Journal of Plastic Surgery and Hand Surgery最新文献

{"title":"Short term treatment of secondary lymphedema with hyaluronidase injections reduces mouse hindlimb lymphedema.","authors":"Farima Dalaei,&nbsp;Amar Bucan,&nbsp;Alexander Wiinholt,&nbsp;Mads Gustaf Jørgensen,&nbsp;Christian Rønn Hansen,&nbsp;Christina Baun,&nbsp;Svend Hvidsten,&nbsp;Eva Kildall Hejbøl,&nbsp;Henrik Daa Schrøder,&nbsp;Jens Ahm Sørensen","doi":"10.2340/jphs.v58.7791","DOIUrl":"https://doi.org/10.2340/jphs.v58.7791","url":null,"abstract":"<p><p>Lymphedema is a common complication following breast cancer treatment with axillary lymphadenectomy and radiotherapy. Currently, there is no curative treatment for this disease, hence there is a need for new therapeutic suggestions. The aim of this study was to investigate the effect of hyaluronidase (HYAL) injections after inducing hindlimb lymphedema in 36 female C57BL/6 mice. HYAL injections were administered every second day for 14 days in three groups: (1) HYAL for 1 week followed by saline for 1 week, (2) HYAL for 2 weeks, and (3) saline injections for 2 weeks. Volume of the lymphedema limb was weekly assessed with micro-computed tomography (μ-CT) scans for a total course of 6 weeks. Lymph vessel morphometry was assessed in the end of the study after staining cross-sections of the hindlimb for anti-LYVE-1 blindly. Lymphatic function was assessed by lymphoscintigraphy to assess lymphatic clearance. There was a significant reduction of the volume of lymphedema in mice treated with HYAL-7 compared with mice treated with HYAL-14 (p < 0.05) and saline (p < 0.05). No differences were detected in lymph vessel morphometry and the lymphoscintigraphy between groups. Short-term treatment with HYAL-7 might be a potential therapeutic suggestion for secondary lymphedema induced in mouse hindlimbs. In the future, clinical studies are needed to investigate the potential of HYAL treatment in human beings.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"40-47"},"PeriodicalIF":1.2,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term longitudinal follow-up of individuals with UCLP after Gothenburg twostage palate closure: surgical and speech outcomes.","authors":"Hans Mark,&nbsp;Jan Lilja,&nbsp;Christina Havstam","doi":"10.2340/jphs.v58.7317","DOIUrl":"https://doi.org/10.2340/jphs.v58.7317","url":null,"abstract":"<p><strong>Background: </strong>Delayed hard palate closure in unilateral cleft lip and palate (UCLP) patients show on a safe surgical method and good speech outcome, however, occurrence of orally retracted articulation before hard palate closure at 8 years. The aim of this study was to describe surgical and speech outcome in UCLP patients closing the hard palate at 3 years.</p><p><strong>Methods: </strong>A consecutive of 28 participants were operated with Gothenburg two-stage method including soft palate closure at 6 months and hard palate at 3 years. Surgical and speech outcome were evaluated. Recordings of sentences and spontaneous speech at 5, 10, 16, and 19 years were analyzed blindly and independently by three speech-language pathologists. Compensatory articulation, hypernasality, hyponasality, weak pressure consonants, and nasal air leakage were evaluated on ordinal four-point and intelligibility and perceived velopharyngeal function on three-point scales.</p><p><strong>Results: </strong>Long-term follow-up revealed a safe surgical method. Articulation disorders were present in 25-30% at 5-year but largely not later. About 20% had incompetent velopharyngeal function at 5 years but none at 19 years. Most participants were well intelligible after 5 years. Hard palate closure at 3 years indicated less occurrence of orally retracted articulation compared with a cohort who had hard palate closure at 8.2 years.</p><p><strong>Conclusions: </strong>Long-term, follow-up of individuals with UCLP after Gothenburg two-stage palate closure including closure of the soft palate closure at 6 months and hard palate at 3 years of age shows a safe surgical method and indicates less retracted oral articulation compared with hard palate closure at 8 years.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"19-25"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effects of homodigital dorsal branch of the proper digital artery flap on repairing soft tissue defects of fingers.","authors":"Yong Zhang,&nbsp;Jupu Zhou,&nbsp;Jianzhong Qin","doi":"10.2340/jphs.v58.11967","DOIUrl":"https://doi.org/10.2340/jphs.v58.11967","url":null,"abstract":"<p><p>Homodigital dorsal branch of proper digital artery flaps (HDBPDAF) have been proved to be an excellent alternative for repairing distal soft tissue defects of fingertip. This study was to evaluate the clinical effects of HDBPDAF on repairing various soft tissue defects of fingers, including thumb and multi-fingers defects. A retrospective study was conducted in 40 patients with 44 finger defects treated with HDBPDAF from August