Repair of thumb abduction contracture by microsurgical transfer of partial toe (original) (raw)
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Osteoplastic thumb reconstruction in a case of neglected hand burn
Bangladesh Journal of Plastic Surgery, 2014
In this article we report a case of neglected hand burn with total loss of thumb with additional first web space and wrist contracture of the nondominant hand of a young female. Osteoplastic technique was applied for thumb reconstruction with additional fillet flap and posterior interosseous flap for first web space and thenar area. In this era of microsurgical reconstruction this simple and basic technique can still be useful in selected cases. DOI: http://dx.doi.org/10.3329/bdjps.v4i1.18691 Bangladesh Journal of Plastic Surgery January 2013, 4(1): 32-35
Study on Surgical Management of Post Burn Hand Deformities
Journal of clinical and diagnostic research : JCDR, 2015
Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome. It's a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department. Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months. Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties...
Surgical Management of Post Burn Hand Deformities
Pakistan Journal of Medical Sciences
Objective: To evaluate the efficacy of different surgical procedures on post burn contracture of hand. Methods: A quasi-experimental study design was conducted at the Department of Plastics and Reconstructive Surgery, Dow University of Health Science, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan from 1st June 2019 to 30th November 2019. Ninety-three participants of burned hand contracture of either gender, aged between 6- 60 years were included in the study. Resurfacing surgery with skin graft and loco-regional flaps were done according to type of contracture with individualization for each patient. All patients were kept under follow up for ninety days to assess efficacy of contracture release for each surgical procedure was noted. SPSS version 23 was used to analyse data. Results: Full thickness skin graft (FTSG) was performed in 60.2% cases, 17.2% with split thickness skin graft (STSG) and 12.9% with cross finger flaps. About 25% of recurrence was observed in cross finger ...
Journal of Evidence Based Medicine and Healthcare
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.
Indications and Predictors for Reconstructive Surgery After Hand Burns
The Journal of Hand Surgery, 2017
k{# and the Dutch Burn Repository R3 Group Purpose The objective of this study was to analyze the prevalence, indications, and type of reconstructive surgery and predictors of the outcomes of reconstructive surgery after hand burns. Methods A retrospective cohort study was conducted that included all patients admitted with acute hand burns in the Dutch burn centers from January 1998 through December 2002. The details of reconstruction including frequency, timing, indication, and techniques were collected over a 10-year follow-up period. Results Hand burns were seen in 42% (n ¼ 562 of 1,334) of all patients admitted with acute burns. Reconstructive surgery during the 10-year follow-up period was required in 15%. Contractures, especially of the first web space and little finger, were the most frequent indications for reconstructive surgery. Web spaces 1 to 3 and the little finger were the location most frequently operated on. The most frequently performed surgical technique was release of the contractures and the use of a random flap. Eighty percent of the reconstructive surgery patients required more than 1 reconstructive procedure, most often within 2 years of the initial injury. Secondary operations at the same location were required in 12%. In 40% of the patients, the first reconstructive surgery was performed within the first postburn year. Significant independent factors related to the need for reconstructive hand surgery were a larger area of full-thickness burns and surgical treatment of the hand during the acute phase. Conclusions Reconstructive surgery was required in 15% of patients who sustained hand burns. The majority of the patients requiring reconstructive surgery of the hand needed 2 or more operations to correct the contractures of the hand. Contractures of the little finger and first web space were the locations most frequently operated on. Patients with more extensive burns and who required hand surgery during the acute phase were more likely to need reconstructive surgery.
Plastic and Reconstructive Surgery, 2004
Correspondence and brief communications are welcomed and need not concern only what has been published in this journal. We shall print items of interest to our readers, such as experimental, clinical, and philosophical observations; reports of work in progress; educational notes; and travel accounts relevant to plastic surgery. We reserve the right to edit communications to meet requirements of space and format. Any financial interest relevant to the content of the correspondence must be disclosed. Submission of a letter constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the journal and in any other form or medium. The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such letters.
Late results of replantations in tip amputations of the thumb
Acta Orthopaedica et Traumatologica Turcica, 2008
Amaç: Başparmak Tamai tip 1 amputasyonlarda uygulanan replantasyonlar geriye dönük olarak değerlendirildi. Çalışma planı: Çalışmaya, başparmak tırnak yatağı distalinde meydana gelen Tamai tip 1 amputasyonlar nedeniyle replantasyon uygulanan ve tedavi sonrasında dolaşım devamı sağlanan 14 hasta (12 erkek, 2 kadın; ort. yaş 28; dağılım 14-40) alındı. Tüm hastalarda santral digital arter anastomozu yapıldı. Anastomoza uygun ven bulunabilen dört hastada birer adet volar ven anastomozu yapıldı. Sinir tamiri sadece üç hastada yapılabildi. Duyu değerlendirmesi Semmes-Weinstein testi, iki nokta ayrım testi, hareketli iki nokta ayrım testi ve vibrasyon testi ile yapıldı; ayrıca, hastalar parmak atrofisi, soğuk intoleransı ve tırnak yatağı deformiteleri açısından incelendi. Ortalama takip süresi 11 ay (dağılım 6-48) idi. Sonuçlar: Semmes-Weinstein testi beş parmakta (%35.7) yeşil (dağılım 2.83-3.22), sekiz parmakta (%57.1) mavi (dağılım 3.22-3.61), bir parmakta (%7.1) mor (dağılım 3.84-4.31) idi. İki nokta ayrım testi ortalama skoru 6.9 mm (dağılım 3-11 mm), hareketli iki nokta ayrım testi ortalama skoru 4.5 mm (dağılım 3-6 mm) bulundu. Aynı elin sağlıklı parmaklarıyla karşılaştırıldığında, vibrasyon altı başparmakta (%42.9) artmış, altı başparmakta azalmış bulunurken, iki başparmağın (%14.3) vibrasyonu diğer parmaklarla eşit idi. Beş parmağın (%35.7) replante edilen kısmında atrofi; üçer hastada (%21.4) ise soğuk intoleransı ve tırnak deformitesi görüldü. Hastaların işe dönüş süreleri ortalaması 3.2 aydı (dağılım 2-6 ay). Çıkarımlar: Başparmak distal uç replantasyonları, teknik zorluklara rağmen, görünüm açısından ve fonksiyonel açıdan iyi sonuçlar vermektedir. Sinir tamiri yapılamayan olgularda da yeterli duysal iyileşme sağlanmaktadır.