Piezoelectric Bone Surgery. Overview in Applications and Proof of Feasibility in Hand and Plastic Surgery.

Purpose: Piezoelectric bone surgery was already extensively used in a number of surgical procedures ranging from dental to maxillofacial surgery. The authors aimed to determine whether piezosurgery was suitable and advantageous for performing osteotomies in Hand and Plastic reconstructive surgery.

Methods: The authors overviewed a variety of applications for Piezosurgery Device, from Mectron, in bone reconstructive surgery with over the last 8 years.

Retrospective study of radial dome osteotomy with volar plate fixation versus K-wires in Madelung's deformity: long-term follow-up.

Purpose: The emerging role of the locking plate improved the technique also in corrective osteotomies in Madelung's deformity, but there is a lack of analyses between the fixation techniques, as well as little information in functional outcomes and long-term follow-up. The current study compared the outcomes, pitfalls, and advantages of volar plate and screws fixation versus K-wires fixation in a long-term follow-up.

Methods: Twenty-eight children presenting the "distal radius" variant of Madelung's deformity underwent Vickers ligament release and distal radial dome osteotomy between 2009 and 2015.

Digital Replantations: Comparison Veins Anastomoses first versus Arteries Anastomoses first.

Purpose: This retrospective study analyses the effect performing veins anastomoses before arteries anastomoses in digital replantation.

Patients And Methods: 38 adult patients with replantation of 12 thumbs and 39 fingers, in whom the veins anastomoses were performed prior to the arteries anastomoses, were compared with 29 patients with replantation of 9 thumbs and 30 fingers, in whom the arteries anastomoses were done first, with respect to the survival rate, total active motion, grip strength, and duration of the replantation.

Results: There was no significant difference between the two groups with respect to the survival rates, total active motion, and grip strength, while the duration of the replantation was significantly shorter in patients, in whom the veins anastomoses were performed prior to the arteries anastomoses (2 hours and 50 minutes versus 3 hours and 42 minutes; p < 0.

Outpatient paediatric hand surgery: strategy in healthcare implementation and cost-efficient manner.

The 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.

Upper limb traumatic injuries: A concise overview of reconstructive options.

Different options for upper limb reconstruction are described in literature: advancement or rotation flaps, regional flaps and free flaps are the most common. Local and regional flaps can represent the reconstructive options for small defects while large wounds require the use of free flaps or distant pedicled flaps. In case of large wound, the use of free flaps rather than distant pedicle flaps is usually preferred.

Modified dome osteotomy and anterior locking plate fixation for distal radius variant of Madelung deformity: a retrospective study.

Purpose: Dome osteotomy of the distal radius with Vickers ligament release is an established method of treatment for Madelung deformity. Many different surgical procedures have been proposed in literature but techniques, patient inclusion and efficacy evaluations are heterogeneous.

Materials And Methods: A retrospective review of children affected by 'distal radius' Madelung deformity and treated with a standardized surgical procedure (modified reverse dome osteotomy of the distal radius and volar fixation with a small locking plate) between 2010 and 2018 at a single center was performed.

The Challenges in restoration of extensor tendons function at the hand.

Introduction: The authors discuss challenges in extensor function restoration at the finger level following distal posterior interosseous or tendon complex injuries, according to the typologies of lesions or the specific patient requirements.

Materials: The authors report on two cases describing challenging resolutions. One patient with EDC lag from zone 6B to 8 requiring FCU prolonged with cadaveric grafts.

Soft tissue coverage of the upper limb: A flap reconstruction overview.

Different opinions about the reconstructive choice for upper limb are described in literature: advancement or rotation flaps, regional flaps and free flaps are the most common reconstructive options. Local and regional flaps can be used to cover small defects while large wounds require the use of free flaps or distant pedicled flaps. The coverage of large wounds opens a discussion about when to use free flaps and when distant pedicled flaps.

The Telematic solutions in plastic surgery during COVID-19 pandemic.

During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown.

Retrospective Review of Long-term Outcomes of Patients Undergoing CMC Arthroplasty With Interposition Scaffold.

The treatment of rhizarthritis involves several surgical techniques; among them, bioabsorbable scaffolds have begun to be proposed to avoid the use of other biological tissues or artificial permanent devices. In this study, we evaluated the long-term outcomes of poly-ld-lactic acid scaffold in interposition arthroplasty in a series of patients treated in our department. Strength, range of motion, and pain improved after the intervention and lasted over the years; nonetheless, most of the radiographs showed a progressive collapse of the first metacarpal.

Management of Locked Volar Radio-ulnar Joint Dislocation.

Isolated volar dislocation of the distal radio-ulnar joint is an extremely rare lesion. Diagnosis is commonly missed. The authors report their experience about a case of an acute locked volar distal radio-ulnar joint dislocation.

Median Nerve Injury Caused by Screw Malpositioning in Percutaneous Scaphoid Fracture Fixation.

An unusual complication of percutaneous fixation of a schapoid fracture in a 36-year-old man is described. After this surgery, the patient complained of numbness and tingling within the median nerve distribution and thenar weakness. An Electromyography showing moderate CTS had led to carpal tunnel decompression, which resulted unsuccessful.

Incidence estimates of hand and upper extremity injuries in Italy.

Objective: The purpose of this investigation is to estimate the incidence rates of upper extremity injuries and to give an overview of the most frequent diagnoses.

Materials And Methods: Two population databases were queried for all injuries in the upper extremities, the SINIACA-IDB (S-IDB: Emergency Department Injury Database in Italy) and the Hospital Discharge Register (HDR). The diagnoses codes of hand trauma were selected from both databases in order to estimate the national incidence rate.

A rare case of acral myxoinflammatory fibroblastic sarcoma at the hand.

One case of acral myxoinflammatory fibroblastic sarcoma is presented. Most of the soft tissue tumefactions of the distal extremities are benign. Sarcomas are rare and usually high grade.

The total anterior tenoarthrolysis in the treatment of the stiffness in flexion of the fingers.

The total anterior tenoarthrolysis (TATA) allows tenolysis, arthrolysis and skin repair in the same operation, avoiding combined different surgical procedures. The authors present a series of personal and original indications and propose a partial anterior tenoarthrolysis (PATA) for the treatment of isolated stiffness of the proximal interphalangeal joint or in the presence of less severe flexion contractures. The etiology was wide various, and the TATA revealed to be extremely useful also in tetraplegia or spasticity, permitting respectively the following tendon transfer and the hygienic improvement, and in the presence of global stiffness following complex lesions, reflex sympathetic algodystrophy or psychotic contracture.

Surgical correction of crossover deformity of the second toe: a technique for tenodesis.

Twenty-seven patients with 30 crossover toe (COT) deformities of the second toe were evaluated. This deformity in the transverse and sagittal planes at the second metatarsophalangeal joint may be caused by hindfoot pronation. Compression of the lateral plantar nerve may produce incompetence of the second dorsal interosseous muscle and an increased extension-adduction pull by the lumbrical and first dorsal interosseous muscles.

Intra-articular osteoid osteoma of the lower extremity: diagnostic problems.

We report five cases of intra-articular osteoid osteoma. Physical findings of osteoid osteoma vary with the site of the tumor. Juxta- and intra-articular osteoid osteomas present various atypical and nonspecific features.