Acute Hand Injuries

Cannon, David

doi:10.1016/b978-0-323-07243-4.00065-7

Campbell's Operative Orthopaedics 2013

DOI: 10.1016/b978-0-323-07243-4.00065-7

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Acute Hand Injuries

David Cannon¹

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2019

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Cited by 2 publications

References 124 publications

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The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands

Woo¹,

Lee

Chong

et al. 2019

J Hand Surg Eur Vol

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We report the fate of neglected vascular injury in cases of incomplete amputation of the digits and hand after delayed revascularization. Twelve patients underwent primary bone fixation, tendon or skin repair for hand injuries without vessel repair despite ischaemic findings. There was discoloration or necrosis of the fingertips during follow-up examination and the patients were referred to us for treatment. The mean warm ischaemic time was 53 hours (range 17–120). Delayed revascularization was performed with end-to-end anastomosis of the digital arteries in eight and vein graft in four cases. Digital nerves were repaired in four cases and flexor tendons in two cases. Of the 12 cases, eight cases showed complete survival. However, in four patients, complete necrosis of the fingers occurred, with one finger surviving partially. Revision amputation was performed in the four cases where necrosis occurred. We conclude that neglected vascular injury associated with incomplete amputation of digits and hands can be overcome in some patients by delayed revascularization even after prolonged warm ischaemic time. Level of evidence: IV

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The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands

Woo¹,

Lee

Chong

et al. 2019

J Hand Surg Eur Vol

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Longitudinal extensibility of the dorsal skin of the hand

Bağır

Eskandari

2019

J Hand Surg Eur Vol

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We aimed to assess the longitudinal extensibility of the dorsal skin of the hand. Measurements were done in five hand positions on the dominant hands of 64 volunteers. The positions were full flexion of the wrist and fingers, drop hand, flat hand, hand with opposed thumb and full extension. Dorsal marks were made on the skin in full flexion. The marks were transferred to transparent parchment paper strips with the hand in the different positions. Skin extensibility was assessed by the change in the distance between two skin marks from the full extension position to the other positions. Opposition required the highest degree of skin extensibility in the dorsal radial region, followed orderly by ulnar and central regions. Generally, the extensibility increased from distal to proximal and from ulnar to radial. These findings may be useful in the management of dorsal hand soft tissue defects.

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Acute Hand Injuries

Cited by 2 publications

References 124 publications

The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands

The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands

Longitudinal extensibility of the dorsal skin of the hand

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