ABSTRACT
Due to the exposure of the hands in the daily routine, defect wounds of the hand are common. The injury severity varies and ranges from small fingertip defects to large soft tissue lesions with exposed tendons, nerves and vessels. The complete extent of the soft tissue defect is often only recognizable after meticulous debridement. A considerable variety of techniques for defect coverage are available to the surgeon but the actual challenge is to select the most appropriate procedure which will result in the smallest possible residual defect. This review article presents the diagnostic approaches to soft tissue defects of the hand and current treatment options.
Subject(s)
Debridement , Finger Injuries/surgery , Occlusive Dressings , Skin Transplantation , Soft Tissue Injuries/surgery , Thumb/injuries , Thumb/surgery , Finger Injuries/classification , Finger Injuries/diagnosis , Humans , Postoperative Care , Soft Tissue Injuries/classification , Soft Tissue Injuries/diagnosis , Surgical Flaps/surgeryABSTRACT
Carpal bone fusions for secondary reconstruction are still indispensable despite state of the art diagnostic tools and modern treatment techniques for wrist lesions. The former fusions stabilize the wrist and enable sufficient residual carpal mobility. Pain can be reduced significantly by arthrodesis of destroyed joints and the progress of osteoarthritis may be stopped or delayed. This review presents commonly used fusions with their inherent indications, contraindications and complications.
Subject(s)
Arthrodesis/instrumentation , Arthrodesis/methods , Joint Diseases/diagnosis , Joint Diseases/surgery , Physical Examination/methods , Wrist Joint/diagnostic imaging , Wrist Joint/surgery , Diagnosis, Differential , Evidence-Based Medicine , Humans , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Fractures of the distal radius are very common. The majority of patients are elderly females. High impact trauma are often responsible for fractures in young men. Clinical and radiological diagnostics, including computer-assisted tomography (CAT) scan, are generally sufficient. The indication for conservative treatment is still recommended for specific fracture patterns. Application of palmar locking plates after open reduction proved to be efficacious for the majority of fracture patterns. Furthermore, precise detection and treatment of concomitant lesions are mandatory in order to prevent complications.
Subject(s)
Fracture Fixation, Internal/methods , Postoperative Complications/prevention & control , Radius Fractures/diagnosis , Radius Fractures/therapy , Wrist Injuries/diagnosis , Wrist Injuries/therapy , Bone Plates , Bone Screws , Combined Modality Therapy/methods , Evidence-Based Medicine , Exercise Therapy/methods , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/instrumentation , Germany , Humans , Immobilization/methods , Postoperative Complications/etiology , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Joint infections of the hand may lead to irreversible lesions and impairment of hand function due to early cartilage damage. Furthermore, persistent infections which are not treated immediately can cause osteitis and/or spread systemically. Finger joints are prone to infection due to bite wounds or crush and sharp injuries. Whereas the wrist is often affected in patients with immunosuppression or chronic diseases, such as diabetes mellitus. If diagnosis and therapy are delayed, joint damage may be inevitable. Therefore, urgent treatment of the infected joint is imperative to preserve the function of the hand. This article reviews the current diagnostics and treatment of joint infections of the hand.
