this study were to describe the anatomy of the deep branch of the posterior interosseous nerve (PIN) to the thumb extensor muscles (DBPIN), and to report the clinical results of transferring the distal anterior interosseous nerve (DAIN) to the DBPIN.

Methods: The PIN was dissected in 12 fresh upper limbs. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.02.011DOI Listing

Bilateral Congenital Absence of Small Finger Flexor Digitorum Superficialis Tendons in a Trauma Patient.

Cureus 2020 Feb 11;12(2):e6948. Epub 2020 Feb 11.

Orthopaedics, Texas Tech University Health Sciences Center, El Paso, USA.

The flexor digitorum superficialis (FDS) is the only muscle in the intermediate layer of the flexor compartment of the forearm. Its main function is flexion of the proximal interphalangeal (IP) joint. Variations of the FDS are common, and knowledge of these variations is necessary for hand surgeons because the little finger tendon of the FDS is commonly used in hand reconstruction surgery. Read More

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http://dx.doi.org/10.7759/cureus.6948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067351PMC
February 2020

Basal thumb osteoarthritis surgery improves health state utility irrespective of technique: a study of UK Hand Registry data.

J Hand Surg Eur Vol 2020 Jun 12;45(5):436-442. Epub 2020 Mar 12.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

We used UK Hand Registry data to study two aspects of basal thumb osteoarthritis surgery: first, whether health-related quality of life improves after surgery. Second, whether results from trials comparing simple trapeziectomy and trapeziectomy with ligament reconstruction and tendon interposition are reproducible in routine clinical practice. Prospectively collected EQ5D index and Patient Evaluation Measure part 2 data were compared at baseline and at 3, 6, and 12 months postoperatively in 1456 patients (median age 67 years; 78% female). Read More

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http://dx.doi.org/10.1177/1753193420909753DOI Listing

Reconstruction of chronic thumb metacarpophalangeal radial collateral ligament injuries with free tendon grafts.

Jt Dis Relat Surg 2020 ;31(1):62-7

Department of Orthopedics and Traumatology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.

Objectives: This study aims to review our reconstruction method to treat chronic grade 3 thumb metacarpophalangeal (MP) joint radial collateral ligament (RCL) tears using free tendon grafts.

Patients And Methods: Thirteen male patients (mean age 41 years; range, 20 to 67 years) who received a free tendon graft to treat chronic grade 3 thumb MP joint RCL injury between May 2016 and July 2018 were evaluated prospectively. Patients with incomplete bone maturation (n=1), those who had additional injuries in the same extremity (n=1), and those who had previously undergone surgery on the same extremity (n=1) were excluded. Read More

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http://dx.doi.org/10.5606/ehc.2020.70796DOI Listing
January 2020

A simple approach to thumb amputation reconstruction at metacarpal base with toe transfer, two case reports.

Int J Surg Case Rep 2020 21;68:136-139. Epub 2020 Feb 21.

Upper Extremity Trauma and Microsurgery Department, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hanoi, Viet Nam. Electronic address:

Introduction: Reconstruction for thumb amputation at the metacarpal base by toe transfer is challenging. To restore a thumb with normal or near-normal length, the reconstruction plan usually involves a complicated and challenging process either in two stages (stage 1: resolving soft tissue and bone defect; stage 2: toe transfer) or a single stage by using two free flaps (one free soft tissue flap and one toe flap). However, is it necessary to restore the full length of the thumb for functional and aesthetic achievement?

Presentation Of Cases: Two male patients (21 and 22 years old) had a thumb amputation at the metacarpal base. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.02.037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058843PMC
February 2020

An analytical solution to the dispersion-by-inversion problem in magnetic resonance elastography.

Magn Reson Med 2020 Jul 6;84(1):61-71. Epub 2020 Mar 6.

Department of Radiology, Charité - Universitätsmedizin Berlin, Germany.

Purpose: Magnetic resonance elastography (MRE) measures stiffness of soft tissues by analyzing their spatial harmonic response to externally induced shear vibrations. Many MRE methods use inversion-based reconstruction approaches, which invoke first- or second-order derivatives by finite difference operators (first- and second-FDOs) and thus give rise to a biased frequency dispersion of stiffness estimates.

Methods: We here demonstrate analytically, numerically, and experimentally that FDO-based stiffness estimates are affected by (1) noise-related underestimation of values in the range of high spatial wave support, that is, at lower vibration frequencies, and (2) overestimation of values due to wave discretization at low spatial support, that is, at higher vibration frequencies. Read More

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http://dx.doi.org/10.1002/mrm.28247DOI Listing

Factors affecting the final outcomes after reconstruction of the median and ulnar nerve at the level of the forearm: Analysis of 41 patients.

