This study aimed to analyze cases of anterolateral thigh (ALT) free flap used for hand reconstruction with terminal perforator-to-digital artery anastomosis. Patients who underwent ALT free flap placement with terminal perforator-to-digital artery anastomosis for hand reconstruction between January 2011 and August 2021 were included. The number, length, and diameter of the perforators and veins, flap size, and operative time were investigated through a retrospective review of charts and photographs. The occurrences of arterial thrombosis, venous thrombosis, arterial spasm, and flap necrosis were analyzed. In total, 50 patients were included in this study. The mean diameter and length of the perforators were 0.68 mm and 3.25 cm, respectively, and the mean number of veins anastomosed was 1.88, with a mean diameter of 0.54 mm. Complications included four cases of arterial thrombosis, one case of venous thrombosis, seven cases of partial necrosis, and one case of total flap failure. Regression analysis showed that a longer perforator was associated with arterial thrombosis whereas larger flap size and number of anastomosed veins were associated with partial necrosis ( < 0.05). The terminal perforator-to-digital artery anastomosis offers advantages in using compact free flaps with short pedicle lengths to cover small hand defects.
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http://dx.doi.org/10.1055/a-2161-7419 | DOI Listing |
J Plast Reconstr Aesthet Surg
November 2024
Department of Hand Surgery, Herlev/Gentofte University Hospital of Copenhagen, Hospitalsvej 1, 2900 Hellerup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
The restoration of nerve function after the injury might be complicated by the development of a disorganized fibrous mass-a neuroma. This results in sensory and/or motor deficits and pain that can be severely debilitating. Surgical excision of the painful neuroma may leave a gap, which can be bridged using autografts or allografts.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany.
Introduction: The endoscopic assisted release for cubital tunnel syndrome (CuTS) gained popularity in recent years with unclear long-term results. This study aims to evaluate long term results regarding functional and subjective outcomes after endoscopic assisted release for the CuTS.
Materials And Methods: Thirty one patients who have been treated by endoscopic assisted release for CuTS between 2006 and 2013 were followed up both clinically and with a questionnaire with a mean follow up of 152 months (range 120-204 months).
BMC Musculoskelet Disord
December 2024
Department of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics Karlsruhe, Steinhaeusserstr. 18, Karlsruhe, D-76135, Germany.
Purpose: The aim of the study was to determine preoperative patient- and fracture-related risk factors for estimating the risk of fracture sequelae after surgically treated proximal humerus fractures (PHF) using locking plate osteosynthesis. The purpose was to develop a fracture sequelae risk score as an additional tool to facilitate the treatment strategy for PHF.
Methods: All patients with PHF who underwent surgery with locking plate osteosynthesis were included.
Neuroradiology
December 2024
Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
Background And Purpose: Craniosynostoses are rare congenital craniofacial malformations, variably affected by hearing loss, often requiring repeated CT examinations to assess skull or temporal bone (TB) abnormalities. In order to avoid radiation exposure in these young patients, efforts are made to assess the skull abnormalities on MR bone imaging sequences, such as Black Bone (BB). Our aim is to compare BB, a radiation-free imaging technique, with CT for the assessment of the TB.
View Article and Find Full Text PDFFront Surg
December 2024
Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
One of the primary challenges in hand microsurgical reconstruction lies in addressing severe hand injuries, particularly those involving multiple finger amputations, as autologous replantation might not fully restore hand functionality. In such scenarios, fully shaped reconstruction of a severed finger combined with Ectopic banking could yield superior reconstructive outcomes and enhance the amputated limb's function. This case report presents a unique approach that combines ectopic replantation of an amputated finger with interphalangeal reconstruction methods to restore both the form and function of the hand.
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