Hand clinics
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Review Case Reports
World experience after more than a decade of clinical hand transplantation: update from the Louisville hand transplant program.
In the last 12 years, the Louisville CTA program has screened more than 600 interested hand transplant candidates and has transplanted 6 patients with 7 hand allografts. The program is a collaborative effort between the surgeons and staff of Kleinert, Kutz and Associates, Jewish Hospital and St. ⋯ The functional outcome and long-term results of clinical hand transplantation have exceeded initial expectations both within the program and in the community at large. This report summarizes the successes and challenges of the Louisville CTA experience in composite tissue allotransplantation.
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This article summarizes the findings from 3 recipients of hand allografts, including a description of the preparatory surgery and the transplant and secondary procedures to enhance the function of the hand, forearm, and arm allografts. The study focuses on the complications and disability reported by each patient, with a minimum follow-up of 2 years. ⋯ Hand transplantation is a major reconstructive procedure that requires careful medical follow-up. The authors provide the first report of a significant improvement in disabilities of the upper limb as a result of hand allotransplantation.
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Review Case Reports
World experience after more than a decade of clinical hand transplantation: update on the Polish program.
It has been demonstrated over the past decade that the generally achieved functional outcomes of patients after hand transplantation (HTx) are better than those of equivalent replantations. However, HTx should be performed in specialized centers with Institutional Review Board-approved transplantation programs. ⋯ A main emphasis of this subdepartment is to make the very involved process of donor recruitment, recipient screening, surgery, and postoperative treatment fully transparent. This article summarizes the experience of this center with HTx over the past 5 years.
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The first successful hand transplant in the modern era of reconstructive transplantation was performed in 1998. Since then, more than 65 hand and upper limb transplantations have been performed around the globe, with encouraging results. ⋯ The transplant must be successfully integrated into the patient's body and self-image and the recipient should be satisfied with the recovery of sensitivity and muscle function of the new limb. To achieve these goals, a proper and thorough design of the rehabilitation regimen is of critical importance.
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This article covers new and emerging techniques in small joint arthroscopy in the hand. Recent improvement in the quality of small joint scopes and advancement in techniques have allowed for many new small joint arthroscopic procedures in the hand. ⋯ Arthroscopic treatment of pantrapezial arthrosis is reviewed. Metacarpophalangeal arthroscopy for the treatment of synovitis, arthritis, fractures, and gamekeeper injuries are discussed, as is arthroscopy of the proximal interphalangeal, pisotriquetral, fourth and fifth CMC, and distal interphalangeal joints.