The Reconstruction of the Mutilated Hand

Neumeister, Michael W.; Hegge, Thersa; Amalfi, Ashley N.; Sauerbier, Michael

doi:10.1055/s-0030-1253245

Cited by 32 publications

(23 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, we used groin flap to cover the dorsal defect that agreed with Neumeister, et al [19] .who used the groin flap to cover dorsal hand defect. Derek, et al [5] .noticed that the success of a contracture release was not related to achieving normal abduction angles, it might be related to achieving a change in the abduction angles from the patients' preoperative values.…”

Section: -D)supporting

confidence: 58%

Reconstruction of Postburn Contracture of First Web Space of the Hand

Ahmed

2016

Zagazig University Medical Journal

View full text Add to dashboard Cite

Background: Soft tissue reconstruction of the first web space remained a challenge for plastic and reconstructive surgeons. First web space adduction contractures are a common consequence of hand burns. Many reconstructive techniques are used and investigation for more effective methods continues. Objective: assess the range of movement as regard opposition, palmar abduction and thumb extension. Also assessed the depth of web space after reconstruction of post burn contracted first web space to ass the method of covering the defect after release.. Materials and Methods: 35 patients' ages ranged from 12 to 59 years (with mean 31.7), years; 23 males and 12 females admitted to our Hospital during the period from June 2008 to May 2012. All patients were suffering from post-burn first web contractures. The patients underwent a variety of surgical procedures. The follow-up period ranged from one to three years. Results: Full range of motion achieved in most patients, but not those with joint affections. Conclusions: In our experience, surgical correction of first web space contractures-in the form of flaps good results followed by skin grafts-results in meaningful functional enhancement. The outcomes depend primarily on the severity of contracture. Functionally limiting recontracture is rare in our experience and its best prevented by appropriate therapy

show abstract

Section: -D)supporting

confidence: 58%

Reconstruction of Postburn Contracture of First Web Space of the Hand

Ahmed

2016

Zagazig University Medical Journal

View full text Add to dashboard Cite

show abstract

“…Depending on the size, depth, and geometry of the wound bed as well as the extent of involvement of associated structures, free tissue transfers are often most appropriate and can be performed by designing fasciocutaneous, myocutaneous, fascia only, or chimeric flaps to address various issues such as the requirement for dead-space obliteration, resurfacing, coverage for exposed hardware, tendon glide, functional transfers, and simultaneous musculotendinous and nerve repairs. 22 Notwithstanding the incredible versatility of free flaps in addressing the multitude of possible defect configurations, it is of utmost importance for the surgeon to have an appreciation for the fine balance between the reconstruction required and further morbidity from donor flap harvest.…”

Section: Algorithmic Approachmentioning

confidence: 99%

Approach to Complex Upper Extremity Injury: An Algorithm

Askari

Chim

2015

Seminars in Plastic Surgery

View full text Add to dashboard Cite

Patients with complex upper extremity injuries represent a unique subset of the trauma population. In addition to extensive soft tissue defects affecting the skin, bone, muscles and tendons, or the neurovasculature in various combinations, there is usually concomitant involvement of other body areas and organ systems with the potential for systemic compromise due to the underlying mechanism of injury and resultant sequelae. In turn, this has a direct impact on the definitive reconstructive plan. Accurate assessment and expedient treatment is thus necessary to achieve optimal surgical outcomes with the primary goal of limb salvage and functional restoration. Nonetheless, the characteristics of these injuries places such patients at an increased risk of complications ranging from limb ischemia, recalcitrant infections, failure of bony union, intractable pain, and most devastatingly, limb amputation. In this article, the authors present an algorithmic approach toward complex injuries of the upper extremity with due consideration for the various reconstructive modalities and timing of definitive wound closure for the best possible clinical outcomes.

show abstract

“…In theory, the contralateral hip may be used if the ipsilateral tissue is absent or unreliable. Neumeister et al provide an exhaustive summary of alternatives for mutilated hand reconstruction [25]. Free tissue options such as the latissimus dorsi are capable of covering large areas, and the serratus flap is effective for smaller defects.…”

Section: Discussionmentioning

confidence: 99%