1,721,070 research outputs found
Microsurgical reconstruction of the traumatized thumb
No full textAmputation of the thumb means serious functional, aesthetic and psychological damage. Thumb reconstruction has been the subject of great interest in recent years and the advent of microsurgery has radically modified the surgical approach. Composite transfer of the hallux or second toe makes it possibile to reconstruct a thumb of sufficient lenght, sensitivity and grip stability and, above all, with and acceptable aesthetic appearance, thanks to the presence of the nail, which is similar to contralateral thumb. The different microsurgical transfer techniques might suggest the existence of a great freedom of choice in therapeutic indications. The different possibilities are, however, considerably restricted if all the factors necessary to arrive at a correct surgical indication are considered. It can be maintained that every case of thumb amputation ideally requires a specific reconstructive procedure. The purpose of the present paper is to describe the use of the various reconstructive techniques on the basis of levels of thumb amputation in the attempt to identify on each occasion the correct technique that enables us to construct a custom-made thumb
Radial head fractures: review of current evidence about assessment, classification and management
No full textThe radial head fractures are frequent elbow injuries with several fracture patterns and associated lesions. The literature highlights the importance of correct patient management right from the earliest stages to achieve the best results and to avoid complications. The purpose of this article was to provide an overview of current concepts of the management of radial head fractures. The main goal of each treatment should be to restore elbow biomechanics, kinematics and stability to achieve a complete range of motion and to early begin rehabilitation programs. For Mason type 1 fractures the nonoperative management is the best choice providing good or excellent results in most patients. There is less agreement regarding Mason type 2 fractures, in term of nonoperative or surgical treatment. When surgical treatment is chosen, open reduction and internal fixation seems to guarantee the best clinical outcomes with excellent results reported. The Mason type 3 or 4 fractures are managed with surgical treatment. However, the best method of treatment remains controversial in literature between open reduction and internal fixation, radial head arthroplasty and radial head excision. In the last years, arthroscopy is going to assume an important role in the management of elbow diseases, not only as diagnostic tool but also as surgical solution and probably in the future its role will become more and more relevant. Further studies with long-term follow-up are needed to determine the best form of treatment of these complex injuries. (Cite this article as: Tarallo L, Negri A, Novi M, Micheloni G, Keeling E, Porcellini G. Radial head fractures: review of current evidence about assessment, classification and management
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
Volar PEEK plate for distal radial fracture: analysis of plate ruptures in a group of 120 patients
No full textScapholunate interosseous ligament injury in professional volleyball players
Full text linkInjuries to the scapholunate interosseous ligament (SLIL) are the most common cause of carpal instability. A SLIL injury typically follows a fall on an outstretched hand, with the wrist in hyperextension, ulnar deviation and intercarpal supination. We hypothesize that repetitive axial loading on the wrist in hyperextension, during the reception and digging motions of volleyball, can lead to functional overloading of the SLIL. To identify patients and to determine the clinical history and surgical treatment performed, we analyzed hospital records, X-rays, electronic databases containing all the operations performed, and image files (including before and after surgery and follow-up). We identified three SLIL injury cases in national volleyball team players, also at the libero position, who were treated at our clinic between 2007 and 2013 for scapholunate instability. Open reduction and Berger capsulodesis was performed in all cases. At a mean follow-up of 3 years (range, 22â 50 months), the mean pain level on VAS was 0.3 (range, 0â 1) at rest and 1.7 (range 1â 2) during sport activities. The mean DASH score was 4 (range 2â 5). The mean wrist flexion was 60° (range 55â 70°) and extension was 80° (range 75â 85°). Given the greater susceptibility of these players for developing a SLIL injury, a high index of suspicion is needed when managing athletes presenting with wrist pain or instability
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
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