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At least 649 records · Page 36Linked to original sources
PubMed1996

[Treatment of complications of plastic surgery on the tendons of finger flexors].

From experience in the treatment of more than 800 patients by various methods of autotendoplasty which had been developed in the clinic earlier, the authors analysed the most characteristic complications of these operations. Separation of the wound edges and partial marginal necroses of the skin occurred in 7-8% of patients, mainly in bilateral damage to the neurovascular bundles of the fingers, ligature fistulas in 6-7%, ruptures in 5%, flexion contractures of the fingers formed in 2% of patients who had been operated on, suppuration of the wounds was practically not encountered. The peculiarities of surgical sanative procedures for ligature fistulas depending on their localization are described. The operative tactics in rupture of the tendon sutures after tendoplasty was elaborated: immediate repeated autoplasty is recommended in late-term ruptures, whereas in early ruptures the best results are produced by two-stage tendoplasty with temporary endoprosthetics of the tendon with silicone no earlier than 2-3 months after the rupture. The authors discuss the method for treatment of formed flexion contractures of the fingers by means of a distraction apparatus at a slow distraction mode, which produces good functional results.

Adult↗
PubMed1979

Surgical repair of the boutonnière deformity of the fingers.

Boutonnière is discussed. The results of twenty-seven digits operated on are presented. The operative technique used was that directed to the central tendon. The results were analysed according to the digit affected, to the type of lesion, if closed or opened, to the association with other lesions and to the time between the lesion and the surgery.

Adolescent↗
PubMed1979

Distal digital nerve grafts: clinical and anatomical studies.

An anatomical study of the terminal branches of the digital nerves of thumb and finger indicated a constant trifurcation at the level of the distal interphalangeal joint. Twelve microscopic interfascicular nerve grafts were done in 11 patients who had nerve division at this level with insensitive fingertips. All patients exhibited improved sensibility. Eight of 12 or 67% achieved 6 mm of two-point discrimination. Although there were no children in this study, the subjects under 30 years of age enjoyed better final results.

Adolescent↗
PubMed1987

Skin necrosis complicating mallet finger splinting and vascularity of the distal interphalangeal joint overlying skin.

Two patients are reported with full-thickness skin necrosis over the dorsum of the distal interphalangeal (DIP) joints after dorsal splint immobilization in hyperextension to treat acute mallet finger. An investigation was carried out to study the relationship of hyperextension to the dorsal circulation of the DIP joint. In 66 digits, the average degree of DIP joint hyperextension at which the skin blanches was 50% of the total passive hyperextension. It is recommended, therefore, when the DIP joint is immobilized to treat acute mallet finger, the degree at which the dorsal skin begins to blanch must be determined, and the amount of hyperextension should not exceed that degree. Excessive localized pressure to the dorsal skin should be avoided by adjusting the angle of the dorsal splint.

Adolescent↗
PubMed1983

Early mobilization of fractures of the metacarpals and phalanges.

Early mobilization of fractures of the metacarpals and phalanges is advocated. It should begin as soon as the stability of the fracture and the condition of the soft tissues permits. It has to be adapted to each case, and often consists of mobilization of the distal phalanges with the wrist and metacarpophalangeal articulations immobilized in a protective position. It is effective in preventing stiffness. Because it is a specific technique, it must be entrusted to specially trained physiotherapists, and requires regular and repeated clinical and radiologic follow up by the surgeon.

Bone Wires↗
PubMed1998

Extensor digiti minimi tendon "rerouting" transfer in permanent abduction of the little finger.

Permanent abduction of the little finger is a bothersome deformity which usually occurs in the context of sequelae of ulnar nerve palsy (Wartenberg's sign), but also in rheumatoid arthritis. The authors report an original technique for correction of this deformity. The extensor digiti minimi tendon is sectioned at its distal insertion and transferred in the wrist through the extensor retinaculum. The "rerouted" tendon is finally resutured distally on the radial aspect of the interosseous muscle. Side-to-side suture of the transferred tendon to the extensor digitorum tendon of the little finger further reinforces the solidity of the procedure. The distal insertion of the extensor digiti minimi tendon is consequently radialized. Its new direction eliminates the abduction component, and the tendon then behaves as an active adductor of the little finger. Five cases (2 cases of ulnar nerve palsy, 3 cases of rheumatoid arthritis) are reported with a mean follow-up of 19 months. All patients have complete active adduction of the little finger in extension, with a persistent capacity for abduction. The other correction techniques published in the literature are discussed.

Adolescent↗
PubMed1993

A new nerve pedicle for finger sensibility: the dorsal digital sensory nerve.

Restoration of sensibility to the traumatized finger can be a difficult problem. Two patients with insensibility to the volar distal finger after trauma underwent delayed digital nerve repair. In the first patient, the dorsal branch of the radial proper digital nerve was approximated to the distal stump as a pedicle to span a 12-mm gap resulting from neuroma excision. The second patient had a 14-mm defect after scar-tissue excision 8 months following primary neurorrhaphy after trauma. Reconstruction was performed by approximating the dorsal branch of the radial proper digital nerve to the distal stump. Both patients had fingertip sensibility restored 1 year postoperatively, as documented by two-point discrimination. Anatomic dissections of 12 fresh cadaver fingers revealed a consistent pattern. Of the 24 proper digital nerves dissected, 23 had a distal dorsal sensory branch arising at the midportion of the proximal phalanx. The dorsal branch-vascularized pedicle of the proper digital nerve has not been described previously as a method for restoring finger sensibility in cases not amenable to primary neurorrhaphy. We believe this technique should be added to the repertoire of the practicing hand surgeon.

Adult↗
PubMed2002

The harvest and clinical application of the superficial peroneal sensory nerve for grafting motor and sensory nerve defects.

Potential donor nerves for autografting are finite and usually limited to cutaneous nerves of the extremities. The superficial peroneal nerve is the major lateral branch of the common peroneal nerve that innervates the peroneus longus and brevis muscles and provides sensation to the lateral aspect of the lower leg and the dorsal foot. It has generally been overlooked as a potential donor of nerve autografts. Cadaver dissections were performed on 10 fresh lower extremity specimens to investigate the anatomic characteristics of the superficial peroneal nerve and to refine a harvesting technique for the nerve. Thirty-one patients underwent nerve grafting of 39 upper and lower extremity nerves using the superficial peroneal donor. There were nine median nerves, four ulnar nerves, two radial nerves, two brachial plexus lesions, 16 digital nerves, and six lower extremity nerves grafted. The superficial peroneal nerve provided a consistently long donor, comparable in length to the sural nerve. The anatomic pattern is consistent, the patient positioning is simple, the surgical harvesting technique is straightforward, and the donor defect is acceptable. The superficial peroneal nerve provides a safe and valuable donor nerve, particularly in cases where multiple or very long nerve grafts are required.

Adolescent↗