Adult ; Hand Injuries ; surgery ; Humans ; Male ; Occupational Diseases ; surgery ; Paint

A traumatic carpometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. Optimal treatment strategies for this injury are still a subject of debate. In this article, we report a case of bilateral thumb carpometacarpal joint dislocations: a unique combination of injuries. We believe our case is the second report of bilateral carpometacarpal joint dislocation regarding the thumb in English literature. It was successfully treated with closed reduction and percutaneous K-wires fixation on one side, and an open reduction and reconstruction of the ligament on the other side.
Bone Wires ; Carpometacarpal Joints/*injuries/*surgery ; Dislocations/*surgery ; Hand Injuries/*surgery ; Humans ; Male ; Middle Aged ; Thumb/*injuries/*surgery

The paper summarizes the academic thought and clinical experience of professor LI De-hua in treatment of facial nerve injury after total parotidectomy with blade needle based on jingjin (muscle region of meridian, sinew/fascia) theory. This disease is located at muscle regions of hand-/foot-three yang meridians; and the sinew/fascia adhesion is its basic pathogenesis, manifested by "transversely-distributed collaterals" and "knotted tendons". In treatment, the knotted tendons are taken as the points. Using the relaxation technique of blade needle, the lesions of sinews/fascia are dissected and removed to release the stimulation or compression to the nerves and vessels so that the normal function of sinews/fascia can be restored.
Humans ; Facial Nerve Injuries/surgery* ; Fascia ; Foot ; Hand ; Lower Extremity

OBJECTIVETo investigate the efficacy of buried purse-string suture in the treatment of mallet finger deformities.

METHODSFrom February 2009 to February 2010, 12 patients with closed non-fracture mallet fingers were treated by buried purse-string suture. The rupture tendons were sutured by purse-string suture with an atraumatic needle, and the knots were buried under subcutaneous tissue. External fixator was used at the extension position of the finger every night within three weeks after operation.

RESULTSAll patients were followed up for 6-12 months, mean 7 months. According to the Patel's evaluation criteria, 2 cases (17%) obtained excellent results, 7 good (58%), 2 fair (17%) and 1 poor (8%). The overall rate of the cases with excellent and good outcomes was 75%.

CONCLUSIONBuried purse-string suture is an easy and effective way to treat mallet finger deformities, with no serious postoperative complications or no need for reoperation.

External Fixators ; Finger Injuries ; surgery ; Hand Deformities, Acquired ; Humans ; Sutures ; Tendon Injuries ; surgery

OBJECTIVETo explore a new method for repair of concurrent skin and nerve defect at palm and carpal on ulnar side.

METHODSFrom April 2000 to August 2009, five cases with concurrent skin and nerve defect at palm and carpal on ulnar side were reconstructed with free medial plantar flaps. Palmar nervous proprii defect at ulnar side of little finger was repaired by the first toe tibia nervous proprii in one case. The superficial branch of radial nerve was applied to repair the defect of ulnar nerve, as well as its deep or superficial branch in two cases. The superficial branch of radial nerve was also used to repair the defect of superficial branch of ulnar nerve, common palmar digital nerve of the fourth finger, Little finger ulnar palmar nervous proprii in one case. The dorsal branch of ulnar nerve was applied to repair the defect of superficial branch of ulnar nerve, common palmar digital nerve of the fourth finger, little finger ulnar palmar nervous proprii in one case. The vascular bundle of medial plantar flap was anastomosed with ulnar vascular bundle. The wounds at donor sites were covered with free skin grafts which were obtained from upper leg.

RESULTSAll the flaps and skin grafts were survived completely. The five patients were followed up for six months to four years with no muscular atrophy or claw hand deformity. The esthetic result was satisfied. The Sensory of flaps and fingers recovered to S3 to S3+. The two-point discrimination distance on flaps was range from 7 mm to 10 mm. The postoperative comprehensive evaluation was excellent in the cases whose superficial and deep branches of ulnar nerve were repaired.

CONCLUSIONSFree medial plantar flap is an effective method to repair concurrent skin and nerve defect at palm and carpal on the ulnar side.

Adult ; Female ; Foot ; surgery ; Free Tissue Flaps ; Hand Injuries ; surgery ; Humans ; Male ; Skin ; injuries ; Ulnar Nerve ; injuries ; surgery ; Wrist Injuries ; surgery ; Young Adult

OBJECTIVETo summarize the experience of repairing of severely burned hand and wrist with abdominal thin skin flaps in insertion pattern.

METHODSTwelve burn patients with the dorsum of the hands and wrist being severely injured were enrolled in this report. The donor sites of the flaps were selected on the upper abdomen in 4 cases and on the lower abdomen in 8 cases. The division of the flap pedicles was done on the 10th - 13th postoperative days.

