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At least 451 records · Page 25Linked to original sources
PubMed1982

The forearm flap.

We present our experimental and clinical experiences with the free neurovascular forearm flap. The flap is based on the radial artery, one of the great veins of the forearm (cephalic, basilic, or interconnecting vein), and one or two cutaneous forearm nerves (ulnar, median, or lateral). Because of the standard anatomy, the large caliber of blood vessels, the good sensory supply, the quality and quantity of the forearm skin, and the thin layer of subcutaneous fat, the free forearm flap is a technically easy and safe flap for reconstruction of soft-tissue defects, especially those in the head and neck and those areas of the extremities where sensitive skin is desired.

Adult↗
PubMed2003

Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fractures.

This case-control epidemiologic study examines the relationship between hormone replacement therapy (HRT) and risk for fractures of four sites among women 45 years of age and older. From October 1996 to May 2001, incident patients with distal forearm ( n=744), foot ( n=618), proximal humerus ( n=331), and pelvis ( n=109) fractures were recruited from five Kaiser Permanente Medical Centers in northern California. Controls ( n=1617) were selected at random from the same five medical centers over the same time period within strata defined by 5-year age group, gender, and white versus nonwhite or unknown recorded race/ethnicity. Trained interviewers collected information using a standardized questionnaire. Compared with postmenopausal women who never used HRT, postmenopausal women currently using HRT for at least 3 months had a decreased risk of fracture at the distal forearm (adjusted OR=0.55, 95% CI: 0.43, 0.72), proximal humerus (adjusted OR=0.51, 95% CI: 0.36, 0.74), and pelvis (adjusted OR=0.51, 95% CI: 0.27, 0.95), but not the foot (adjusted OR=1.05, 95% CI: 0.81, 1.35). Past use of HRT for more than 7 years also appeared to be associated with a reduced risk of fracture at the distal forearm and proximal humerus. The longer a woman went without HRT after her last menstrual period, the greater her risk of fracture in the distal forearm, proximal humerus, and pelvis. The findings of this study support long-term, current use of HRT for the prevention of osteoporotic fractures, but other risks and benefits also need to be considered.

Aged↗
PubMed1994

Technical considerations in two-stage functioning free muscle transplantation reconstruction of both flexor and extensor functions of the forearm.

We report on two patients with severe injuries of the forearm who were reconstructed using functioning free muscle transplantation (FFMT) for individual replacement of flexor and extensor function. In both cases a two-stage procedure was performed: The extensor reconstruction preceded the flexor reconstruction by 4-6 months. The extensor digitorum communis and flexor digitorum profundus were successfully reconstructed in both cases using bilateral gracilis FFMT. In one case the flexor pollicis longus and extensor pollicis longus were also reconstructed using the adductor longus in addition to the gracilis. Clinical follow-up was a minimum of 2 years. Both patients achieved wrist control, excellent finger flexion, and metacarpophalangeal joint extension. One patient also had good interphalangeal finger extension, but the other developed a persistent claw deformity due to the lack of recovery of ulnar nerve function. Performing the extensor reconstruction prior to the flexor reconstruction theoretically allows a more rapid return of function and a shorter rehabilitation period than using the converse sequence.

Adult↗
PubMed1995

Management of isolated radial or ulnar arteries at the forearm.

The effects of management of single forearm arterial injuries without other associated major muscular, vascular, or neurological trauma were studied. Ninety-six patients with acute injuries to either radial or ulnar arteries without obvious associated major injuries were evaluated. No patient had an ischemic hand secondary to arterial injury. The selection of operative treatment by arterial repair or ligation was by surgeon choice (50 injuries were ligated, and 46 were repaired). Six months to six years postoperative follow-up was done. The overall patency rate for all repaired vessels was 52% (24 cases). The collateral arteries appeared to be a factor causing the low patency rate. The remaining intact artery demonstrated a consistent increase in flow velocity. No subject had hand claudication; there were 51 cases (53%) of hand weakness, 27 incidents (28%) of parasthesia, and 14 incidents (15%) of cold sensitivity independent of patency of the damaged forearm vessel. In the absence of acute hand ischemia, ligation of a lacerated radial or ulnar artery is safe and cost effective.

Adolescent↗
PubMed2004

Partially retained small finger flexor digitorum profundus function despite complete tendon loss in the forearm.

A case of traumatic laceration of the small finger flexor digitorum profundus (FDP) tendon in the distal forearm with retained partial active flexion at the small finger distal interphalangeal joint (DIP) joint is described. Tendinous interconnections between the ring and small FDP tendons and lumbrical muscles may permit partial FDP function at the DIP joint despite a complete deficit of the proximal tendon.

Biomechanical Phenomena↗
PubMed1994

[Forum: cover flaps of the upper limb. In practice: indications of pedicled flaps of the upper limb].

