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A method for assessing hand function following loss of the long finger extensors in Zones 6 and 7 (Verdan, 1968) is described. It relies on a number of mechanical and functional tests combined with a detailed questionnaire.
Soft tissue loss with digital nerve defect in the finger was reconstructed with the reverse digital artery neurovascular cross-finger flap in two cases with favorable results. The flap harvested from the lateral side of the proximal phalanx of the neighboring healthy finger is nourished by a distally based digital artery. The flap contained a segment of digital nerve dorsal branch, which is used to bridge the nerve gap in the wound while the flap is used to reconstruct the soft tissue defect concomitantly. The reverse digital artery neurovascular cross-finger flap seems to be a useful addition to the options for complicated finger damage involving soft tissue loss and nerve defect.
One microsurgical unit's experience with leech application to 67 patients is surveyed. Five illustrative cases are presented to explain strategies of leech use, and plans for future research are discussed.
Five patients are presented in whom a traumatically amputated extremity or digit was perfused with oxygenated Fluosol DA-20%. Perfusion lasted between 16 and 46 hours. Microcirculatory oxygenation was monitored using pO2 measurements. Moreover, K¿lactate, glucose, and ATP levels were measured and electron microscopic sections of the vessels were investigated at the end of the experiment. All above-mentioned parameters suggest that the tissue was sufficiently provided with oxygen and viable after many hours of perfusion. Conclusive evidence of the viability of a perfused digit was given by its successful replantation after 17 hours of Fluosol perfusion (at approximately 15 degrees C).
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The biology, management, and results of primary repair and secondary reconstruction are reviewed. Repair of the tendon sheath and controlled mobilization appear to improve the results of both groups.
Many physicians and trainers are not aware of the entity of avulsion of the profundus tendon insertion. This is unfortunate, since early diagnosis and prompt surgical treatment generally produce the best result. Late, untreated patients who are asymptomatic are best left alone. For late instability of the DIP joint, fusion should be considered. A one- to two-stage flexor tendon graft can be performed in carefully selected, untreated patients, but the potential risks may outweigh the possible advantages in some individuals.
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Explore the source record for details and available documents.
The results of complex treatment of acute purulent inflammatory diseases of the digits and hand with the use of vacuum-therapy in 109 patients are presented. Shortening of the time required for wound cleaning, reduction in disease and temporary invalidity duration were noted.
The present report deals with the therapeutic possibilities of the management of deep defects of soft tissues on the dorsum of fingers. In addition to the commonly used methods are presented two less common procedures which are in certain cases less time consuming and provide more comfort both to the patient and to the surgeon.
PURPOSE: To evaluate the ability of ultrasound to detect a central tear of the finger extensor tendon mechanism. METHODS: Twelve fresh-frozen and thawed cadaver fingers were used. All fingers had a midradial incision with exposure of the extensor mechanism over the proximal interphalangeal joint. Six fingers had a sharp transection of the central slip. The other 6 fingers were used as sham dissection controls. All fingers had the exposure closed by suture and then were examined by a musculoskeletal ultrasonographer. RESULTS: All 12 fingers were identified correctly as either sham controls with intact central slips or as injury models that had a transected central slip. Thus there was a sensitivity of 100% a specificity of 100%, and a positive predictive value of 1.000, which were statistically significant. CONCLUSIONS: Diagnostic ultrasound is a very accurate noninvasive study that can identify central slip injuries in the extensor mechanism of the finger. We recommend that clinically suspected cases of boutonniere injury be scanned by high-frequency ultrasound to confirm the diagnosis and allow either early initiation of splinting or eliminate the need for prolonged splinting required for this injury.