The current state of bionic limbs from the surgeon's viewpoint.

Amputations have a devastating impact on patients' health with consequent psychological distress, economic loss, difficult reintegration into society, and often low embodiment of standard prosthetic replacement.The main characteristic of bionic limbs is that they establish an interface between the biological residuum and an electronic device, providing not only motor control of prosthesis but also sensitive feedback.Bionic limbs can be classified into three main groups, according to the type of the tissue interfaced: nerve-transferred muscle interfacing (targeted muscular reinnervation), direct muscle interfacing and direct nerve interfacing.

Lower limb replantation: 27 years follow up.

Replantation of lower extremity is a very complex and difficult procedure. There are still a lot of controversies about indications, even numerous scoring systems are now available that can facilitate the surgeon's decision. We present the functional results of a replanted below-knee amputation in an elderly patient, 27 years after the injury and discuss the indication for replantation.

"Close-open-close free-flap technique" for the cover of severely injured limbs.

The treatment of severely injured extremities still presents a very difficult task for trauma orthopaedic surgeons. Despite improvements in technology and surgical/microsurgical techniques, sometimes a limb must be amputated, otherwise severe and potentially fatal complications may develop. There is a well-established belief that severe open fractures should be left open.

What microsurgeon, orthopaedic and plastic surgeon should know about bionic hand.

Hand loss is a catastrophic event that generates significant demands for orthopedics and prosthetics. In the course of history, prostheses evolved from passive esthetic replacements to sophisticated robotic hands. Yet, their actuation and particularly, their capacity to provide patients with sensations, remain an unsolved problem.

Radial nerve palsy.

As a result of its proximity to the humeral shaft, as well as its long and tortuous course, the radial nerve is the most frequently injured major nerve in the upper limb, with its close proximity to the bone making it vulnerable when fractures occur.Injury is most frequently sustained during humeral fracture and gunshot injuries, but iatrogenic injuries are not unusual following surgical treatment of various other pathologies.Treatment is usually non-operative, but surgery is sometimes necessary, using a variety of often imaginative procedures.

Ilizarov fixation for the treatment of scaphoid nonunion: a novel approach.

Objectives: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.

Design: This is a prospective study of 20 consecutive patients in one center.

Patients And Methods: This study included 20 patients (19 males) with a mean SNU duration of 14.

Giovanni Battista Monteggia (1762-1815).

Giovanni Battista Monteggia was born in Laverne on the 8th of August 1762. Monteggia started his education in the School of Surgery at the Hospital Maggiore in Milano in 1779.This hospital was called "Big House"and it is one of the oldest medical institutions in Italy.

Fractures of the humerus during arm wrestling.

Background/aim: Humeral shaft fractures may occur as a result of arm wrestling. The aim of this study was to present our treatment of humerus fracture sustained during arm wrestling.

Methods: A total of six patients, aged 22 to 48, were treated at our department form January 2008 to January 2010 with open reduction and internal fixation and with hanging arm casts.

Open Dislocation of the High Ankle Joint After Fibular Graft Harvesting.

The free microvascular fibula and soft tissue transfer has become a widely used method for reconstruction of different regions. Donor site morbidity for free fibula microvascular flaps has generally been reported to be low, or at least acceptable. We describe the case of a patient who underwent vascularized free fibula graft harvest for mandibular reconstruction.

Fractures of the scaphoid, diagnosis and management--a review.

The scaphoid is vitally important for the proper mechanics of wrist function. Fracture of the scaphoid bone is the most common carpal fracture. Among all wrist injuries the incidence of scaphoid fracture is second only to fractures of the distal radius.

Operative treatment of metacarpal and phalangeal fractures with Kirschner wire fixation--a review.

Although hand fractures are most common fractures treated in orthopedic practice, many practicians treat them as trivial injuries. Improperly managed they can cause consequences and impair hand function. Metacarpal and phalangeal fractures are classified based on geometry, anatomic localization and wound presence and treatment depend on mechanism of injury.

Distal radius fractures--systematic review.

Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. They represent approximately 3% of all upper extremity injures. Severity of these fractures is directly related to bone mineral density of the patient, and clinical results are dependent on this parameter as well.

Replantation of upper extremity, hand and digits.

Replantation is defined as reattachment of the part that has been completely amputated and there is no connection between the severed part and the patient. In Boston in 1962 Malt successfully replanted a completely amputated arm of a 12-year-old boy. Komatsu and Tamai reported the first successful replantation of an amputated digit by microvascular technique.

[Baron Gijom Dipitren, Guillaume Dupuytren (1777-1835)].

Baron Dupuytren, Guillaume (1777-1835), French anatomist, pathologyst and surgeon, although was a personal doctor of Napoleon, Lui XVI and Sharles X, remain known for Dupuytrene contracture, due to his name, after he described this disease of palmar fascia in 1833. He started his education at Paris at age of 12, at 18 he was chief demostrator of anatomist prosectors. In 1802.

[Digital nerve injury of the hand-epidemiologic and clinical analysis].

The aim of this study was to show the significance of epidemiologic factors of digital nerve injury and their social influence. 108 patients were operated with primary suture within first 48 h after injury. We record factors as sex, age, etiology, dominance and level of injury.

[Operative treatment of flexor pollicis longus tendon with Krackow suture, functional results--preliminary results].

Introduction: Surgical treatment of the injuried flexor tensons is the important part of hand surgery. Tendon adhesions, ruptures, joint contcatures-stifness are only one part of the problem one is faced during the tendon treatment. In spite of improvement in surgical technique and suture material, the end result of sutured flexor tendons still represent a serious problem.