ABSTRACT
[Objective]To investigate the etiology,pathological characteristic and therapeutic effect of spontaneous rupture of the finger extensors.[Method]Twelve patients were included in this research group.Eight cases were diagnosed as spontaneous rupture of the extensor pollicis long(EPL) and were repaired by transfer of the extensor indicis proprius(EIP).Three cases were spontaneous double rupture of the the ring and small finger extensors.The distal stump of the ring finger extensor was woven into the middle finger extensor and the EIP was transferred to reconstruct the extensor digiti quinti.There was one case of spontaneous triple rupture of the the middle,ring finger and small finger extensors.Transplantation of frozen allogenic extensors was utilized.[Result]The finger extensor rupture occurred after either rheumatic arthritis or distal radius fracture.The former pathological examination showed that the tenosynovitis and chronic inflammation of tendons accompanying with localized necrosis was dominant,while tendon fiber rupture played an important role in the latter.All patients achieved 100% of good results and no recurrent rupture occurred.[Conclusion]The inflammation invasion or attrition in the fracture site was a patological basis to cause spontaneous rupture of finger extensors.The EPI transposition was a reliable option to reconstruct the EPL.It is suggested that allogenic tendon transplantation be applied in the case of multiple ruptures of the extensor tendons.
ABSTRACT
[Objective]To report the surgical managements and their outcomes in high pressure injection injuries of the hand(HPIIH) in 5 cases.[Method]Open wound technique and series debridement in all 5 cases were performed.The residual skin defects following debridement were repaired with cross-finger island flap in 1 case.[Result]From November 2001 to November 2005,5 cases of HPIIH were treated in our department and the wounds were healed satisfactorily.The flap was survived.Amputation of the finger was executed in 1 case.[Conclusion]The time of the first debridement after injury determines the prognosis.Aggressive wound debridement is a key point for good wound healing in HPIIH.
ABSTRACT
Objective To investigate the clinical result of reconstructed thumbs and fingers using frozen allogeneic composite tissues of fingers and autogenous toe Methods Fifty thumbs and fingers were reconstructed in 24 patients (25 hands) by allogeneic composite tissues of finger wrappoed by free neurovascular big toe nail skin flap and combined transplantation with autogenous second toe 15 patients were followed up for 4 years in average with examination in the ambulant clinic, communication and X ray photography to evaluate the clinical effect Results Recovered sensory function of the reconstructed fingers as well as good opposition function were seen There were Charcot's like arthrosis of allogeneic MP and arthroclisisof IP in 2 cases The postoperative gait of the doner's feet was normal The site of grafted skin on big toe was rubbed easily in 4 cases and the valgus hallexo of the doner's foot were seen in 3 cases, the plantaris callus in 2 cases Postoperative immunological rejection didn't elicit The junction between implanted allo phalangen tendon and autophalanges tendon were reliably healed Conclusions This operation gives reconstructed more fingers without sacrificing more toes for patients The walking function of donor foot is good The antigenicity of allogeneic grafts could be abated after preservation under 30℃ or frozen dried