Injury 2020 Feb 24. Epub 2020 Feb 24.

Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, ul. 28 Czerwca 1956r. nr 135/147 61-545, Poznań, Poland.

Background: Upper extremity injuries have a significant impact on social and professional life. They represent about 10% of visits to emergency departments. Nerve lacerations are one of the biggest problem because loss of innervation results in muscle atrophy, decreased sensibility, and therefore permanent dysfunction. Read More

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http://dx.doi.org/10.1016/j.injury.2020.02.117DOI Listing
February 2020

Total Hip Arthroplasty for High Hip Dislocation.

Z Orthop Unfall 2020 Apr 4;158(2):170-183. Epub 2020 Mar 4.

Musculoskeletal Surgery Centre, Charité - University Medicine Berlin.

Introduction: Total hip arthroplasty in patients with high hip dislocation is a surgically demanding procedure. This is due to the congenital disorder of hip maturation and the resulting anatomical features. The aim of the arthroplasty is implantation of the cup prosthesis in the original centre of rotation, at the same time correcting femoral deformities and reducing the hip joint. Read More

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http://dx.doi.org/10.1055/a-0946-2750DOI Listing

Modified Littler Flap Reconstruction of the Small Finger.

Eplasty 2020 9;20:ic1. Epub 2020 Jan 9.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041508PMC
January 2020

Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries.

Clin Sports Med 2020 Apr;39(2):443-455

Atrium Musculoskeletal Institute, OrthoCarolina, 1915 Randolph RD, Charlotte, NC 28207, USA. Electronic address:

Thumb metacarpophalangeal collateral ligament injuries are common in athletes and occur via forced abduction or hyperextension. Management primarily depends on the grade of ligamentous injury and the presence of a Stener lesion or large avulsion fracture. Surgeons should consider the athlete's position, hand dominance, duration of season remaining, and goals. Read More

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http://dx.doi.org/10.1016/j.csm.2019.12.003DOI Listing

Reconstruction of Basic Hand Function by a Free Osteocutaneous Spare-Part Flap From the Lower Leg After Septicemia: A Case Report.

Hand (N Y) 2020 Feb 26:1558944720906499. Epub 2020 Feb 26.

Hannover Medical School, Germany.

Spare-part surgery is widely accepted and offers an option in extremely traumatized patients for reconstructive maneuvers. Standardized techniques are lacking, and the therapy needs to fit the patient's clinic. In a woman with necrosis of almost all extremities due to septic infection, we used the lower leg as a free osteocutaneous flap to reconstruct a basic hand function after amputation. Read More

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http://dx.doi.org/10.1177/1558944720906499DOI Listing
February 2020

Nerve Versus Tendon Transfer for Radial Nerve Paralysis Reconstruction.

J Hand Surg Am 2020 May 21;45(5):418-426. Epub 2020 Feb 21.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil. Electronic address:

Purpose: With radial nerve lesions, the results of nerve transfers and how they objectively compare with the outcomes of tendon transfers remain unstudied. We compared the results after nerve transfer in patients with less than 12 months since radial nerve injury with the results after tendon transfer in patients not eligible for nerve surgery because of longstanding paralysis (minimum of 15 months).

Methods: In 14 patients with radial nerve lesions incurred less than 12 months previously, we transferred the anterior interosseous nerve to the nerve of the extensor carpi radialis brevis (ECRB), while the nerve to the flexor carpi radialis was transferred to the posterior interosseous nerve. Read More

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http://dx.doi.org/10.1016/j.jhsa.2019.12.009DOI Listing

Glomus Tumor of Uncertain Malignant Potential in Thumb: A Case Report and Review of Literature.

Arch Bone Jt Surg 2020 Jan;8(1):117-120

Orthopedics Department, Imam Hospital Complex, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Malignant transformation of glomus tumor is exceedingly rare and most common reported in lower extremity and abdominal viscera. We could find only 6 previous case report of malignant glomus tumor in the hand. Although large and deeply located glomus tumors are considered to be malignant, evidence has shown that most of these cases were clinically benign. Read More

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http://dx.doi.org/10.22038/abjs.2019.35225.1928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007706PMC
January 2020

Blast injury of the hand related to warfare explosive devices: experience from the French Military Health Service.

BMJ Mil Health 2020 Feb 20. Epub 2020 Feb 20.

