1/285. Articular fractures of the proximal interphalangeal joint with missing elements: repair with partial toe joint osteochondral autografts.Five cases of traumatic destruction of a condyle of the proximal interphalangeal joint repaired with a free autogenous graft of a corresponding toe condyle are presented. Precise fitting is essential: 1 patient required a second graft when the initial undersized graft was absorbed. Four of the 5 cases regained laterally stable bicondylar joints and functional fingers. Range of motion varied inversely to the magnitude of the injury and the surgery. Active range of motion at the proximal interphalangeal joint was 80 degrees in 2 digits, 45 degrees in 1, and 10 degrees in 1 complex case; 1 case was considered a failure.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/285. Isolated tenosynovitis associated with psoriasis triggered by physical injury.A 60-year-old man who had been suffering from psoriasis for 20 years developed finger dactylitis and inflammatory swelling with pitting edema over the dorsum of the hand one week after a contusive trauma to the left hand. These were not followed by any other clinical manifestations of PsA.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
3/285. Fingertip reconstruction with flaps and nail bed grafts.We retrospectively reviewed the cases of 14 fingertips reconstructed with a combination of local or regional flaps and nail bed grafts, some of which were placed wholly or partially over a de-epithelialized flap. Most of the fingertips sustained a crushing injury and were reconstructed at the time of the injury. Soft tissue coverage was provided by palmar V-Y flaps in 6 cases, thenar flaps in 4, lateral V-Y flaps in 2, a Moberg flap in 1, and a cross-finger flap in 1. Split toenail bed grafts were used in 6 cases, full-thickness nail bed grafts from the amputated part in 6, and split nail bed grafts from the injured digit in 2. There was 1 partial graft loss and 1 partial flap loss. The remaining cases had completely successful grafts and good soft tissue healing. Subsequent nail growth and adherence were good in all but the 1 digit requiring secondary composite grafting.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
4/285. Leech-borne serratia marcescens infection following complex hand injury.leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry aeromonas hydrophila infection, and a second or third generation cephalosporin antibiotic has traditionally been given as prophylaxis against infection. We report a new observation that leeches can carry serratia marcescens and give rise to clinically significant infection. The implication for prophylaxis and treatment of leech-associated cellulitis is discussed.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
5/285. Volar dislocation of the metacarpophalangeal joint of the ring finger. Report of two cases.Volar dislocation of the metacarpophalangeal joint of the finger is a rare injury. Two cases of an isolated volar dislocation of the ring finger metacarpophalangeal joint are reported. The dislocation was treated successfully by closed reduction shortly after injury in both cases. Closed reduction should be attempted in all cases of this injury because successful reduction may be possible.- - - - - - - - - - ranking = 3keywords = injury (Clic here for more details about this article) |
6/285. Ring finger ray amputation: a 25-year follow-up.The treatment of class III ring avulsion injuries remains controversial. This case report presents a 25-year follow-up of a class III ring avulsion injury treated with secondary ring finger ray amputation. This case shows long-term excellent functional and cosmetic results of ring finger ray resection without bony transposition.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
7/285. Successful revascularization of subtotal amputation of a digit in a neonate.A successful revascularization was performed in a neonate who sustained a subtotal amputation of the right ring finger with cord scissors while the umbilical cord was being cut. Successful revascularization of the digit was achieved within 5 hours of the injury using standard microsurgical techniques.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
8/285. Digital nerve repair by autogenous vein graft in high-velocity gunshot wounds.Gunshot wounds to the hands are high-energy injuries that cause widespread tissue damage, including to the nerves. Great difficulty is encountered in later reconstruction with nerve grafting of gaps in these destructive and scarred wounds. We present our experience with three patients with digital nerve repair by autogenous vein graft performed at an early stage in this type of injury. Based on our experience and that of others, this simple and rapid technique suggests a high rate of satisfactory results. It also avoids extensive and destructive late dissection and the morbidity associated with other late reconstructive procedures.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
9/285. bone resorption of the proximal phalanx after tendon pulley reconstruction.A 35-year-old male worker sustained a degloving injury of the left hand. An abdominal flap was used for skin coverage. Tenolysis and reconstruction of the A2 pulley was done using a procedure based on the 3-loop technique, which was modified by putting the tendon loop under the extensor apparatus and periosteum. X-ray revealed hourglass-shaped bone resorption around the proximal phalanx, just under the reconstructed pulley. Diaphyseal narrowing remained present in follow-up x-rays obtained 9 and 10 years later. The remodeling of the resorption was poor. Too much pressure may have caused this bone resorption from the shortened pulley and the circulatory deprivation may have been caused by the dissected periosteum and blocking by the surrounding tendon loop. The degloving injury, which also deprived the digits of a blood supply, may have been an additional underlying risk factor. We recommend that future comparative studies of pulley reconstruction take into account mechanical effectiveness as well as force distribution.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
10/285. Free toe pulp transfer for digital reconstruction after high-pressure injection injury.We report two cases of high-pressure injection injuries to the fingertip in which free toe pulp flaps were used to resurface the palmar surface of the finger following extensive wound debridement. There was good return of sensibility and, because of the high durability of the donor skin, both patients regained good functional use of the injured digits and returned to heavy manual work. There was minimal associated morbidity of the donor sites. The free toe pulp flap represents an excellent alternative for resurfacing the digit with a large residual skin defect after high-pressure injection injury.- - - - - - - - - - ranking = 5keywords = injury (Clic here for more details about this article) |
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