163 results match your criteria Wrist and Forearm Amputations

Shoulder kinematics plus contextual target information enable control of multiple distal joints of a simulated prosthetic arm and hand.

J Neuroeng Rehabil 2021 01 6;18(1). Epub 2021 Jan 6.

Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, UMR 5287, CNRS and Univ. Bordeaux, 146 rue Léo Saignat, 33076, Bordeaux, France.

Background: Prosthetic restoration of reach and grasp function after a trans-humeral amputation requires control of multiple distal degrees of freedom in elbow, wrist and fingers. However, such a high level of amputation reduces the amount of available myoelectric and kinematic information from the residual limb.

Methods: To overcome these limits, we added contextual information about the target's location and orientation such as can now be extracted from gaze tracking by computer vision tools. Read More

View Article and Full-Text PDF
January 2021

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

J Hand Microsurg 2020 Oct 2;12(Suppl 1):S70-S74. Epub 2019 Nov 2.

Department of Orthopaedic and Plastic Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, United States.

 We review the benefits of early motion protocols following replantation of a total right hand amputation at 1 and 2 years after replantation, and provide recommendations for postoperative management.  Replantation of the entire right hand in zone-4 was performed and supported by rigid external fixation spanning the forearm and hand. An early active "place-and-hold" motion protocol was initiated within the first 3 postoperative days. Read More

View Article and Full-Text PDF
October 2020

A Muscle Synergy Framework for Cross-Limb Reconstruction of Hand Muscle Activity Distal to a Virtual Wrist-Level Disarticulation.

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:3285-3288

Currently, myoelectric prostheses lack dexterity and ease of control, in part because of inadequate schemes to extract relevant muscle features that can approximate muscle activation patterns that enable individuated dexterous finger motion. This project seeks to apply a novel algorithm pipeline that extracts muscle activation patterns from one limb, as well as from forearm muscles of the opposite limb, to predict muscle activation data of opposite limb intrinsic hand muscles, with the long-range goal of informing dexterous prosthetic control. Read More

View Article and Full-Text PDF

All hands on deck: Hand replantation versus transplantation.

SAGE Open Med 2020 27;8:2050312120926351. Epub 2020 May 27.

Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Objectives: Our hands play a remarkable role in our activities of daily living and the make-up of our identities. In the United States, an estimated 41,000 individuals live with upper limb loss. Our expanding experience in limb transplantation-including operative techniques, rehabilitation, and expected outcomes-has often been based on our past experience with replantation. Read More

View Article and Full-Text PDF

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

Ann Plast Surg 2020 12;85(6):612-617

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

View Article and Full-Text PDF
December 2020

Residual rotation of forearm amputation: cadaveric study.

BMC Musculoskelet Disord 2020 Jan 18;21(1):40. Epub 2020 Jan 18.

Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.

Background: The purpose of this study was to investigate residual rotation of patients with forearm amputation and the contribution of involved muscle to residual rotation.

Methods: Testing was performed using five fresh-frozen cadaveric specimens prepared by isolating muscles involved in forearm rotation. Amputation was implemented at 25 cm (wrist disarticulation), 18 cm, or 10 cm from the tip of olecranon. Read More

View Article and Full-Text PDF
January 2020

Upper extremity replantation results in our series and review of replantation indications.

Ulus Travma Acil Cerrahi Derg 2020 Jan;26(1):123-129

Department of Emergency and First Aid, European Vocational High School, İstanbul-Turkey.

Background: Upper extremity amputations are usually not life-threatening, but they negatively affect the life quality of the victim. In addition to the functional disabilities of upper extremity amputation, disfigurements frequently cause psychological and social debilitations.

Methods: Between 2007-2015, fourteen cases were admitted to emergency with total major amputation of the upper extremity. Read More

View Article and Full-Text PDF
January 2020

[Limb salvage strategies for patients with high voltage electric burns of extremities on the verge of amputation].

Zhonghua Shao Shang Za Zhi 2019 Nov;35(11):776-783

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

To explore the limb salvage strategies for patients with high voltage electric burns of extremities on the verge of amputation. From January 2003 to March 2019, 61 patients with high voltage electric burns of extremities on the verge of amputation were treated in our hospital. All of them were male, aged 15-58 years, including 49 cases of upper limbs and 12 cases of lower limbs. Read More

View Article and Full-Text PDF
November 2019

Self-amputation of the Upper Extremity: A Case Report and Review of the Literature.

