[Restoration of the thumb by transposition of the fingers of the injured hand].
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A case of successful replantation of multiple digits and circular palm amputation caused by an industrial punch force is reported. The two-level amputation was reconstructed by first replanting the severed fingers to the palmar segment and then connecting the palm segment to the hand stump. An arterial crisis was treated with urokinase, and postoperative functional recovery is described.
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This article describes an incision which incorporates principles of both the Bunnell midlateral incision and the Bruner zig-zag. It allows rapid access to the volar aspect of the digit without sacrificing exposure or risking flexion contractures while maintaining an unviolated volar skin flap. In this study of 125 patients, 189 digital problems were treated, using the modified midlateral incision. Ages ranged from eleven months to seventy-one years. Complications following surgery were unrelated to the incision.
A method of repair of boutonnière deformity is described, using the transverse retinacular ligament. Six fingers in five patients were treated by this procedure. The deformity was improved in all fingers; complete or almost complete correction was obtained in four fingers and incomplete correction in two. However, severe limitation of flexion of the D.I.P. joint appeared in two fingers after surgery. This procedure is not indicated for boutonnière deformities with severe contracture of the lateral band; its best indication is in cases in which the central slip is defective and conservative treatment is not effective.
We report two cases in which white spirit has been injected accidentally into the hand by golfers, while attempting to remove the grip of the golf-club handle in order to replace it. One of our patients has anecdotal evidence of this happening in at least two other cases, one of which resulted in amputation of the index finger, and the other in severe damage to the thumb.
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