ABSTRACT
Essential aspects of emergency department assessment and initial treatment of patients with traumatic amputations are outlined. Pitfalls of early treatment and indications for replantation are discussed. The dogmatic approach is avoided.
Subject(s)
Amputation, Traumatic/surgery , Hand Injuries/surgery , Replantation , Age Factors , Contraindications , Finger Injuries/surgery , Humans , Vascular Surgical ProceduresABSTRACT
450 wrists in 362 patients underwent release of carpal tunnel compression combined with synovialectomy and reconstruction of the retinaculum flexorum between 1981 and 1989. To reconstruct the retinaculum flexorum, a "flap" of the antebrachial fascia continuous with the retinaculum flexorum, based radially and distally, was elevated and sutured to the hook of the hamate. This technique provides for carpal tunnel decompression while preserving the biomechanical role of the retinaculum flexorum and the normal anatomic relationship between the flexor tendons and the axial skeleton. The patients in this study appeared to recover function faster and more completely than those undergoing division of the retinaculum flexorum alone. No secondary procedures for recurrent carpal tunnel compression were necessary.
