Jaganmohan Janardhanam - Academia.edu (original) (raw)

Uploads

Papers by Jaganmohan Janardhanam

Research paper thumbnail of KEYWORDSGroin Flap, Fenestrated Groin Flap, PBSC Thumb, Z Deformity Thumb

Versatility of Fenestrated Groin Flap in the Reconstruction of Post-Burn Dorsal Contractures of Thumb, Dec 25, 2019

Research paper thumbnail of Single-Stage Reconstruction with Innate Chimeric-Free Fibula Flap in Limb-Preserving Excision of Upper Limb Sarcomas

Journal of Hand and Microsurgery

Introduction The limb-preserving excision is the standard of care in upper limb sarcoma managemen... more Introduction The limb-preserving excision is the standard of care in upper limb sarcoma management, but the resulting complex composite defects are exacting the expertise of the reconstructive surgeons. This study was done to evaluate a novel single-stage reconstruction of these defects using an innate chimeric-free fibula flap (a nonfabricated, anatomically available multiple tissue components harvested on independent perforators arising from the same peroneal source vessel). Patients and Methods Twenty patients (16 male/4 female) with an average age of 29.5 years with upper extremity sarcoma (Enneking IIA/IIB) were treated by wide local excision and innate chimeric-free fibula flap reconstruction from March 2012 to March 2020. All the patients were followed for an average period of 18.3 months. At the end of the follow-up, the outcome was assessed by musculoskeletal tumor score (MSTS). Results The flow-through flap was done in five patients. Muscle-tendon unit defects were reconst...

Research paper thumbnail of A stratified reconstructive approach in the management of congenital vaginal insufficiencies and agenesis

Research paper thumbnail of Pedicled Chimeric Perforator Flap Based on Inferior Gluteal Vessel Axis for the Reconstruction of Stage-Four Primary Ischial Pressure Sores—A New Design

Indian Journal of Plastic Surgery

Background “Subfascial void reconstruction” in ischial pressure sores (IPSs) goes a long way in t... more Background “Subfascial void reconstruction” in ischial pressure sores (IPSs) goes a long way in the amelioration of the common complications like persistent drainage, infection, wound dehiscence, and late recurrence. No locoregional flaps suffice this requirement. So we have designed a chimeric pedicled flap based on the inferior gluteal vessel axis (IGVA) perforators with two tissue components: (1) Pacman-style fasciocutaneous flap on a perforator and (2) gluteus maximus muscle (inferior portion) on another independent perforator. Aim and Methods After confirming the feasibility of novel design of chimeric pedicled IGVA perforator flap with cadaver study, we embarked on the clinical study with this chimeric flap. In this prospective cohort study, the study and the control existed in the same patient so that the biological factors affecting the wound healing would be the same. Results Twenty-one patients were included whose mean age was 39 years. Late recurrence occurred in one pati...

Research paper thumbnail of Subungual Glomus Tumours of Hand: An Institutional Study

Glomus tumours were rst described by HOYER in 1877 , while the rst complete clinical descriptio... more Glomus tumours were rst described by HOYER in 1877 , while the rst complete clinical description was given by MASSON in 1924. A glomus tumour is a rare neoplasm arising from the glomus body and mainly found under the nail, on the ngertip or in the foot. The majority of glomus tumours are benign, but they can also show malignant features in less than 2% cases. Our study includes 8 clinical cases of glomus tumours and our institutional experience in their management.

