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PubMed2004

Preventing tourniquet effect when dressing finger wounds in children.

Hand and finger injuries are common injuries in children seen in emergency departments. Many of these are soft tissue injuries, which are often caused by household items, such as doors and exercise equipment. Once these injuries are repaired, usually they are covered with a simple dressing using a material such as Coban (3M, Minneapolis, MN). This dressing often is applied by winding it circumferentially around the digit. However, with very little manipulation, this dressing can be lifted and rolled up the digit in a distal direction, creating a tourniquet effect, which can cause hypoxia and tissue necrosis. To prevent the tourniquet effect, the dressing must include the hand and wrist.

Bandages↗
PubMed1986

Insidious erosion of a digit by a ring.

Avulsion injuries in fingers can be caused by rings worn on fingers. If the ring is tight, it can also cause an unusual problem, that of deep erosion into the finger. Only two cases with such erosion, both of them in adults have been reported so far. A child with a similar problem is presented here as a case report.

Child↗
PubMed2006

An unusual dorsal fracture-dislocation of the proximal interphalangeal joint.

A case of dorsal fracture-dislocation of the proximal interphalangeal joint in which the volar plate had been pulled from its distal attachment without bony or cartilaginous attachments and the lip of the volar plate had also been detached separately and was obstructing full flexion of the joint is presented. A tentative mechanism of causation of this unusual variant of a common injury is suggested.

Adolescent↗
PubMed1986

Second toe to thumb transfer with extensor digitorum brevis opponensplasty.

A second toe to hand transfer is described for thumb reconstruction which includes the extensor digitorum brevis as a simultaneous opponensplasty. This procedure was effective in a young man injured in a bomb explosion that completely destroyed the first ray. The second toe was dissected in continuity with the extensor digitorum brevis muscle, its nerve was anastomosed to the motor branch of the median nerve. Thus a one-stage operation allowed a complete reconstruction of the first ray proximally to the trapezium. Recovery at 2 years is good, and the muscle transfer can be demonstrated to work.

Adolescent↗
PubMed1993

Soft tissue coverage for the upper extremity.

Soft tissue coverage of the upper extremity continues to be a challenging and evolving field. The expeditious and reliable methods of soft tissue coverage currently in use are discussed with reference to their shortcomings and advantages. For soft tissue coverage of fingertip injuries, open treatment or local flaps from the hand remain the mainstay of treatment. For dorsal and volar hand defects, distal axial flaps, such as the groin flap or microvascular tissue transfer, are utilized most commonly. For large defects proximal to the wrist, trunk axial pattern flaps, microvascular transfer, or the radial forearm flap have the greatest utility. Finally, technical points necessary for the success of some of the flaps are discussed.

Arm↗