Cureus 2019 Oct 7;11(10):e5858. Epub 2019 Oct 7.

Plastic and Reconstructive Surgery, University of Texas Health Science Center, Houston, USA.

Indications for upper-extremity replantation include wrist-level and wrist-proximal amputations, due to the devastating loss of function incurred from these severe injuries. Decisions regarding replantation must be made expeditiously at these proximal levels in an effort to minimize ischemia time. This decision-making process becomes more complicated when a patient presents following intentional self-amputation of an extremity, especially in the setting of an associated mood disorder, psychiatric illness, and/or frank psychosis. Read More

View Article and Full-Text PDF
October 2019

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

Sang Hyun Woo

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

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

View Article and Full-Text PDF
November 2019

Osteosarcoma of the Upper Extremities: A National Analysis of the US Population.

Anticancer Res 2019 Oct;39(10):5663-5668

Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A.

Background/aim: Osteosarcoma of the upper extremities is rare, and characteristics in this location have not been described before. We aimed to analyze the characteristics and survival rate of osteosarcoma of the upper extremities.

Materials And Methods: A retrospective cohort study was performed by querying the National Cancer Database. Read More

View Article and Full-Text PDF
October 2019

Functional Outcomes of Secondary Procedures in Upper Extremity Replantation and Revascularization.

Cureus 2019 Jul 17;11(7):e5164. Epub 2019 Jul 17.

Dermatology, Pakistan Air Force Hospital, Islamabad, PAK.

Introduction Traumatic amputation of the upper limb has significant associated morbidities and disabilities. After successful replantation surgery, the micro-surgeons' tasks are far from over. The replanted and revascularized segments have numerous functional restrictions and need various corrective secondary procedures. Read More

View Article and Full-Text PDF

Upper extremity myxofibrosarcoma mimicking an erosive inflammatory arthritis: a case report.

Skeletal Radiol 2019 Oct 15;48(10):1643-1649. Epub 2019 Apr 15.

Imaging Institute, Cleveland Clinic, 9500 Euclid Ave. A21, Cleveland, OH, 44195, USA.

Myxofibrosarcoma is a malignant fibroblastic soft tissue neoplasm containing a variable amount of myxoid stroma that commonly presents as a slow-growing mass in elderly patients. The neoplasm may be superficial or deep to the muscle fascia and characteristically has an infiltrative growth pattern with a dominant or multinodular mass. We describe an unusual case of high-grade myxofibrosarcoma of the wrist and forearm that infiltrated the muscles, tendons, and wrist joint, causing bone erosions. Read More

View Article and Full-Text PDF
October 2019

Hand, Wrist, Forearm, and Arm Replantation.

Matthew L Iorio

Hand Clin 2019 05;35(2):143-154

Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Colorado, Anschutz Medical Center, 12631 East 17th Avenue, C309 (Room 6414), Aurora, CO 80045, USA; Department of Orthopedics, University of Colorado, Anschutz Medical Center, 12631 East 17th Avenue, C309 (Room 6414), Aurora, CO 80045, USA. Electronic address:

Level of injury plays a significant role in decisions to perform replantation, with improved function, nerve regeneration, and decreased rate of reperfusion injury for injuries at the distal forearm or wrist compared with proximal injuries. The principles of a functional and sensate outcome dictate replantable parts, whereas patient comorbidity, expectations, and safety dictate patient candidacy. Vascular grafts are an expected part of the operation, and the contralateral arm or a lower extremity should be prepped into the surgical field. Read More

View Article and Full-Text PDF

Targeted Muscle Reinnervation for Prosthesis Optimization and Neuroma Management in the Setting of Transradial Amputation.

J Hand Surg Am 2019 Jun 4;44(6):525.e1-525.e8. Epub 2019 Feb 4.

Carolinas Medical Center, Atrium Health, Charlotte, NC; Reconstructive Center for Lost Limbs, OrthoCarolina Hand and Wrist Center, Charlotte, NC. Electronic address:

Targeted muscle reinnervation (TMR) is a surgical technique that improves modern myoelectric prosthesis functionality and plays an important role in the prevention and treatment of painful postamputation neuromas. Originally described for transhumeral amputations and shoulder disarticulations, the technique is being adapted for treatment of transtibial, transfemoral, transradial, and partial hand amputees. We describe a new technique for forearm TMR following transradial amputation with an emphasis on selecting nerve transfer patterns, managing sensory nerves, improving terminal soft tissue coverage, and employing pattern recognition technology. Read More

View Article and Full-Text PDF

Traumatic Divergent Elbow Dislocation with Associated Forearm Amputation in an Adult: A Case Report.