Research paper thumbnail of Synoviosarcoma of arm in 4-month-old infant reconstructed with sensate free anterolateral thigh flap

Indian Journal of Plastic Surgery

The most common histologic subtypes of soft-tissue sarcoma seen in the hand are epitheloid sarcom... more The most common histologic subtypes of soft-tissue sarcoma seen in the hand are epitheloid sarcoma, synovial sarcoma and malignant fibrous histiocytoma. [1] The synovial sarcoma arising in the arm and that too in the 4-month-old infant is rare. [3-5]

Research paper thumbnail of Technical Refinements in Posterior Interosseous Artery flap

Journal of Medical Science And clinical Research

Research paper thumbnail of Management of Hand Phalangeal Fractures with Long Aluminium Splint Traction (LAST)

Journal of Evidence Based Medicine and Healthcare

BACKGROUND Phalangeal fractures are common fractures of the hand. Various treatment protocols and... more BACKGROUND Phalangeal fractures are common fractures of the hand. Various treatment protocols and options, ranging from splinting, percutaneous wires, external fixators, interfragmentary screw fixation to mini fragment plates exist in handling cases of proximal phalangeal fractures. The aim of the study is to find the outcome of fingernail traction with a digital aluminium splint in the management of closed phalangeal fractures of the hand. METHODS A prospective study was conducted among 24 patients between November 2017-October 2019 who were treated with Long Aluminium Splint Traction (LAST), a fingernail traction using a long aluminium splint in the management of closed fractures involving proximal and middle phalanx of the hand. The outcome measures included post reduction radiographic evaluation and total active motion (TAM) in the finger at the final follow-up. RESULTS On radiological assessment, 20 patients had good reduction, 2 had fair reduction and 2 patients had poor reduction. At final assessment with TAM score, 19 patients had good TAM score, 3 had fair and 2 had poor TAM. Complication was noted in two cases in the form of misalignment with poor reduction which required ORIF with K-wire fixation. CONCLUSIONS Long aluminium splint is readily available, cost effective and it is simple to apply traction. With traction splinting and early range of motion exercises, these patients were found to have an acceptable outcome with fewer complications when compared to ORIF with plates and screws.

Research paper thumbnail of Versatility of Fenestrated Groin Flap in the Reconstruction of Post-Burn Dorsal Contractures of Thumb

Journal of Evidence Based Medicine and Healthcare

BACKGROUND In reconstruction of post burn scar contracture of hand, thumb reconstruction is cruci... more BACKGROUND In reconstruction of post burn scar contracture of hand, thumb reconstruction is crucial. Among various flaps that are available for thumb reconstruction groin flap is ideal for large defects and defects also involving 1 st webspace. Modification in groin flap with fenestration provides more inset, splints thumb in abduction thereby maintaining 1 st web space and no soddening of thumb and 1 st web space. METHODS In a 2-year period between 2017 and 2019, fenestrated groin flap was performed. It was done in 12 cases of which 9 were males and 3 were females. RESULTS All 12 patients had Post-burn Dorsal Contracture (PBSC). The time interval between injury and reconstruction ranges from 10 months to 8 years (mean 3.25). All patients after contracture release were reconstructed with fenestrated groin flap in 2 stages. After 2 weeks flaps were divided and remaining insets were given. Donor sites were closed primarily by undermining or resurfaced with SSG where necessary. All flaps survived with no postoperative complication. CONCLUSIONS Based on our experience with fenestrated groin flap, this is an ideal flap after release of dorsal PBSC thumb.

Research paper thumbnail of Application of embryonic equivalents in male-to-female sex reassignment surgery

Indian Journal of Plastic Surgery

Introduction: The feeling of incongruence between phenotypic sex and psychological recognition of... more Introduction: The feeling of incongruence between phenotypic sex and psychological recognition of self-gender is termed gender dysphoria. Transsexualism is the most extreme form of this disorder. Aims and Objectives: The aims and objectives of the study are to evaluate the esthetic and functional outcome of embryonic equivalents-based male-to-female sex reassignment surgery in transwomen using the institutional scoring system. Materials and Methods: Thirty transwomen who had undergone male-to-female embryonic equivalents-based sex reassignment surgery (MFEEbSRS) from October 2012 to March 2016 were retrospectively studied. The outcome was evaluated by two independent plastic surgeons, based on interview with the individuals, visual assessment, and measurements. Surgical Technique: Clitoris was created from reduced glans on dorsal penile pedicle mounted on the crura of the conjoined corpora cavernosa. De-gloved unfurled proximal penile skin formed the introitus, hood for clitoris and...

