SURGICAL MANAGEMENT OF DISTAL PHALANGEAL INJURIES OF FINGERS (review)

Khodzhabaghyan, Z.S.; Pshenisnov, Kirill P.; Abraamyan, D.O.; Vinnik, Sergey V.

doi:10.17223/1814147/56/11

Issues of reconstructive and plastic surgery 2016

DOI: 10.17223/1814147/56/11

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SURGICAL MANAGEMENT OF DISTAL PHALANGEAL INJURIES OF FINGERS (review)

Z.S. Khodzhabaghyan¹,

Kirill P. Pshenisnov²,

D.O. Abraamyan³

et al.

Abstract: Настоящий обзор основан на анализе отечественной и зарубежной литературы о хирургическом лечении повреждений дистальных фаланг пальцев кисти. Приведено описание имеющихся на настоящий момент клас-сификаций повреждений кончиков пальцев, возможных ошибок, допускаемых в ходе лечения на разных уров-нях оказания медицинской помощи. Особое внимание уделено современным методикам восстановления целостности кончиков пальцев кисти, оценке результатов лечения, наиболее часто встречаемым осложнениям и некоторым методам их… Show more

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Cited by 2 publications

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Microsurgery Techniques for Patients with Traumatic Thumb Amputation

Валеев

Garapov

Бикташева

2019

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. Traumatic amputations of a thumb may happen as a result of severe mechanical injuries with the primary detachment and destruction of tissues, or following deep burns, frostbites or ischemia. In 70 to 80% of cases of disability and the loss of occupational fitness the key causes are traumatic digit and hand amputations. In 50% of cases the loss of ability to work is due to an amputation of a thumb. This makes the issue of thumb reconstruction a priority in surgery of the hand.Materials and methods. This paper presents our experience in the reconstruction of the functional abilities of the hand in 48 patients with traumatic amputations of a thumb. This was performed with the use of reconstructive plastic microsurgery techniques, namely the free transplantation of a second toe onto the hand. All the patients had a thumb stump at the level of the distal part of the metacarpal bone or the proximal part of the proximal phalanx.Results and discussion. A positive outcome was achieved in 45 out of the 48 patients treated. Autograft necrosis occurred in three cases. For these patients the thumb reconstruction was performed with the use of other, less functional methods. The functional condition of the hand manifested an improvement according to the electromyography data obtained at the maximum tonic tension of the thenar eminence muscles, flexor and extensor muscles of the reconstructed digit. In all the cases the hand strength increased by 40 to 90% after the reconstructive surgery; the authors attribute this to the recovery of the key handgrip abilities. According to Doppler ultrasonography data the blood flow velocity and the level of blood filling increased in the hand treated.Conclusion. The reconstruction of functional abilities of the hand with traumatic thumb amputation must be carried out taking into account the available methods of surgical correction and which one of these would be optimal, the evaluation of the patient’s mental status and his or her drive for the fastest possible recovery of the shape and function of the hand. The free autograft of a second toe in place of the lost thumb with microsurgical vascular anastomoses makes it possible to restore most completely the aesthetic and functional abilities of the hand in the shortest possible timeframe.

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Microsurgery Techniques for Patients with Traumatic Thumb Amputation

Валеев

Garapov

Бикташева

2019

Kreativnaâ hirurgiâ i onkologiâ

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Replantation fingertip without venous anastomoses in children

et al. 2021

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Objective. Traumatic complete and partial finger amputations are rare in comparison with adults. There are significant differences between mechanism of trauma, principles of treatment children with this type of injury in comparison with adults.Clinical case. A 15-years old child suffered from injury by axe, which caused the traumatic fingertip amputation of III and IV digits of his right hand. Replantation of both amputated parts was performed. Arteries and nerves were repaired with no veins anastomosed. As a result - survival of replanted parts.Discussion. A submillimeter diameter of vessels and potential venous congestion are basic problems that a surgeon deal with when perform the replantation of fingertips. Respectively, a difficulty in post-operative care of patient appears.Conclusion. Replantation of amputated part of finger is a golden standard of treatment of children with a described type of injury. The correct deliverance of amputated parts, the shortest time of ischemia as possible, a qualitive operation and post-operative care play an important role in successful survival of the replanted segments.

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SURGICAL MANAGEMENT OF DISTAL PHALANGEAL INJURIES OF FINGERS (review)

Cited by 2 publications

References 52 publications

Microsurgery Techniques for Patients with Traumatic Thumb Amputation

Microsurgery Techniques for Patients with Traumatic Thumb Amputation

Replantation fingertip without venous anastomoses in children

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