The Journal of hand surgery, European volume
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We have developed a simple, cheap and efficient method of management of fingertip injury using a semi-occlusive dressing ("Opsite"--Smith and Nephew). The fingertip is covered with the "Opsite" once a week only. ⋯ This semi-occlusive "skin" allows the healing environment to reach an optimal milieu (e.g. pH, oxygen, tension, immunoagents) actively promoting granulation tissue formation and epithelialization. The result of 200 fingertip injuries treated with this method proves the development of a near normal pulp shape and useful epithelium within an average of 20 days.
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J Hand Surg Eur Vol · Apr 1993
Minimal tourniquet pressure to maintain arterial closure in upper limb surgery.
Complications of the pneumatic tourniquet used during limb surgery result from excessive direct pressure. Traditional recommendations suggests parameters for maximum pressure and time limits rather than the minimal effective pressure to achieve a bloodless field. A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate haemostasis in the upper limb. ⋯ The mean calculated tourniquet pressure was 202.3 +/- 34.2 mmHg, well below the 250 to 300 mmHg previously recommended. The technique consisted of inflating the tourniquet to a pressure of 300 mmHg, then reducing it to the calculated value. A bloodless field was maintained in all patients.
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J Hand Surg Eur Vol · Oct 1992
Dorsal fracture subluxation of the proximal interphalangeal joints treated by extension block splintage.
In a prospective study, 27 consecutive patients with dorsal fracture subluxation of the PIP joint were treated conservatively using an extension block splint, with good results in 70%. The percentage surface involved with the fracture varied considerably (19-77%) the average being 55%. ⋯ These patients had a less favourable outcome. We feel that all such fractures can be treated by splintage, provided that early reduction is maintained in the splint and checked by serial radiology.
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J Hand Surg Eur Vol · Oct 1992
Dorsal fracture subluxation of the distal interphalangeal joint of the finger and the interphalangeal joint of the thumb treated by extension block splintage.
In a prospective study six patients with dorsal fracture subluxation of the IP joint of the thumb or the DIP joint of the finger were treated conservatively using an extension block splint. The fracture size varied from 22% to 47% of the articular surface of the volar base of the terminal phalanx. ⋯ Only one case in the study complained of any pain, and this was minimal. Conservative treatment using extension block splintage for this injury is as good as a surgical approach.
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J Hand Surg Eur Vol · Oct 1992
Comparative StudyIs early vascularization of nerve grafts necessary?
Revascularization and regeneration through vascularized and non-vascularized nerve grafts were compared on optimal and adverse graft beds in 76 rabbit sciatic nerves. A delay in revascularization of more than 14 days was found to occur in 30 mm long, non-vascularized nerve grafts placed on completely avascular graft graft beds. ⋯ In rabbits, the provision of early vascularity does not appear to confer superior regeneration through nerve grafts. The clinical use of vascularized nerve grafts is discussed in the light of these results.