of 2014 to December of 2021. The defects were located on fingertip and finger pulp (n = 28), finger pulp (n = 10), and dorsum of fingers (n = 6) with bone, tendon or nerve exposed. The average size of the flaps was 1.9 × 3.9 cm. Semmes Weinstein monofilament (SWM) test, Static two-point discrimination (2-PD), Total active motion (TAM) scores, the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score were evaluated through long-term follow-up. Forty-two flaps survived completely and uneventfully. Partial flap necrosis was observed in two flaps because of the absence of dorsal branch of proper digital artery. No visible scar contracture and joint limitation were noticed. The mean SWM score of flaps was 4.11 ± 0.4 g. The average 2-PD of the flaps was 8.9 ± 0.9 mm. The mean TAM of injured fingers was 268.7 ± 5.2° (contralateral side: 283.2 ± 6.4°, p < 0.05). The mean DASH score value was 29.7 ± 7.9. The HDBPDAF was an optimal and reliable alternative to repair various distal soft tissue defects of fingers, despite a lower absent rate of dorsal branch.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"18-23"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Dihydroartemisinin Improves Wound Healing in Diabetic Mice.","authors":"Shanshan Shi,&nbsp;Yanhong Gong,&nbsp;Hailiang Hu,&nbsp;Shuai Peng,&nbsp;Ju Liu","doi":"10.2340/jphs.v58.5775","DOIUrl":"https://doi.org/10.2340/jphs.v58.5775","url":null,"abstract":"<p><p>Impaired skin wound healing is a common complication of diabetes mellitus. Angiogenesis is a critical step in wound healing because it allows oxygen and nutrients to reach the injured area, thereby promoting wound cell proliferation, re-epithelialisation, and collagen regeneration. However, the neovascularisation ability of patients with diabetes often decreases. Therefore, finding ways to improve diabetic angiogenesis is important for treating diabetic wounds that do not heal. To the best of our knowledge, it is unclear whether dihydroartemisinin (DHA) affects diabetic wounds. This study sought to determine how topical DHA affects the healing of diabetic wounds and how it is related to markers of angiogenesis. We topically applied DHA to full-thickness cutaneous lesions in a streptozotocin (STZ)-induced diabetic mouse model. Under a fluorescence microscope, the pathological morphology of the wound skin was observed, together with the positive expression of platelet endothelial cell adhesion molecule-1 (CD31) and vascular endothelial growth factor (VEGF). Western blotting was used to determine the CD31 and VEGF protein expression levels. The mRNA expression was determined using qualitative real-time polymerase chain reaction (qRT-PCR). We found that DHA can improve the expression of CD31 and VEGF, and accelerate wound healing in diabetic mice. We believe that DHA promotes angiogenesis, which is associated with increased VEGF signalling in vivo. Therefore, DHA can effectively accelerate the process of diabetic wound healing by promoting angiogenesis, implying that DHA may be used as a topical drug for the treatment of diabetic wounds.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"26-32"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and validation of a Finnish version of the Facial Clinimetric Evaluation (FaCE) Scale.","authors":"Arttu Mentula,&nbsp;Mikko Uimonen,&nbsp;Andrew Lindford,&nbsp;Sinikka Suominen,&nbsp;Jussi P Repo,&nbsp;Tuija Ylä-Kotola","doi":"10.2340/jphs.v58.6533","DOIUrl":"https://doi.org/10.2340/jphs.v58.6533","url":null,"abstract":"<p><strong>Background: </strong>The Facial Clinimetric Evaluation (FaCE) scale is a patient-reported health status instrument developed for assessing the health-related quality of life (HRQoL) in patients with facial nerve paralysis. The aim of this study was to translate and validate the FaCE scale for the Finnish-speaking population.</p><p><strong>Methods: </strong>The FaCE scale was translated according to international guidelines. Sixty patients in an outpatient clinic prospectively completed the translated FaCE scale and generic HRQoL instrument (15D). The objective facial paralysis grading was made using the Sunnybrook and House-Brackmann scales. Repeated FaCE and 15D instruments were mailed to patients 2 weeks later. Total scores of the FaCE instrument and subscales were calculated, and floor and ceiling effects were examined. Exploratory factor analysis was made. Internal consistency, reliability, and repeatability were assessed. Convergence with 15D instrument, Sunnybrook, and House-Brackmann scales was examined.</p><p><strong>Results: </strong>The total internal consistency of the FaCE scale was high (Cronbach's alpha 0.83). There were no statistically significant differences found between mean scores of the subscales in test-retest analysis (p > 0.05). Intra-class correlations coefficients were high, ranging between 0.78 and 0.92, and the correlations were statistically significant (p < 0.001). There were statistically significant correlations observed between the FaCE scale and the 15D, Sunnybrook, and House-Brackmann scores.