RESULTSAll the flaps survived except that there were two necrotic areas sized 2 cm x 2 cm and 1 cm x 1 cm, respectively, on the distal ends of the flaps in two cases. The hand function and contour recovered satisfactorily after the operation.

CONCLUSIONIt could be an ideal choice for the repair of severely burned hand and wrist with abdominal thin skin flaps.

Abdomen ; Adult ; Burns ; surgery ; Female ; Hand Injuries ; surgery ; Humans ; Male ; Skin Transplantation ; methods ; Time Factors ; Wound Healing ; Wrist Injuries ; surgery

OBJECTIVETo introduce a new free composite flap for the treatment of electric injuries of hands, which can repair the skin, blood vessels, tendons and nerves injuries in just one operation. It may improve the prognosis of electric hand injuries.

METHODS5 patients with electric injuries at wrist were treated by the free composite flap. The procedure is followed: The composite flap was harvested from medial lateral crural skin flap. Its blood supply was from tibial posterior vessels. The perforans arteries to flap and the branches to plantaris were preserved, and the nerve suralis and tendon plantaris were compound into the flap by carefully dissection of crural fascia. At the same time, 3-4 tendons of extensor digitorum longus were inserted into the superficial crural fascia. Thus, blood vessels, nerves and tendons were combined into the flap before transplantation. The composite flap was then transplanted into the recipient site of the electric injuries of hand to repair the long defects of the skin, blood vessels,nerves and tendons in one operation. The evaluation methods of the prognosis are the follows: the active motion function of finger was assessed by flexion and extension function of the fingers. The sensibility function was tested by the standards recommended by British Medical Association.

RESULTSThe patients were followed up from 3 to 12 months. All the flaps were survived. Six months after operation, the flexion distance from tip to palmar crease and extension distance from tip to horizontal level of 3 patients were 4-5 cm and 3-4 cm respectively, and the other 2 patients were recovered from 6 cm and 5 cm to 4 cm and 4 cm respectively. The sensibility of finger skin reached to S2 level, and skin temperature rose.

CONCLUSIONThe free medial lateral crural composite flap was an ideal one to cure electric injuries at wrist, for it repairs skin, nerves, vessels and tendons defects in just one operation.

Adult ; Electric Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Surgical Flaps ; Wrist ; surgery ; Wrist Injuries ; surgery ; Young Adult

Adult ; Barotrauma ; diagnosis ; surgery ; Hand Injuries ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Paint

OBJECTIVETo investigate the applied anatomy of the proximal posterior interrosseous artery perforator flap (PIAP) and report the clinical results of repairing the soft tissue defects in hands.

METHODSBetween September 2007 and January 2011, 21 patients with 24 soft tissue defects in hands were repaired with the free proximal PIAP flap transplantation. The size of the flaps ranged from 2.0 cm x 1.5cm to 7cm x 5cm. The longest length of these flaps was 9 cm. 9 flaps were dissected with one additional superficial vein to anastomose with the superficial vein at the recipient sites.

RESULTS19 flaps survived completely. Bubbles and violet color happened in 4 flaps which survived finally after partial suture removal. Flap necrosis occurred in one flap. The clinical results were satisfactory after 6-25 months of following-up, and the scars at the donor sites were not obvious.

CONCLUSIONSThe free PIAP flaps have constant, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defects in the hands.

Forearm ; Graft Survival ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; blood supply ; transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo investigate the therapeutic effects of microsurgical one-stage repair of hand flexor tendon injuries.

METHODSAmong 97 patients with (182 flexor tendons) hand injuries, 59 patients were male and 38 patients were female, ranging in age from 6 to 65 years, with an average of 32 years. Twenty-two patients got injuries by glasses, 32 patients got injuries by knife, 29 patients got injuries by saw, and 14 patients got crush injuries. The tendon injuries in this study consisted of 12 cases of I zone, 35 cases of II zone, 28 cases of III zone, 8 cases of IV zone and 14 cases of V zone. Sixty-eight patients complicated with injuries of blood vessel and nerve, and 53 patients also had fingers fractures. All the patients were treated with modified Kessler method to repair tendon at one-stage, and were given early rehabilitation step by step.

RESULTSAfter the treatment, 97 patients were followed up from 3 to 24 months. According to TAM standard, 48 patients got an excellent result, 39 good, 8 fair and 2 bad.

CONCLUSIONMicrosurgical one-stage tendon repair should be applied. Early rehabilitation and microsurgery repair are important for preventing tendon adhesion.

Adolescent ; Adult ; Aged ; Child ; Female ; Hand Injuries ; rehabilitation ; surgery ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Tendon Injuries ; rehabilitation ; surgery