Department of Orthopaedic, Trauma and Reconstructive Surgery, Percy Military Hospital, Clamart, France.

Introduction: The objective was to report on the experience of the French Army Health Service in the management of blast injury of the hands related to warfare explosive devices.

Methods: A retrospective study was conducted in the Percy Military Hospital (role 4 medical treatment facility) among French soldiers who presented with a combat-related blast injury of the hand between 2002 and 2018. The functional result was assessed by the disabilities of the arm, shoulder and hand (DASH) and the Orthotics and Prosthetics User Survey (OPUS, upper extremity functional status) scores. Read More

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http://dx.doi.org/10.1136/jramc-2019-001326DOI Listing
February 2020

The Prognostic Value of Preoperative Patient-Reported Function and Psychological Characteristics on Early Outcomes Following Trapeziectomy With Ligament Reconstruction Tendon Interposition for Treatment of Thumb Carpometacarpal Osteoarthritis.

J Hand Surg Am 2020 Jun 13;45(6):469-478. Epub 2020 Feb 13.

Department of Orthopaedics, University of Utah, Salt Lake City, UT.

Purpose: Biopsychosocial factors are associated with patient-reported upper extremity disability; however, their impact on postoperative outcomes remains less clear. Our purpose was to test the hypothesis that high levels of preoperative patient-reported upper extremity and psychological disability are associated with lower magnitudes of improvement following trapeziectomy with ligament reconstruction tendon interposition (LRTI).

Methods: Adult patients undergoing LRTI by fellowship-trained hand surgeons between February 2014 and March 2017 were considered for inclusion. Read More

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http://dx.doi.org/10.1016/j.jhsa.2019.11.016DOI Listing

No Single Approach Is "The Best" in Reconstruction of Devastating Proximal Thumb Amputations: Individualize, Combine, and Think out of the Box.

Authors:
Nidal F Al Deek

Plast Reconstr Surg 2020 Feb 12. Epub 2020 Feb 12.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.

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http://dx.doi.org/10.1097/PRS.0000000000006788DOI Listing
February 2020

[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

A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis.

BMC Musculoskelet Disord 2020 Feb 1;21(1):63. Epub 2020 Feb 1.

Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.

Background: The aim of the study was to evaluate patient reported outcome measures (PROM) before and after trapeziectomy with or without ligament reconstruction and tendon interposition for trapeziometacarpal joint arthritis with special focus on possible differences due to gender, age and surgical method.

Methods: Data from the Swedish quality registry for hand surgery (HAKIR) was analyzed preoperatively, 3 months and 1 year postoperatively for 1850 patients (mean age 63 years, 79% women).

Results: One year postoperatively, mean pain at rest was reduced from 50 to 12 of maximum 100. Read More

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http://dx.doi.org/10.1186/s12891-020-3045-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995059PMC
February 2020

Use of Distal Hypothenar Perforator Free Flaps for Pulp Defects.

J Hand Surg Asian Pac Vol 2020 Mar;25(1):20-25

Saitama Hand Surgery Institute, Saitama Seikeikai Hospital, Saitama, Japan.

A hypothenar perforator free flap, which is harvested from the palm, is suitable for reconstruction of a finger pulp skin defect, but this flap has rarely been reported, and most of these flaps in previous published reports were designed on the proximal zone of the hypothenar area. In the present report, hypothenar perforator free flaps on the distal zone, namely distal hypothenar perforator free flaps, including two sensate flaps, were used for four cases with pulp defects. Four distal hypothenar perforator free flaps were used for four patients with skin defects of the finger pulp, including one thumb, two index fingers, and one little finger. Read More

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http://dx.doi.org/10.1142/S2424835520500022DOI Listing

Design, Modeling, and Evaluation of Fabric-Based Pneumatic Actuators for Soft Wearable Assistive Gloves.

Soft Robot 2020 Jan 29. Epub 2020 Jan 29.

Robotics Institute, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.

Textile fabrics are compliant, lightweight, and inherently anisotropic, making them promising for the design of soft pneumatic actuators. In this article, we present the design, modeling, and evaluation of a class of soft fabric-based pneumatic actuators (SFPAs) for soft wearable assistive gloves that can simultaneously assist the thumb abduction and finger flexion and extension motions for brachial plexus injury patients. We investigate the mechanical behaviors of various woven fabrics and rib weft-knitted fabric structures, guiding us to design a thumb-abduction SFPA, a finger-flexion SFPA, and a finger-extension SFPA. Read More

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http://dx.doi.org/10.1089/soro.2019.0105DOI Listing
January 2020

Our surgical technique to treat premature growth plate closure 7 years after toe-to-thumb transfer. A case report.