</p><p><strong>Conclusion: </strong>The FaCE scale was successfully translated and validated in Finnish with good validity and reliability. We also demonstrated statistically significant correlations between the generic HRQoL15D instrument and both the Sunnybrook and House-Brackmann physician-based grading scales. The FaCE scale is now ready for use in Finnish facial paralysis patients.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"33-39"},"PeriodicalIF":1.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fresh human amniotic membrane wrapping promotes peripheral nerve regeneration in PGA-collagen tubes.","authors":"Atsuhiko Iwao,&nbsp;Hiroto Saijo,&nbsp;Takafumi Nakayama,&nbsp;Akihito Higashi,&nbsp;Kazuya Kashiyama,&nbsp;Norisato Mitsutake,&nbsp;Katsumi Tanaka","doi":"10.2340/jphs.v58.6496","DOIUrl":"https://doi.org/10.2340/jphs.v58.6496","url":null,"abstract":"<p><strong>Background: </strong>An artificial nerve conduit can interpose the peripheral nerve defect without donor site morbidity. However, treatment outcomes are often unsatisfactory. Human amniotic membrane (HAM) wrapping has been reported to promote peripheral nerve regeneration. We evaluated the effects of a combined application of fresh HAM wrapping and a polyglycolic acid tube filled with collagen (PGA-c) in a rat sciatic nerve 8-mm defect model.</p><p><strong>Methods: </strong>The rats were divided into three groups: (1) the PGA-c group (n = 5), in which the gap was interposed with the PGA-c; (2) the PGA-c/HAM group (n = 5), in which the gap was interposed with the PGA-c bridge, then HAM (14 × 7 mm) was wrapped around it; and (3) the Sham group (n = 5). Walking-Track recovery, electromyographic recovery, and histological recovery of the regenerated nerve were evaluated at 12 weeks postoperatively.</p><p><strong>Results: </strong>Compared to the PGA-c group, the PGA-c/HAM group showed significantly better recovery in terminal latency (3.4 ± 0.31 ms vs. 6.6 ± 0.72 ms, p < 0.001), compound muscle action potential (0.19 ± 0.025 mV vs. 0.072 ± 0.027 mV, p < 0.01), myelinated axon perimeter (15 ± 1.3 μm vs. 8.7 ± 0.63 μm, p < 0.01), and g-ratio (0.69 ± 0.0089 vs. 0.78 ± 0.014, p < 0.001).</p><p><strong>Conclusion: </strong>This combined application highly promotes peripheral nerve regeneration and may be more useful than PGA-c alone.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"13-17"},"PeriodicalIF":1.2,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9887007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of orbital fractures - a critical analysis of ophthalmic outcomes and scenarios for re-intervention.","authors":"Anna A E Persson,&nbsp;Hanna M Lif,&nbsp;Alberto Falk-Delgado,&nbsp;Daniel Nowinski","doi":"10.2340/jphs.v58.6580","DOIUrl":"https://doi.org/10.2340/jphs.v58.6580","url":null,"abstract":"<p><strong>Background: </strong>Malplaced implants in orbital reconstruction may lead to serious complications and necessitate re-intervention. The aim of this study was to describe outcomes, complications and scenarios of re-intervention in a historical case series of orbital fractures treated with free-hand orbital wall reconstruction. The main hypothesis was that early re-interventions are mainly because of malplaced implants in the posterior orbit.</p><p><strong>Methods: </strong>Retrospective review of 90 patients with facial fractures involving the orbit, reconstructed with radiopaque orbital wall implants, from 2011 to 2016. Data were obtained from medical records and computed tomography images. Recorded parameters were fracture type, ocular injury, ocular motility, diplopia, eye position, complications and re-interventions. Secondary reconstructions because of enophthalmos were volumetrically evaluated.</p><p><strong>Results: </strong>Early complications requiring re-intervention within 1 month were seen in 12 (13%) patients, where all except two were because of malplaced implants. The implant incongruence was without exception found in the posterior orbit. Late complications consisted of four (4%) cases of ectropion and five (5%) cases of entropion that needed corrective surgery. The majority of the patients with eye-lid complications had undergone repeated surgeries. Secondary orbital surgeries were performed in nine (10%) patients. Five of these patients had secondary reconstruction for enophthalmos and associated diplopia. None of these patients became completely free from either enophthalmos or diplopia after the secondary surgery.</p><p><strong>Conclusion: </strong>Re-intervention after orbital reconstruction is mainly related to malplaced implants in the posterior orbit. Incomplete results in patients requiring secondary surgery for enophthalmos infer the importance of accurate restoration of the orbit at primary surgery. Abstract presented at: Swedish surgery Week 2021 and SCAPLAS 2022.