JBJS Case Connect 2018 Oct-Dec;8(4):e92-5

Western Orthopaedics, Denver, Colorado.

Case: A 49-year-old right-hand-dominant man sustained an auger-related injury that resulted in open dislocation at the left wrist and palm, with complete amputation of the distal aspect of the forearm and the hand. The injury at the elbow included instability with an ulnar coronoid fracture, posterior dislocation of the ulna, and posterolateral dislocation of the radius. To restore stability of the forearm stump and elbow, we performed a complete resection of the radius, open reduction and internal fixation of the coronoid tip, a repair of the lateral collateral ligament, and transfer of the distal biceps tendon to the coronoid. Read More

View Article and Full-Text PDF
November 2019

Restoring Natural Forearm Rotation in Transradial Osseointegrated Amputees.

IEEE Trans Neural Syst Rehabil Eng 2018 12 13;26(12):2333-2341. Epub 2018 Nov 13.

Osseointegrated transradial prostheses have the potential to preserve the natural range of wrist rotation, which improves the performance of activities of daily living and reduces compensatory movements that potentially lead to secondary health problems over time. This is possible by enabling the radius and the ulna bone to move with respect to each other, restoring the functionality of the original distal-radioulnar joint. In this paper, we report on psychophysics tests performed on an osseointegrated transradial amputee with the aim to understand the extent of mobility of the implants that is required to preserve the natural forearm rotation. Read More

View Article and Full-Text PDF
December 2018

Three-year (2014-2016) activity report of the Replantation Service for hand amputations in Poland.

Pol Przegl Chir 2018 May;90(4):1-5

Uniwersytet Medyczny w Gdańsku Katedra i Klinika Ortopedii i Traumatologii Narządu Ruchu.

The paper summarizes 32 months (January 2014 - August 2016) of activity of the Replantation Service for hand amputation in Poland. Over this period a total of 568 cases of total and subtotal amputations as well as other complex injuries to the hand were referred. Of these, 354 referrals (62%) were accepted and 214 (38%) rejected. Read More

View Article and Full-Text PDF

Upper extremity injuries associated with all terrain vehicle accidents: A multicenter experience and case review.

Injury 2018 Oct 22;49(10):1805-1809. Epub 2018 Aug 22.

Division of Plastic Surgery, Medical University of South Carolina, Charleston, SC 29425, United States; Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29425, United States. Electronic address:

Background: All terrain vehicle accidents are a common cause of trauma admission and often associated with extremity injuries. However specifics of injury patterns to the upper extremity has not previously been described. A multicenter, retrospective study was conducted to determine the frequency and distribution of upper extremity injuries sustained from ATV accidents. Read More

View Article and Full-Text PDF
October 2018

[Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 10;31(10):1220-1224

Department of Vascular Surgery, Chengde Medical College Affiliated Hospital, Chengde Hebei, 067000, P.R.China.

Objective: To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter.

Methods: Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). Read More

View Article and Full-Text PDF
October 2017

Radiological comparison of conventional versus modified sauvé-kapandji procedure with stabilization of the proximal ulnar stump using the extensor carpi ulnaris tendon: A retrospective case-control study.

Medicine (Baltimore) 2018 Mar;97(11):e0118

Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan.

The Sauvé-Kapandji procedure is a reliable option for patients with various disorders of the distal radioulnar joint (DRUJ). However, postoperative pain over the proximal ulnar stump frequently develops during forearm rotation or when lifting heavy objects, although many clinically satisfactory results have been reported. This stump pain has been suggested to result from dynamic instability of the proximal ulnar stump. Read More

View Article and Full-Text PDF

[Wound repair and functional reconstruction of high-voltage electrical burns in wrists].

Zhonghua Shao Shang Za Zhi 2017 Dec;33(12):738-743

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

To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type Ⅰ, 69 of type Ⅱ, 9 of type Ⅲ, and 19 of type Ⅳ. According to the wrist injuries, different surgical operations were performed. Read More

View Article and Full-Text PDF
December 2017

Wrapping degloved fingers with a distal-based radial forearm perforator flap: A repair method for multiple digital degloving injury.

Ulus Travma Acil Cerrahi Derg 2017 Nov;23(6):525-527

Department of Plastic Reconstructive and Aesthetic Surgery, İnönü University Turgut Özal Medical Center, Malatya-Turkey.

