1,721,034 research outputs found
Innesti massivi omoplastici nella ricostruzione ossea della mano
No full textInnesti massivi omoplastici nella ricostruzione ossea della mano
Closed reduction of acute volar dislocation of the distal radioulnar joint
No full textIsolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury. In this report we describe a case of acute traumatic volar dislocation of the ulnar head in a 70-year-old man after an accidental fal
Island radial artery fasciotendinous flap for dorsal hand reconstruction
No full textThe authors report a one-stage repair for a dorsal hand injury that involves the loss of skin and tendons. The injury was repaired using an island radial artery flap complete with fascia and tendons, leaving the forearm skin behind. The functional and aesthetic results are excellent, and there was minimal donor site morbidity
Nonvascularized osteoarticular allograft replacement of the proximal interphalangeal joint after extensive loss of bone, joint, and extensor tendon
No full textNonvascularized small-joint allografts are a potentially attractive alternative to prosthetic implantation in cases of posttraumatic destruction of the proximal interphalangeal joint combined with metaphyseal and diaphyseal metacarpal or phalangeal bone loss, as well as soft tissue tendon defects of the digital extensor mechanism. Benefits include the absence of donor site defect, the ability to simultaneously reconstruct deficiency of the extensor mechanism, restore digital length and phalangeal (and metacarpal) bone stock in the face of bone loss, and the provision of an osteoinductive platform onto which creeping substitution can occur. Difficulties include an increased potential for infection and the potential for narrowing of the joint space because of articular cartilage loss. Early results suggest that the benefit of this technique lies in its ability to restore bone stock and soft tissue integrity that would make later prosthetic joint replacement feasible. © 2007 Lippincott Williams & Wilkins, Inc
Le ricostruzioni diafisarie dell'arto superiore con perone vascolarizzato
No full textLe ricostruzioni diafisarie dell'arto superiore con perone vascolarizzato
Non vascularised osteoarticular allograft replacement of the proximal interphalangeal joint after extensive loss of bone, joint and extensor tendon
No full textNonvascularized small-joint allografts are a potentially attractive alternative to prosthetic implantation in cases of posttraumatic destruction of the proximal interphalangeal joint combined with metaphyseal and diaphyseal metacarpal or phalangeal bone loss, as well as soft tissue tendon defects of the digital extensor mechanism. Benefits include the absence of donor site defect, the ability to simultaneously reconstruct deficiency of the extensor mechanism, restore digital length and phalangeal (and metacarpal) bone stock in the face of bone loss, and the provision of an osteoinductive platform onto which creeping substitution can occur. Difficulties include an increased potential for infection and the potential for narrowing of the joint space because of articular cartilage loss. Early results suggest that the benefit of this technique lies in its ability to restore bone stock and soft tissue integrity that would make later prosthetic joint replacement feasible
Procuring price and quality using scoring auctions: where do we stand?
No full textThis study assesses the rapidly growing literature on scoring rule auctions (SRA), in which all participants submit a multidimensional bid comprising prices and levels of one or more qualities. These elements are weighted using a linear combination, that is, the scoring function. The result of this function is a score and the bid that obtains the highest score is awarded the contract. We provide a comprehensive overview of key theoretical and empirical results. In addition, we discuss structural estimation techniques applied to SRA and we conclude with three main limitations of this awarding mechanism
Treatment of fingertips amputation using the Hirase technique
No full textThe management of very distal finger amputations when the amputated part is saved is still difficult and controversial. Both re-attachment of the amputated portion as a composite graft and microvascular anastomosis can fail in this distal location. Replantation is, in fact, associated with certain problems, such as technical difficulty, risk of failure because of the poor venous drainage, and costs. With the exception of children, amputations at the level of the lunula poorly survive direct re-attachment. Hirase has described a new replantation model without vascular anastomosis and used ice water and aluminium foil to enhance survival of the composite graft. Cooling the entire recipient site retards cellular degeneration in the graft until neovascularisation occurs. The present authors applied this method to seven cases in which a digit had been amputated between the tip and the lunula. In four cases the method proved to be completely successful, whereas in two an area of tip necrosis was observed. The Hirase method has proven to be a simple and reliable surgical technique for fingertip re-attachment
Outpatient paediatric hand surgery: strategy in healthcare implementation and cost-efficient manner
No full textThe increasingly cost of health care is a relevant problem as well as prolonged waiting time for admission also in emergencies. Effective cost containment measures and expenditure controls are needed to achieve and maintain clinical and organizational appropriateness. Outpatient management has proven to be the most useful method for lower-cost treatment in less severe pathologies, requiring surgery without hospitalization. The current study provided to evaluate how this model was successfully applied also to the paediatric population in hand surgery. Methods. A retrospective cohort study of 645 patients from 8 to 18 years (mean age 14.9) was performed in children treated in outpatient setting from 2015 to 2019. The direct costs were evaluated as well as the mean waiting time for surgery, comparing the data with the previous five-year period. The mean reduction in waiting time for children emergencies was 57% (from 72 to 31 h) due to the Outpatient setting into a dedicated Day-Surgery Service organizational model. The visual graphed data showed a general clear growing trend towards outpatient surgery in adults and children. The overall effect was a 29.2% of reduction in spending between expected and achieved costs, recovering resources toward the increasing technology and innovation expenditures.Outpatient paediatric hand surgery was an effective and attractive option which leaded to decreased individual and social costs, with increased clinical and organizational appropriateness. Thus, reduced delay in treatment and provided benefits for children and familiars
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