Techniques in hand & upper extremity surgery
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Tech Hand Up Extrem Surg · Mar 2018
Case ReportsReconstruction of a Circumferential Upper Extremity Soft Tissue Defect With a Dermal Regeneration Template and Skin Grafting.
Extensive degloving injuries of the upper extremity are rare and pose unique reconstructive challenges. Circumferential loss of soft tissue coverage over the elbow treated by skin grafting is often complicated by elbow contracture and decreased range of motion, requiring secondary contracture release and free-flap reconstruction to restore function. As an alternative approach, we report a good outcome after the use of a dermal regenerative template and subsequent split-thickness skin grafting. ⋯ Six months after skin grafting, the patient had stable soft tissue coverage of the upper extremity. Shoulder motion measured 120-degree abduction and 140-degree forward flexion and elbow range of motion was 15 to 150 degrees. In this case, an excellent clinical outcome was obtained with a dermal regenerative template, aggressive wound care, and a multidisciplinary team approach.
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Tech Hand Up Extrem Surg · Mar 2018
Interlocking K Wires Followed by Immediate Mobilization for Fractures of the Hand.
We describe a technique of interlocking Kirschner wires to improve stability after fixation of fractures of the hand. This enables immediate mobilization of the injured fingers thus reducing the need for prolonged postoperative physical therapy and consequently diminishing chances of posttraumatic stiffness. ⋯ The technique has proven to be simple, versatile, and cost-effective. Patient compliance and satisfaction has been high and results have been gratifying.