The Experts below are selected from a list of 270 Experts worldwide ranked by ideXlab platform
Atalla Hammouda - One of the best experts on this subject based on the ideXlab platform.
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Reverse osseofasciocutaneous radial forearm flap for Thumb Reconstruction: a flap design and case series.
The Journal of hand surgery, 2005Co-Authors: Hamdy A. El-khatib, Atalla HammoudaAbstract:Purpose To report the outcome of the modified design of the osseofasciocutaneous radial forearm flap. The flap was modified because of problems associated with the use in Thumb Reconstruction. Methods We performed retrospective review of all patients who sustained nonreplantable Thumb amputations who had this procedure between August 2000 and March 2005. The patients' ages ranged between 24 and 39 years. Demographic data and details of the level of amputation and alternative surgical procedures were reviewed. Eight male patients were identified and constituted the study cohort. The size of flap, length of the radius harvested, time to union, sensibility (moving 2-point discrimination test), grip and pinch strengths, complications, and patient outcome were determined. Results All patients who had the butterfly design of the reverse-flow osseofasciocutaneous radial forearm flap had an adequate and painless soft-tissue padding on the tip of the reconstructed Thumb that provided good protection for the distal stump of the vascularized bone graft. Patients did not experience strictures at the bottom of the reconstructed tubes. Conclusions The butterfly design is a useful modification of the skin paddle of the reverse osseofasciocutaneous radial forearm flap for Thumb Reconstruction. The design offers an easy way to reconstruct a tube shape with adequate padding on the tip and no terminal scar. In addition it prevents the constricting effect of the circumferential scar on the button of the reconstructed tube. Type of study/level of evidence Therapeutic, Level IV.
Hamdy A. El-khatib - One of the best experts on this subject based on the ideXlab platform.
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Reverse osseofasciocutaneous radial forearm flap for Thumb Reconstruction: a flap design and case series.
The Journal of hand surgery, 2005Co-Authors: Hamdy A. El-khatib, Atalla HammoudaAbstract:Purpose To report the outcome of the modified design of the osseofasciocutaneous radial forearm flap. The flap was modified because of problems associated with the use in Thumb Reconstruction. Methods We performed retrospective review of all patients who sustained nonreplantable Thumb amputations who had this procedure between August 2000 and March 2005. The patients' ages ranged between 24 and 39 years. Demographic data and details of the level of amputation and alternative surgical procedures were reviewed. Eight male patients were identified and constituted the study cohort. The size of flap, length of the radius harvested, time to union, sensibility (moving 2-point discrimination test), grip and pinch strengths, complications, and patient outcome were determined. Results All patients who had the butterfly design of the reverse-flow osseofasciocutaneous radial forearm flap had an adequate and painless soft-tissue padding on the tip of the reconstructed Thumb that provided good protection for the distal stump of the vascularized bone graft. Patients did not experience strictures at the bottom of the reconstructed tubes. Conclusions The butterfly design is a useful modification of the skin paddle of the reverse osseofasciocutaneous radial forearm flap for Thumb Reconstruction. The design offers an easy way to reconstruct a tube shape with adequate padding on the tip and no terminal scar. In addition it prevents the constricting effect of the circumferential scar on the button of the reconstructed tube. Type of study/level of evidence Therapeutic, Level IV.
Edward A. Athanasian - One of the best experts on this subject based on the ideXlab platform.
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Thumb Reconstruction following resection for malignant tumors.
Plastic and reconstructive surgery, 2008Co-Authors: Babak J. Mehrara, Ahid Abood, Joseph J. Disa, Andrea L. Pusic, Eric G. Halvorson, Peter G. Cordeiro, Edward A. AthanasianAbstract:Background: Although limb salvage is possible for most extremity sarcomas, amputation has often been advocated as the treatment of choice for tumors involving the digits. The Thumb poses a dilemma, however, because loss of its function can severely impair the use of the hand and entire upper limb. The authors report their experience with Thumb Reconstruction following wide excision of bone and soft-tissue tumors of the Thumb. Methods: This was a retrospective review of all patients who underwent excision of Thumb or first ray tumors between 1994 and 2005 followed by Reconstruction at Memorial Sloan-Kettering Cancer Center. Patient demographics, tumor pathologic findings, ablative and reconstructive operations performed, postoperative adjuvant therapy, recurrence, and survival were analyzed. Function and Reconstruction outcomes were assessed. Results: Seventeen patients were identified with bone or soft-tissue sarcomas, melanoma, or squamous cell carcinoma. Median follow-up was 33 months (range, 6 to 105 months; mean, 47 months). Negative resection margins were achieved in all patients. Of the 16 patients who underwent Reconstruction, three had a Reconstruction using free tissue transfer, four had a pedicled flap, one had an axial based local flap, one had a fillet flap, and seven achieved wound closure directly or with the use of skin grafts. The mean American Musculoskeletal Tumor Society Score following Reconstruction was 28.8 (95.8 percent). Conclusions: Thumb Reconstruction and salvage after tumor resection following wide excision is technically possible. Reconstruction following accepted reconstructive principles and techniques can result in acceptable functional outcomes with low risk of complication.
Yang Jin - One of the best experts on this subject based on the ideXlab platform.
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Clinical experience of finger and Thumb Reconstruction
Journal of Practical Hand Surgery, 2008Co-Authors: Yang JinAbstract:Objective To explore the clinical effect of finger or Thumb Reconstruction with free toe.Methods 42 patients with 46 finger defects received different types of digital reconstructive operation with free toe tissue from September of 2000 to April of 2007.Results 45/46 fingers survive. According to the criterion of the Society of Hand Surgery CMA:Good rate was 77.7%.Conclusion Proper operation time ,skilled microsurgical technique, treatment of vascular variation or crisis and active rehabilitation training were the keys to the finger Reconstruction.
Alexander Y Shin - One of the best experts on this subject based on the ideXlab platform.
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traumatized index finger pollicization for Thumb Reconstruction
Journal of Hand Surgery (European Volume), 2008Co-Authors: Cesar J Bravo, Todd Horton, Steven L Moran, Alexander Y ShinAbstract:Purpose When the index finger is injured or severed in conjunction with a traumatic amputation of the Thumb, transfer of the injured index finger can restore the important function of the Thumb. The purpose of this study is to evaluate the results of the transfer of an injured index finger for traumatic loss of the Thumb. Methods Seven patients treated by pedicled transfer of a traumatized index finger after amputation to the ipsilateral Thumb were reviewed retrospectively. Postoperative evaluations included Thumb range of motion, opposition and pinch function, grasp and pinch strength, sensation, a pick-up test, and a patient-rated appearance of the Thumb and hand. Vascular patency of the traumatized index finger and Thumb was evaluated in each patient prior to Thumb Reconstruction. Results After an average of 4 years of follow-up for surviving patients, all had excellent postoperative function and satisfactory results. The period between injury and Thumb Reconstruction ranged from 5 months to 4 years. All patients were men with a mean age of 43 years. Amputation levels included the metacarpophalangeal joint in 2 patients, the first metacarpal in 2 patients, and the proximal phalanx in 3 patients. All transferred traumatic index fingers survived without complications. Conclusions Transfer of the injured index finger to the amputated Thumb serves as an excellent adjunct for treatment of traumatic Thumb amputations/crush injuries. Consistent results can be obtained while maintaining opposition and protective sensation after this procedure. However, technical demands are great, and initial injuries to the Thumb and index finger ultimately determine the final outcomes. Type of study/level of evidence Therapeutic IV.