Hand Surg Rehabil 2020 Apr 23;39(2):131-135. Epub 2020 Jan 23.

Chirurgie reconstructrice et esthétique de l'appareil locomoteur, centre chirurgical Emile-Gallé, 49, rue Hermite, 54000 Nancy, France.

In children, traumatic distal amputations of the thumb can be treated by partial first toe transfer. Growth is preserved by conserving a portion of the growth plate in the hallux distal phalanx. In the patient featured here, 7 years after such a distal thumb reconstruction, bone bridge resection was needed to restart growth and correct clinodactyly. Read More

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http://dx.doi.org/10.1016/j.hansur.2019.10.199DOI Listing

Chronological changes in surgical outcomes after trapeziectomy with ligament reconstruction and tendon interposition arthroplasty for thumb carpometacarpal osteoarthritis.

Orthop Traumatol Surg Res 2020 Apr 22;106(2):357-364. Epub 2020 Jan 22.

Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 501-1194, Japan.

Background: Despite satisfactory mid-term and long-term outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) procedures for thumb carpometacarpal osteoarthritis, there is limited literature describing detailed chronological changes in early-phase postoperative outcomes. We investigated chronological changes of subjective, objective, and radiological outcomes within 1 year post-trapeziectomy with LRTI using a longitudinal evaluation and analyzed clinical factors associated with patient-reported subjective outcomes.

Hypothesis: Some parameters influence patient-reported subjective outcomes during the early postoperative period. Read More

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http://dx.doi.org/10.1016/j.otsr.2019.11.020DOI Listing

[Primary treatment of flexor tendon injuries].

Unfallchirurg 2020 Feb;123(2):89-96

Departement Handchirurgie, Klinik für Orthopädie und Unfallchirurgie, Hand‑, Fuß- und Wiederherstellungschirurgie, KKH Gummersbach, Gummersbach, Deutschland.

The treatment of flexor tendon injuries is still challenging, especially in the region of the narrow annular ligaments and tendon sheaths of the 3‑segment fingers and the thumb (zone 2). In the course of time, the primary suture of the flexor tendons has prevailed over traditional recommendations for a secondary tendon replacement after healing of the wound. Improvements regarding suture techniques and materials and, above all the follow-up treatment, have been crucial for better results and remarkable changes in flexor tendon surgery. Read More

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http://dx.doi.org/10.1007/s00113-019-00762-wDOI Listing
February 2020

Retrograde palm venous anastomosis versus anterograde palm venous anastomosis in avulsion distal fingertip trauma: Functional and therapeutic outcomes (FTO) analysis.

Asian J Surg 2020 Jan 17. Epub 2020 Jan 17.

Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050017, China. Electronic address:

Background/objectives: The advance in the microvascular surgeries has made successful replantation of amputee fingertip or toe. Anterograde palm venous anastomosis is generally preferred in avulsion distal fingertip trauma surgeries but is technically challenging. The retrograde venous anastomosis is proved to be easy and effective in larger defects hand reconstruction surgeries. Read More

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http://dx.doi.org/10.1016/j.asjsur.2019.12.010DOI Listing
January 2020

Bone Tunnel Orientation in Suspension Arthroplasty of the Thumb Carpometacarpal Joint: An Anatomical Cadaver Study.

Hand (N Y) 2020 Jan 16:1558944719897137. Epub 2020 Jan 16.

Hannover Medical School, Germany.

Ligament suspension after trapeziectomy is a common technique in patients with osteoarthrosis. In this study, we set out to determine whether the orientation of the bone tunnel in the first metacarpal base affects the intraoperative position of the first metacarpal after surgery. Trapeziectomy and Epping procedure were performed in 32 cadaver hands. Read More

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http://dx.doi.org/10.1177/1558944719897137DOI Listing
January 2020

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

Thumb Hypoplasia Occurring in Patients With Preaxial Polydactyly.

J Hand Surg Am 2020 Mar 10;45(3):182-188. Epub 2020 Jan 10.

Department of Orthopaedic Surgery, Shriners Hospital for Children-Northern California, Sacramento, CA.

