Hand Surgery Program Abstracts

Abstract

Background:The operation scheme of fi nger reconstruction is based on manual measurement and visual estimate at present. The surgery is thus exposed to a large amount of randomness, blindness, and depending on the personal experience of the surgeon, his habits and subjective inclinations, as well as the diverse conditions of the blood supply of donor site, the outcome of the surgery can be greatly affected by these factors. Methods: Toe to hand reconstructive surgeries on 103 patients (123 fi ngers) were aided by preoperative and intra-operative analysis of the blood supply of donor site through CT angiography, computer aided design and 3D printing. Results: One hundred and twenty three fi ngers survived. The successful rate was 100%. Among them, 93 patients (111 fi ngers) had been followed up from 5 to 24 months postoperatively. The appearance of reconstructed fi ngers, static two-point discrimination, total active range of motion, and pinch strength were generally excellent. The majority of the patients were satisfi ed with the fi nal outcome. Conclusion:The aid of digital medicine technology in the reconstruction surgery of thumb and fi nger defect can greatly reduce the blindness and unpredictability, as well as contribute to the more ideal appearance, higher survival rate and better outcomes. HS04 SUPRASCAPULAR NERVE RECONSTRUCTION IN OBSTETRIC BRACHIAL PLEXUS PALSYM itchel S eruya , S hi H ong S hen , S ibon F uzzard , K eith M utimer , D avid M ccombe and B ruce J ohnstone Royal Children ' s Hospital Melbourne, VictoriaIntroduction: The purpose of this study was to evaluate the long-term shoulder function of patients undergoing suprascapular nerve (SSN) reconstruction via cervical root grafting versus spinal accessory nerve transfer. Methods: A retrospective review was performed of all infants treated for OBPP between 1995-2010. Inclusion criteria consisted of infants who underwent suprascapular nerve reconstruction and with preoperative and ≥ 36-month postoperative outcome data. Patients were categorized by the type of SSN reconstruction (graft versus transfer) and compared. Results: 74 patients met the inclusion criteria (46 transfers, 28 grafts). Preoperatively, both groups presented with median Toronto AMS scores of 2.0 for shoulder ABD and 0.0 for ER. Median postoperative follow-up was 9.0 years for grafts and 6.7 years for transfers. Both groups achieved a median AMS score of 5.0 for shoulder ABD at 12, 24, and 36 months postoperatively. Median AMS scores for shoulder ER was 1.0, 2.0, and 2.5 for grafts versus 2.0, 2.0, and 3.0 for transfers at 12 months, 24 months, and 36 months postoperatively. None of these differences reached statistical signifi cance. Composite Mallet scores were 13.3 for grafts versus 15.1 for transfers at 3-years postoperatively ( p < 0.05) and 13.7 for grafts versus 15.3 for transfers at 5-years postoperatively ( p = 0.07). The frequency of secondary shoulder surgery was 57.1% (16 of 28) for grafts and 26.1% (12 of 46) for transfers (OR 3.17, p = 0.02). Conclusions: Suprasca...