Research paper thumbnail of KEYWORDSGroin Flap, Fenestrated Groin Flap, PBSC Thumb, Z Deformity Thumb

Versatility of Fenestrated Groin Flap in the Reconstruction of Post-Burn Dorsal Contractures of Thumb, Dec 25, 2019

Research paper thumbnail of Single-Stage Reconstruction with Innate Chimeric-Free Fibula Flap in Limb-Preserving Excision of Upper Limb Sarcomas

Journal of Hand and Microsurgery

Introduction The limb-preserving excision is the standard of care in upper limb sarcoma managemen... more Introduction The limb-preserving excision is the standard of care in upper limb sarcoma management, but the resulting complex composite defects are exacting the expertise of the reconstructive surgeons. This study was done to evaluate a novel single-stage reconstruction of these defects using an innate chimeric-free fibula flap (a nonfabricated, anatomically available multiple tissue components harvested on independent perforators arising from the same peroneal source vessel). Patients and Methods Twenty patients (16 male/4 female) with an average age of 29.5 years with upper extremity sarcoma (Enneking IIA/IIB) were treated by wide local excision and innate chimeric-free fibula flap reconstruction from March 2012 to March 2020. All the patients were followed for an average period of 18.3 months. At the end of the follow-up, the outcome was assessed by musculoskeletal tumor score (MSTS). Results The flow-through flap was done in five patients. Muscle-tendon unit defects were reconst...

Research paper thumbnail of A stratified reconstructive approach in the management of congenital vaginal insufficiencies and agenesis

Research paper thumbnail of Pedicled Chimeric Perforator Flap Based on Inferior Gluteal Vessel Axis for the Reconstruction of Stage-Four Primary Ischial Pressure Sores—A New Design

Indian Journal of Plastic Surgery

Background “Subfascial void reconstruction” in ischial pressure sores (IPSs) goes a long way in t... more Background “Subfascial void reconstruction” in ischial pressure sores (IPSs) goes a long way in the amelioration of the common complications like persistent drainage, infection, wound dehiscence, and late recurrence. No locoregional flaps suffice this requirement. So we have designed a chimeric pedicled flap based on the inferior gluteal vessel axis (IGVA) perforators with two tissue components: (1) Pacman-style fasciocutaneous flap on a perforator and (2) gluteus maximus muscle (inferior portion) on another independent perforator. Aim and Methods After confirming the feasibility of novel design of chimeric pedicled IGVA perforator flap with cadaver study, we embarked on the clinical study with this chimeric flap. In this prospective cohort study, the study and the control existed in the same patient so that the biological factors affecting the wound healing would be the same. Results Twenty-one patients were included whose mean age was 39 years. Late recurrence occurred in one pati...

Research paper thumbnail of Subungual Glomus Tumours of Hand: An Institutional Study

Glomus tumours were rst described by HOYER in 1877 , while the rst complete clinical descriptio... more Glomus tumours were rst described by HOYER in 1877 , while the rst complete clinical description was given by MASSON in 1924. A glomus tumour is a rare neoplasm arising from the glomus body and mainly found under the nail, on the ngertip or in the foot. The majority of glomus tumours are benign, but they can also show malignant features in less than 2% cases. Our study includes 8 clinical cases of glomus tumours and our institutional experience in their management.

Research paper thumbnail of Synoviosarcoma of arm in 4-month-old infant reconstructed with sensate free anterolateral thigh flap

Indian Journal of Plastic Surgery

The most common histologic subtypes of soft-tissue sarcoma seen in the hand are epitheloid sarcom... more The most common histologic subtypes of soft-tissue sarcoma seen in the hand are epitheloid sarcoma, synovial sarcoma and malignant fibrous histiocytoma. [1] The synovial sarcoma arising in the arm and that too in the 4-month-old infant is rare. [3-5]

Research paper thumbnail of Technical Refinements in Posterior Interosseous Artery flap