Purpose: Thumb polydactyly and thumb hypoplasia are generally regarded as separate clinical entities. However, several case reports indicate that hypoplasia of both the thumb and the radius can occur in patients with thumb polydactyly and improved understanding of the genetics of the developing upper limb may give an embryologic explanation for this occurrence. Our hypothesis was that patients with preaxial polydactyly can have ipsilateral thumb hypoplasia that may not be recognized until after surgical reconstruction of the extra digit. Read More

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http://dx.doi.org/10.1016/j.jhsa.2019.11.001DOI Listing

Distraction Lengthening of First Metacarpal in Traumatic Thumb Amputations.

Indian J Plast Surg 2019 Sep 26;52(3):309-313. Epub 2019 Dec 26.

Department of Plastic and Reconstructive Surgery, PGIMER, Chandigarh, India.

 Based on the level of the thumb loss, phalangization, toe-to-thumb transfer, pollicization, and distraction callotasis of the first metacarpal are the various options available for reconstruction. The aims of the study were to observe the length gained in the distraction process, duration of treatment required, functional recovery in the form of pinch strength, sensations, and patient satisfaction.  It was a prospective study of 10 patients of thumb amputation, conducted from January 2014 to July 2015. Read More

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http://dx.doi.org/10.1055/s-0039-3400203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938427PMC
September 2019

Versatility of Pedicled Perforator-Based V-Y Advancement Flaps for Reconstruction of the Upper Limb: A Case Series and Review of the Literature.

Ann Plast Surg 2020 May;84(5):529-534

From the St Andrew's Centre for Plastic Surgery, Broomfield Hospital, Essex.

Introduction: The aim of any reconstruction is to provide a robust and cosmetically pleasing result that does not significantly alter function. We describe our experience of using the V-Y principle in advancement flaps designed around a distinct perforator to reconstruct soft tissue defects of the upper limb. The shortcomings of fasciocutaneous and fascial flaps requiring skin grafting can be eliminated. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002138DOI Listing

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

Biometry of thenar muscle origins on the flexor retinaculum.

Clin Anat 2020 Jan 2. Epub 2020 Jan 2.

Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.

The transverse carpal ligament (TCL), the main part of the flexor retinaculum, serves as an anchor for the thenar muscles: abductor pollicis brevis (APB), superficial head of the flexor pollicis brevis (sFPB), and opponens pollicis (OPP). Biomechanically, the thenar muscles rely on their TCL anchoring to transmit muscle contractions distally for thumb force and motion production, and reciprocally, muscle contraction interacts with the TCL at the proximal end through the origins. However, scarce knowledge exists regarding the distribution pattern of the thenar muscle origins. Read More

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http://dx.doi.org/10.1002/ca.23558DOI Listing
January 2020

APL Lasso Suspensionplasty for Trapeziectomy.

Tech Hand Up Extrem Surg 2019 Dec 4. Epub 2019 Dec 4.

Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Qld, Australia.

Base of thumb arthritis is a common pathology, with late-stage disease often treated by trapeziectomy and a form of ligament reconstruction or suspension. No therapeutic option for suspension or ligament reconstruction has proven to be superior to others, with risks inherent to all. Here, the authors describe a novel technique utilizing an accessory slip of abductor pollicis longus looped around the second metacarpal base to suspend the metacarpal and prevent subsidence after trapeziectomy. Read More

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http://dx.doi.org/10.1097/BTH.0000000000000276DOI Listing
December 2019

Radiological evaluation of ulnar thumb metacarpophalangeal ligament reconstruction for chronic thumb instability in cadavers.

Hand Surg Rehabil 2020 Apr 23;39(2):120-124. Epub 2019 Dec 23.

Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre chirurgical Emile Gallé, CHU Nancy, 49, rue Hermite, 54000 Nancy, France. Electronic address:

Various techniques have been described to restore metacarpal stability in the thumb. Ligament reconstruction techniques that position the bone tunnels in a triangular configuration, with the apex proximally, are optimal for stabilizing the metacarpophalangeal (MCP) joint, while preserving the thumb's range of motion. Using an interference screw ensures this reconstruction is as strong as the native ligament. Read More

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http://dx.doi.org/10.1016/j.hansur.2019.11.008DOI Listing

Variation in Offer of Operative Treatment to Patients With Trapeziometacarpal Osteoarthritis.

J Hand Surg Am 2020 Feb 16;45(2):123-130.e1. Epub 2019 Dec 16.

Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX. Electronic address:

Purpose: Operative treatment of trapeziometacarpal osteoarthritis (TMC OA) is discretionary. There is substantial surgeon-to-surgeon variation in offers of surgery. This study assessed factors associated with variation in recommendation of operative treatment to patients with TMC OA. Read More

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http://dx.doi.org/10.1016/j.jhsa.2019.10.017DOI Listing
February 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