The author analyses the historical development and disadvantages of pedicled island flaps of the upper limb. The various procedures for skin cover of the upper limb are described region by region: shoulder, arm, elbow, forearm, wrist, hand and fingers. The large number of these procedures means that the reconstructive surgeon would have to be able to master all techniques and indications. Adopting an eclectic approach, the author proposes two main flaps: the latissimus dorsi muscle to cover the proximal region of the upper limb and the pedicled inguinal flap for the distal upper limb.

Arm Injuries↗
PubMed1983

The disparate diameter. A sign of rotational deformity in fractures.

Although clinical assessment is usually better than radiographic evaluation in detecting rotational deformity at a fracture site, the forearm is an exception to this rule. A simple radiologic sign is here described which may uncover rotational fracture deformity: in the absence of comminution, whenever the diameter of a long bone changes abruptly across a fracture line, a significant rotational deformity must be considered. The basis for and applications of this sign are described.

Child↗
PubMed1994

[Preserving the length of amputation stumps by microvascular flap transfer of the lower extremity].

With different case reports we want to show the role of microvascular tissue transfer in preservation of lower extremity amputation length. To salvage amputation stumps after traumatic amputation, as well as in case of chronic soft tissue problems after amputation, the radialis forearm flap is preferred for smaller defects, for example after transmetatarsal amputation, whereas with the latissimus dorsi muscle flap bigger areas can be reconstructed. But also the tensor fascia latae flap and the scapular flap can be used for soft tissue reconstruction. With microvascular soft tissue transfer amputation stump length can be preserved in order to have a better functional outcome, especially for prosthetic rehabilitation.

Adolescent↗
PubMed1995

Flap reconstruction in the upper limb.

The introduction of the free flap and the regional fasciocutaneous flap has added to the methods of skin defect coverage in the upper limb and avoids the disadvantages of conventional flaps. This paper describes the features and indications of regional axial pattern flaps and free flaps for upper limb skin defects. They can be categorised into flaps in the ipsilateral upper limb and flaps from out of the upper limb. Flaps in the upper limb include the lateral arm flap, the radial forearm flap, the posterior interosseous artery flap, the dorsal metacarpal artery flap, and the digital artery flap. Flaps from out of the upper limb comprise the latissimus dorsi myocutaneous flap, the scapular flap, the groin flap and the hemipulp flap. Criteria for flap selection include the patient's age and health, the condition of the skin defects, the location and size of the defects and damage of the deep structure, the patient's cosmetic demand, the surgeon's technical skill and the facilities in the operating room.

Amputation, Traumatic↗
PubMed1987

External fixation of the upper extremity.

External fixation of forearm and arm fractures is an excellent treatment option, particularly in compound, comminuted fractures that result from high-energy trauma. Limb salvage and good function have been achieved in 75% of cases by applying the principles outlined. Problems with delayed bone union have been recognized and emphasize the importance of supplemental bone grafting. A number of external fixation systems are applicable to these upper limb fractures, and the authors have not found one system superior to the others. Open pin insertion is preferred, and pins (three proximal and three distal) are ideally placed near the fracture site for optimal stability.

Arm Injuries↗
PubMed1994

Present status of replantation in Japan.

We conducted a survey among 94 members of the Japanese Society of Reconstructive Microsurgery on the present status of replantation in Japan. The results indicate that 9,664 extremities were replanted (157 upper arms, 415 forearms, 471 hands, 8,320 digits, 33 thighs, 103 calves, 37 feet, and 128 toes); 8,227 replants survived, for a success rate of 85%. The survival rate was over 90% in 23 hospitals, and 7 of these hospitals replanted more than 100 limbs. Postoperative treatment consisted of continuous intravenous infusion of urokinase (120,000-240,000 U/day), heparin (10,000-20,000 U/day), and prostaglandin E1 (80-120 micrograms/day) for 3-10 days. Fifty-six surgeons attempted replantation whenever the patient requested it. At Nara Medical University, continuous local intra-arterial infusion of anticoagulants and fibrinolytic agents has increased the survival rate of the replantation to 97%, compared with 88% when using intravenous infusion.

Alprostadil↗
PubMed1988

Free functional musculocutaneous transfer: electrophysiological studies.

Transplanted autogenous muscles were electrophysiologically studied in 2 patients with forearm crush injury. Only fibrillation action potentials and positive sharp waves were seen at 1 month after the operation. Low-amplitude and short-duration muscular unit potentials (MUPs) appeared at 3 months and high-amplitude, long-duration and polyphasic MUPs were frequently seen at 6-7 months after the transplantation. The distal latencies of the evoked motor responses were gradually shortened from time to time and eventually became normal at about 1 year after the grafting. The mean consecutive difference became normal at about 6 months after the normalization of the distal latencies. We conclude that the motor endplate is functionally completed at about half a year after the completion of the myelination of the grafted nerve.

Action Potentials↗
PubMed1995

The management of impalement injury.

Four cases of impalement injury are described. The principles of management are discussed, these being minimal manipulation of the object before and during transport, preoperative planning, a multidisciplinary approach, and wound care.

Abdominal Injuries↗