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Biomedical subjects

A M MacLeod

Publications and source records attributed to A M MacLeod.

At least 145 records · Page 8Linked to original sources
PubMed1982

Free microneurovascular muscle transfer in limbs to provide motor power.

The experience gained in a series of 7 free microneurovascular muscle transfers to the limbs over a seven-year period has led us to conclude that: free gracilis microneurovascular flaps can be safely transferred and can aid restoration of movement following severe injuries of the limbs, including post-replantation cases; inclusion of a cutaneous island with the muscle is safe, improves cover, and simplifies closure following muscle transfer; tendon adhesions and joint stiffness are the greatest obstacles to transferred muscle function, and early passive extension is recommended; additional procedures are usually required after muscle transfer, to improve the level of function; and additional experimental work is required to determine methods of establishing the correct resting tension in transferred muscles.

Adolescent↗
PubMed1982

Digital reconstruction in the mutilated hand.

Salvage and reconstruction of the mutilated degloved hand or digit pose a problem because of the deficiency of local innervated pulp tissue. Free neurovascular flaps from the first web space of the foot supply a large area of well-padded innervated glabrous skin to resurface such defects. In thumb reconstruction free flaps, which may include the toenail, have many advantages over the conventional ring-finger island flap. Finger and whole-toe transfers are innervated reconstruction par excellence and these, in combination with innervated free flaps, offer a large armamentarium for reconstruction. The quality of sensation, however, is poorer than normal in these transfers and they are therefore limited to circumstances in which their use is not substituted by adjacent normal units.

Finger Injuries↗
PubMed1981

HLA and renal transplantation: yet another approach.

Renal allografts obtained from living related donors have considerably better chances of success than allografts from cadavers. The genetic factors that influence graft survival are linked to the HLA gene complex. Although results of cadaver transplants have not improved significantly when donor and recipient are matched for HLA-A and -B antigens, accumulating data suggest that matching for the more recently recognised HLA-DR antigens may produce increased graft survival.

Graft Survival↗
PubMed1980

Replantation and revascularisation surgery in children.

Salvage of any amputated, or devascularised, digit or extremity in a child should be seriously considered and carefully planned. Bone shortening should be minimised. Replanted and revascularised digits and extremities do grow and often demonstrate minimal retardation when well revascularised and minimally traumatised. Even in more extensive injuries progressive growth is observed. Replanting of single digits is worth while in children. Vein grafting should be seriously considered when replanting any avulsed digit. The return of excellent sensation and good function in amputated parts in children makes these procedures rewarding and beneficial.

Adolescent↗
PubMed1980

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.

Thumb reconstruction requires accurate functional and esthetic approximation to the original. Accepted methods generally have some deficiencies, particularly in appearance, and frequently the secondary morbidity is unacceptable. A method of thumb reconstruction with the use of an iliac crest bone graft and a free neurovascular "wrap-around" flap from the big toe is described that combines the attributes of previous methods without their secondary morbidity.

Adult↗
PubMed1980

The surgical repair of amputations of the thumb.

Twenty-four thumb mutilations have been repaired by using either whole toe transfers or portions of the big toe for reconstruction. The hallux has many of the properties uniquely suitable for thumb reconstruction. Its total sacrifice, however, leaves a significant defect in the foot, and it is usually too big to look convincing as a thumb. Essential portions of it can be transferred without undue deformity in the foot, and these, in combination with an iliac crest bone graft, can be modelled into a most aesthetic and functional thumb.

Amputation, Traumatic↗
PubMed1980

Replantation and revascularization of digits.

Between 1970 and 1978, 160 digits in 120 patients were replanted or revascularized. One hundred and nineteen digits survived, and these patients were assessed objectively and subjectively for functional results and their ability to return to work. Providing that strict indications are observed, long term objective and subjective results of digital replantation have proved most valuable from the point of view of the examiner and the patient. The best results were obtained with replantation of the thumb.

Adolescent↗
PubMed1978

Microvascular great toe transfer for congenital absence of the thumb.

Two cases of microvascular great toe transfer for congenital absence of the thumb in children are reported. A rationale and operative details are discussed. A long term follow up is needed, but at this stage the results are most encouraging. There has been no interference with gait.

Child, Preschool↗
PubMed1978

Simultaneous double toe transfer for severely disabled hands.

Two cases are presented in which a severely damaged hand was reconstructed by the simultaneous transfer of two toes using microvascular techniques. A two year evaluation of the functional result is made in both cases. Conventional reconstructive methods have little place in the reconstruction of these severe disabilities.

Adult↗
PubMed1978

Microvascular second toe transfer for digital reconstruction.

Reconstruction of a severely damaged hand, with multiple amputations of digits, presents a difficult reconstructive problem. The development of a safe method of transfer of the great toe for thumb reconstruction, using the dorsalis pedis artery and the saphenous vein, suggested the possibility of one-stage microvascular transfer of the second toe for reconstruction of fingers. In two patients a one-stage transfer of the second toe was done to replace an index finger and in another for restoration of part of the left ring finger. The transplants survived without anticoagulants and vessel complications were not encountered. Sensory return was adequate and a significant improvement in function was achieved.

Accidents, Occupational↗
PubMed1978

Neurovascular free flaps from the foot for innervation of the hand.

Microneurovascular flaps from the first web space of the foot offer a solution to upgrade sensibility of the denervated hand. Based on the dorsalis pedis artery, it allows simple dissection and a large vessel for easy and safe anastomosis. Seven cases are presented in which combinations of the first web anatomy for a variety of denervation injuries were used. The technique is ideally suited in those cases where no areas of island flap tissue are available for transfer.

Adolescent↗