1,721,040 research outputs found
The RoboticScope can be a Useful Tool for Hand and Microsurgical Procedures during the COVID-19 Pandemic
Full text linkBedeutung des FESSH Hand Trauma Komitees in Europa
No full textIn Europe the need for clear definitions of hand surgery facilities regarding trauma is becoming really important to guarantee a correct and up-dated treatment of lesions more and more frequent and complex. The goal for European patients should be to have similar treatment based on appropriate referral and assistance in centres officially accredited for hand surgery. The target for the European countries, giving the correct support to the centres and surgeons treating these problems, should also be to save the costs of residual invalidities. These are some of the reasons for the European Federation of Societies for Surgery of the Hand (FESSH) decided to form a committee (Hand Trauma Committee) devoted to study this problem, trying to give common guidelines and forming an European net of accredited centres. The first step was to collect data through a network of national representatives. Covering a 487 millions population, 309 centres were recorded, including 1 797 surgeons and 20 363 patients treated during January 2006, then having a clear situation of hand trauma treatment through Europe. Next, the HTC worked on 3 definitions: hand trauma, hand trauma surgeons and hand trauma centres and started to accredit centres applying to these well defined criteria. The HTC is now working on scientific consensus on some traumatic lesions but also on the important topic of prevention of hand traumas. This work is expected to improve an homogenous situation throughout Europe focusing on the better use of the given resources for the prevention and the treatment of these traumatic lesions. © Georg Thieme Verlag KG Stuttgart · New York
Compound or Specially Designed Flaps in the Lower Extremities
No full textNovel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular
Management of neuromas in continuity of the median nerve with the pronator quadratus muscle flap
No full textTreatment of painful neuromas in continuity of the median nerve at the wrist level is a challenging problem. Nine median nerve neuromas were covered with the pronator quadratus muscle preelevated as an island flap. Patients were followed for 10 to 60 months after surgery. Results showed a marked improvement in terms of symptoms in all patients. In particular, 6 patients had complete pain relief and 3 patients complained of mild intermittent pain
Severe Forearm Osteomyelitis Management with Microvascular Fibular Flaps
No full textSevere infections at the forearm level are difficult to treat not only in terms of sterilization but also in terms of functional restitution. Traditional radical debridement is very important, and sometimes the reconstruction of the excised tissues it s difficult with conventional techniques. At the forearm level, local flaps generally are not sufficient in covering big defects. Conventional bone grafts may be resorbed or they cannot help healing when placed in infected and hypovascular tissue bed. Therefore, bone reconstruction is a real challenge. Development of microsurgical techniques has increased the possibilities of treatment when those severe infections occur. Re- construction of large soft tissue defects can be achieved by choosing the appropriate free flap. Vascularized fibular grafts allow the use of a segment of diaphyseal bone which is structurally similar to the radius and the ulna, and of length that would suffice to reconstruct most skeletal defects. In the upper limbs the vascularized fibular graft is indicated for patients in whom conventional bone grafting has failed or large bone defects are p- resent (extending beyond 5 cm). When contemporary soft tissue reconstruction is needed, the fibula may give osteocutaneous and osteomyocutaneous grafts to be transferred. We report the results of a series of 22 cases of severe chronic osteomyelitis of the radius and/or the ulna treated with free vascularized fibula bone grafts. All patients were reviewed at a mean follow-up of 3 years (10-93 months); in all cases the infection never re- curred.We report only one bone resorption, in the case of a double-barrel fibular transfer, which probably oc- curred due to vascularization failure. Even in this case, the patient was able to resume previous occupation
Nerve transfers in distal forearm and in the hand
Full text linkNerve transfers were used, originally, to restore shoulder and elbow function in brachial plexus lesions. This concept has been developed over the years and applied to distal nerve injuries in which lower functionality was expected because of the gap between the injury site and the target muscle. The aim of this review is to describe nerve transfers in the distal forearm and hand for isolated lesions of the median, ulnar and radial nerves. The different advantages achieved by transposition of a functional nerve stump near the effector muscle have opened up new options for the management of nerve lesions. Some of these alternatives have only been recently reported and a few are exclusively case reports
Peripheral Nerve Defects Overviews of Practice in Europe
No full textMany surgical techniques are available for the repair of peripheral nerve defects. Autologous nerve grafts are the gold standard for most clinical conditions. In selected cases, alternative types of reconstructions are performed to fill the nerve gap. Non-nervous autologous tissue based conduits or synthetic ones are alternatives to nerve autografts. Allografts represent another new field of interest. Decision making in the treatment of nerve defects is based on timing of referral, level of the injury, type of lesion, and size of any gap. This review focuses on current clinical practice, influenced by the numerous new experimental researches
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