Degloving hand injuries present challenging situations to hand surgeons as they present with difficulties in reconstructive microsurgery, particularly in multiple digital injuries. Time is a limiting factor when multiple degloving finger amputations are present. Thus, we proposed a repair method for multiple degloving finger injuries that involves coverage with a distal-based reverse forearm flap of all injured fingers in a two-stage procedure. Read More

View Article and Full-Text PDF
November 2017

Postsurgical Pyoderma Gangrenosum Following Carpal Tunnel Release: A Rare Disease Following a Common Surgery.

Eplasty 2017 21;17:e10. Epub 2017 Mar 21.

Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL.

Postsurgical pyoderma gangrenosum is a rare but potentially devastating condition for surgical patients. While pyoderma gangrenosum has 2 subtypes, typical and atypical, each can be further classified by its heralding features. These include ulcerative, pustular, bullous, and vegetative. Read More

View Article and Full-Text PDF

Metacarpal Bone Plane Examination by Ultrasonography for the Diagnosis of Fetal Forearm and Hand Deformity.

Sci Rep 2017 02 7;7:42161. Epub 2017 Feb 7.

Ultrasound Department, The International Peace Maternity &Child Health Hospital of China Welfare Institute, 200030, Shanghai, China.

We explored the value of the metacarpal bone plane in screening for serious fetal forearm and hand deformities, excluding simple polydactyly and dactylion deformity, by ultrasonographic examination. Observed the second to fifth metacarpal bone plane of fetuses in 20,139 pregnant women at a gestational age of 16 to 30 weeks in The International Peace Maternity &Child Health Hospital of China Welfare Institute (IPMCH). There was a total 138 cases of fetal forearm and/or hand deformity among the 20,139 pregnant women. Read More

View Article and Full-Text PDF
February 2017

Aggressive intramuscular hemangiomas in the upper extremity: A case report.

Medicine (Baltimore) 2017 Jan;96(3):e5939

Department of Hand Surgery, the First Affiliated Hospital, College of Medcine, Zhejiang University Department of Hand Surgery, Zhejiang Province People's Hospital, Hangzhou, Zhejiang Province, P. R. China.

Introduction: Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us.

Clinical Findings: This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. Read More

View Article and Full-Text PDF
January 2017

Lumped-parameter electromyogram-driven musculoskeletal hand model: A potential platform for real-time prosthesis control.

J Biomech 2016 12 27;49(16):3901-3907. Epub 2016 Oct 27.

UNC-NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, USA.

Simple, lumped-parameter musculoskeletal models may be more adaptable and practical for clinical real-time control applications, such as prosthesis control. In this study, we determined whether a lumped-parameter, EMG-driven musculoskeletal model with four muscles could predict wrist and metacarpophalangeal (MCP) joint flexion/extension. Forearm EMG signals and joint kinematics were collected simultaneously from 5 able-bodied (AB) subjects. Read More

View Article and Full-Text PDF
December 2016

Functional outcome of en bloc resection of a giant cell tumour of the distal radius and arthrodesis of the wrist and distal ulna using an ipsilateral double barrel segmental ulna bone graft combined with a modified Sauve-Kapandji procedure.

J Hand Surg Eur Vol 2017 May 25;42(4):377-381. Epub 2016 Aug 25.

1 Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.

Giant cell tumour of the distal radius is a locally aggressive lesion. In this study, we performed a wrist arthrodesis reconstruction with an ipsilateral double barrel segmental ulnar bone graft combined with a modified Sauve-Kapandji procedure for a giant cell tumour of the distal radius. From January 2007 to September 2013, we followed eight patients for a mean duration of 36 months. Read More

View Article and Full-Text PDF

Experimental tonic hand pain modulates the corticospinal plasticity induced by a subsequent hand deafferentation.

Neuroscience 2016 08 9;330:403-9. Epub 2016 Jun 9.

Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada; Department of Rehabilitation, Laval University, Québec, Canada. Electronic address:

Sensorimotor reorganization is believed to play an important role in the development and maintenance of phantom limb pain, but pain itself might modulate sensorimotor plasticity induced by deafferentation. Clinical and basic research support this idea, as pain prior to amputation increases the risk of developing post-amputation pain. The aim of this study was to examine the influence of experimental tonic cutaneous hand pain on the plasticity induced by temporary ischemic hand deafferentation. Read More

View Article and Full-Text PDF