1,721,030 research outputs found
Compartment syndrome of the forearm following an electromyographic assessment
No full textWe present a case of compartment syndrome after electromyographic study of the upper limbs. The cause was the unintentional punction and laceration of the ulnar artery while the electromyography was being performed
Distal interphalangeal joint arthrodesis for degenerative osteoarthritis with compression screw : results in 102 digits
No full textPurpose: To assess objective and subjective outcomes of distal interphalangeal joint arthrodesis with a headless compression screw for degenerative osteoarthritis. Methods: We retrospectively analyzed 102 cases of distal interphalangeal joint arthrodesis performed with headless compression screws on 59 patients. We included only primary cases of degenerative osteoarthritis with a minimum follow-up of 7 months. We identified appropriate bone coaptation and hardware positioning on postoperative radiographs in all digits. The mean follow-up period was 26 months (range, 7-67 mo). Results: In 89 of 102 cases, patients were fully satisfied; in 9 cases, they were satisfied. Four complications occurred: 2 cases of prominent hardware, 1 complex regional pain syndrome type 1, and 1 symptomatic bony callus on the fused joint. Secondary surgery was required in each of these 4 cases. No nonunion, malunion, nail dystrophy, pseudarthrosis, or infection occurred. All arthrodeses healed. Conclusions: Distal interphalangeal joint arthrodesis with headless compression screws was shown to be safe and effective in cases of degenerative osteoarthritis, with a low complication rate. Therapeutic IV. © 2012 American Society for Surgery of the Hand. All rights reserved
The role of skin expansion : giant nevi of the hand
No full textThe Authors, after considering the epidemic and evolution of giant nevi, present their surgical protocol for giant melanocitic nevi of the hand. Their experience is based on 2 cases, but the rarity of these lesions of the hand, the reconstructive technique used and the results obtained justify the report in detail. The Authors used in both cases an expanded groin flap to repair the postexcisional wound. Skin expansion allowed both to obtain flaps, which were wide and reliable, and to close primarily the donor areas. The definitive resorption of the subcutaneous fat caused by the expansion allowed to obtain thin and adaptable flaps, which ensured excellent results also in areas of primary functional value, such as the hand. In both cases, the expanded going flap was used to repair the dorsum of the hand. In one case the lateral and medial parts of the fingers were repaired with skin grafts
La posizione della Chirurgia Plastica Ricostruttiva nel contesto delle discipline chirurgiche e nei rapporti con il Diritto e la Medicina Legale
No full textGli autori discutono il profilo ed il diverso ruolo della Chirurgia Plastica Ricostruttiva rispetto alle altre discipline chirurgiche, affrontando poi i problemi giuridici e medico-legale, con particolare riguardo alla responsabilità professionale del chirurgo plastic
Parascapular free flap and fat grafts : combined surgical methods in morphological restoration of hemifacial progressive atrophy
No full textBACKGROUND: Progressive hemifacial atrophy, widely referred to as Parry-Romberg syndrome or Romberg's disease, is a rare pathologic process characterized by an acquired, idiopathic, self-limited, unilateral atrophy of the face, variably involving skin, subcutaneous tissues, fat, muscle and, less frequently, the underlying bone structures. METHODS: Restoration of contour and symmetry is the main challenge in cases of Parry-Romberg syndrome; there are several different reconstructive techniques directed at augmentation of deficient soft-tissue volume. The present study describes the authors' own experience with deepithelialized free parascapular flap transfer combined with Coleman's lipoinjection in treatment of four severe cases affected by Parry-Romberg syndrome. RESULTS: The free microvascular parascapular flap, harvested and transferred for facial contour reconstruction, provided large volumes of tissue at the location of the greatest contour defect. It also has proven useful in restoring atrophic tissues trophism. To achieve the finest reconstructive result, Coleman's lipoinjection technique was used for a modification of the free parascapular flap contour, to restore adjacent atrophic areas, and to treat the remaining small or moderate defects. CONCLUSIONS: Free parascapular flap transfer combined with Coleman's lipoinjection, according to the authors' results, is the procedure of choice for facial contour restoration. Together, they can provide an excellent reconstructive solution directed at restoration of facial morphology, in terms of natural appearance and long-lasting results, with minimal donor-site morbidit
The Care technique : arthroscopic Coraco-Acromial ligament Re-attachment
No full textDuring standard acromioplasty, the inferior fibers of the coracoacromial ligament are inevitably detached. Partial or complete sectioning of the coracoacromial ligament results in secondary weakening of the deltoid muscle and an incremental risk of anterior-superior glenohumeral migration. This technique allows the re-attachment of the inferior fibers to the intact portion of the ligament and re-establishes mechanical continuity of the coracohumeral arc
The pollicization of the index finger in the aplasia of the thumb
No full textWe have examined 11 patients with aplasia of the thumb and we have treated by pollicization of the index finger. We have conducted a follow up of 5 years. The total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation. The absent thumb is as an autosomal dominant pathology or may be sporadic. It is frequently observed in the Holt-Oram syndrome, Fanconi's anemia, and ring D chromosome abnormalities. It is occasionally observed in the Rothmund syndrome, trisomy, thalidomide embryopathology and other congenital syndromes. An absent radius is almost always associated with an absent thumb, except in thrombocytopenia radial aplasia (Fanconi's syndrome), where the thumb is present even when the radius is absent. The treatment in most cases of the absent thumb is to perform a pollicization of the index finger. Our isolated congenital absence of the thumb patients have been treated with pollicization as described by Buck-Gramcko works well. It is a beautiful operation for the congenitally deformed, aplastic, or missing thumb. Pollicization of the index finger gives good functional and cosmetic results which are maintained. Conclusions: The total absence of the thumb in the congenitally pathology gives the hand of the patient insufficient in the functional movement and no cosmetic. So the pollicization with the second index fined gives a good reconstruction for the neo-thumb. In our five years follow-up, the 11 young patients that were treated with the pollicization, they are satisfy and use the neo-thumb like normal thumb. In congenitally absent thumbs clearly support the fact that the pollicized digit is used by most patients and is not ignored or bypassed
Giant congenital nevi of the scalp and forehead treated by skin expansion
No full textCongenital giant melanocytic nevi of the scalp and forehead are rare lesions present at birth. These lesions are associated with risk of malignant transformation, but they primarily represent a psychological problem to both patient and parents and merit early excision and reconstruction. In this study we report our own experience: seven patients, aged 8 months to 9 years, with congenital pigmented nevi involving forehead and scalp, and a 4-year old patient with congenital pigmented nevus of periorbital region and nose were treated successfully with excision and expanded skin flap reconstructions. The mean expansion procedures were 2 (range, 1 to 3), with an average of 8,8 injections for each expansion procedure (range, 6 to 11). In only one patient simultaneous expanders were placed in the scalp and forehead. Follow-up ranged from 4 months to 15 years. We had no rupture, extrusion or infection of the skin expanders. Complications included eyebrow ptosis and asymmetry in two patients underwent correction at a final procedure. In our opinion tissue expansion is an excellent technique for the treatment of giant nevi of the scalp and forehead because it offers the best aesthetic and functional outcomes
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