ABSTRACT
Chondrosarcomas are rare malignant tumours of the bone with hyaline cartilage differentiation - only 1.5% affect the hands. Currently there is a limited range of techniques available to reconstruct the metacarpophalengeal joints affected by such neoplasias. We report a 30-year-old lady who presented with a grade 2 chondrosarcoma in the epiphseal region of her fifth metacarpal who underwent enbloc resection of the affected metacarpal and immediate reconstruction, using a Swansons arthroplasty and non-vascularised iliac crest bone graft. Our findings are presented after follow-up of 9 years and we review the current reconstructive options available.
Subject(s)
Arthroplasty , Bone Neoplasms/surgery , Bone Transplantation , Chondrosarcoma/surgery , Metacarpal Bones/surgery , Metacarpophalangeal Joint/surgery , Adult , Female , HumansABSTRACT
Two cases are presented where the use of epoprostenol sodium (prostacyclin) was used intraoperatively to prevent platelet thrombus during arterial microvascular anastomoses. Both patients required a free muscle transfer at an unfavourable time following injury when platelet thrombus formation was a significant risk.
Subject(s)
Epoprostenol/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Postoperative Complications/prevention & control , Surgical Flaps , Thrombolytic Therapy , Thrombosis/prevention & control , Adult , Anastomosis, Surgical , Blood Platelets/physiology , Humans , Male , Microcirculation/surgery , Microsurgery , Muscles/blood supplyABSTRACT
The use of a single osteotomy combining both rotation and angulation is described, with a means of achieving the correct angle and direction of the osteotomy. Patients who have been treated by this method are presented.
Subject(s)
Hand Deformities, Acquired/surgery , Hand Deformities, Congenital/surgery , Osteotomy/methods , Adolescent , Aged , Child , Child, Preschool , Female , Fingers/surgery , Humans , Male , Middle Aged , Thumb/surgeryABSTRACT
A new incision is described for the correction of radial club hand. By the use of a bilobed flap, redundant skin is transferred from the ulnar side of the wrist to the radial side, where there is tension as the wrist becomes straight. The flap has been shown to be safe and effective in six consecutive cases, and access to the wrist and surrounding soft tissue structures is excellent.