Journal of Medical Science And clinical Research

Research paper thumbnail of Management of Hand Phalangeal Fractures with Long Aluminium Splint Traction (LAST)

Journal of Evidence Based Medicine and Healthcare

BACKGROUND Phalangeal fractures are common fractures of the hand. Various treatment protocols and... more BACKGROUND Phalangeal fractures are common fractures of the hand. Various treatment protocols and options, ranging from splinting, percutaneous wires, external fixators, interfragmentary screw fixation to mini fragment plates exist in handling cases of proximal phalangeal fractures. The aim of the study is to find the outcome of fingernail traction with a digital aluminium splint in the management of closed phalangeal fractures of the hand. METHODS A prospective study was conducted among 24 patients between November 2017-October 2019 who were treated with Long Aluminium Splint Traction (LAST), a fingernail traction using a long aluminium splint in the management of closed fractures involving proximal and middle phalanx of the hand. The outcome measures included post reduction radiographic evaluation and total active motion (TAM) in the finger at the final follow-up. RESULTS On radiological assessment, 20 patients had good reduction, 2 had fair reduction and 2 patients had poor reduction. At final assessment with TAM score, 19 patients had good TAM score, 3 had fair and 2 had poor TAM. Complication was noted in two cases in the form of misalignment with poor reduction which required ORIF with K-wire fixation. CONCLUSIONS Long aluminium splint is readily available, cost effective and it is simple to apply traction. With traction splinting and early range of motion exercises, these patients were found to have an acceptable outcome with fewer complications when compared to ORIF with plates and screws.

Research paper thumbnail of Versatility of Fenestrated Groin Flap in the Reconstruction of Post-Burn Dorsal Contractures of Thumb

Journal of Evidence Based Medicine and Healthcare

BACKGROUND In reconstruction of post burn scar contracture of hand, thumb reconstruction is cruci... more BACKGROUND In reconstruction of post burn scar contracture of hand, thumb reconstruction is crucial. Among various flaps that are available for thumb reconstruction groin flap is ideal for large defects and defects also involving 1 st webspace. Modification in groin flap with fenestration provides more inset, splints thumb in abduction thereby maintaining 1 st web space and no soddening of thumb and 1 st web space. METHODS In a 2-year period between 2017 and 2019, fenestrated groin flap was performed. It was done in 12 cases of which 9 were males and 3 were females. RESULTS All 12 patients had Post-burn Dorsal Contracture (PBSC). The time interval between injury and reconstruction ranges from 10 months to 8 years (mean 3.25). All patients after contracture release were reconstructed with fenestrated groin flap in 2 stages. After 2 weeks flaps were divided and remaining insets were given. Donor sites were closed primarily by undermining or resurfaced with SSG where necessary. All flaps survived with no postoperative complication. CONCLUSIONS Based on our experience with fenestrated groin flap, this is an ideal flap after release of dorsal PBSC thumb.

Research paper thumbnail of Application of embryonic equivalents in male-to-female sex reassignment surgery

Indian Journal of Plastic Surgery

Introduction: The feeling of incongruence between phenotypic sex and psychological recognition of... more Introduction: The feeling of incongruence between phenotypic sex and psychological recognition of self-gender is termed gender dysphoria. Transsexualism is the most extreme form of this disorder. Aims and Objectives: The aims and objectives of the study are to evaluate the esthetic and functional outcome of embryonic equivalents-based male-to-female sex reassignment surgery in transwomen using the institutional scoring system. Materials and Methods: Thirty transwomen who had undergone male-to-female embryonic equivalents-based sex reassignment surgery (MFEEbSRS) from October 2012 to March 2016 were retrospectively studied. The outcome was evaluated by two independent plastic surgeons, based on interview with the individuals, visual assessment, and measurements. Surgical Technique: Clitoris was created from reduced glans on dorsal penile pedicle mounted on the crura of the conjoined corpora cavernosa. De-gloved unfurled proximal penile skin formed the introitus, hood for clitoris and...