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9530909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification and treatment of congenital central slip hypoplasia.","authors":"Yuzhou Liu,&nbsp;Xiuyue Xu,&nbsp;Le Wang,&nbsp;Jie Lao,&nbsp;Yongqing Zhuang,&nbsp;Yousheng Fang","doi":"10.2340/jphs.v58.7262","DOIUrl":"https://doi.org/10.2340/jphs.v58.7262","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to make a diagnosis and a classification for congenital central slip hypoplasia. The surgical treatment was determined according to the classification.</p><p><strong>Methods: </strong>A retrospective study of 25 treated digits in 13 patients with congenital central slip hypoplasia was carried out. The central slip was classified into two types. Type I: The distance between the insertion of central slip and the proximal interphalangeal joint was shorter than or equal to 5 mm. Type II: The distance between the insertion of central slip and the proximal interphalangeal joint was longer than 5 mm. Tendon advancement or tendon graft was used for type I or II, respectively.</p><p><strong>Results: </strong>The preoperative mean extension lag was 91° (range, 80°-100°), and the mean follow-up duration was 18 months (range, 9-24 months). The postoperative mean extension lag was 19° (range, 0°-50°). No matter whether in type I or II, the postoperative ranges of proximal interphalangeal joint extension had significant improvement compared with the preoperative ones. There was no statistical difference of proximal interphalangeal joint extension lag changes before and after surgery between the two types.</p><p><strong>Conclusion: </strong>Congenital central slip hypoplasia could be classified into two types. Either tendon advancement or tendon graft might be effective, which depended on the classification.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"8-12"},"PeriodicalIF":1.2,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9533972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopy-assisted versus open tissue expander placement in plastic and reconstructive surgery: a meta-analysis.","authors":"Chen Dong,&nbsp;Liwei Dong,&nbsp;Zhou Yu,&nbsp;Xianjie Ma","doi":"10.1080/2000656X.2022.2032106","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2032106","url":null,"abstract":"<p><p>Tissue expansion can be used to overcome challenges due to tissue deficiency in plastic and reconstructive surgery; however, the long expansion process is often accompanied by numerous complications. This meta-analysis aimed to determine whether endoscopy-assisted expander placement could decrease complications and shorten treatment time. This study followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in PROSPERO (CRD42021226116). A literature search was performed in eight databases from their inception dates up to 25 August 2021, to identify clinical studies on endoscopy-assisted and/or open tissue expander placement in plastic and reconstructive surgery. Seven studies met the inclusion criteria. In seven studies, 194 underwent endoscopy-assisted expander placement, and 565 underwent open expander placement. The overall complication rate in the endoscopy-assisted group was significantly lower than that in the open group (risk difference (RD) -0.28, 95% confidence interval (CI), -0.38, -0.18, <i>p</i> < .001). Subgroup analysis showed significantly lower incidence rates of hematoma, infection and dehiscence in the endoscopy-assisted group. The complication rate in the head/neck was lower with low heterogeneity (RD, -0.18; 95% CI, -0.26 to -0.09, <i>p</i> < .001; <i>I</i>² = 0%). The endoscopy-assisted group had shorter surgery time, hospital stay and time to full expansion (weighted mean difference (WMD), -13.97 min, -16.88 h, -27.54 days; 95% CI, -15.85, -12.08 min, -24.36, -9.40 h, -38.85, -16.24 days; both <i>p</i> < .001, respectively). Endoscopy-assisted expander placement may help lower the risk of complications, especially in the head/neck, and reduce surgery time, hospital stay, and time to full expansion. <b>Abbreviations:</b> CI: confidence interval; CNKI: China National Knowledge Infrastructure Database; CSTJ, China Science and Technology Journal Database; NOS: the Newcastle-Ottawa Scale; PRISMA: preferred reporting items for systematic reviews and meta-analyses; RCT: randomized controlled trial; RoB: the cochrane risk-of-bias; RD: risk difference; WMD: weighted mean difference; SE: standard error; SND: standard normal deviate.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"193-201"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9359629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the outcomes of fingertip-to-palm and fingertip-to-forearm two-stage flexor tendon reconstruction for isolated flexor digitorum profundus tendon injuries.","authors":"Osman Orman,&nbsp;Ethem Ayhan Ünkar,&nbsp;Kahraman Öztürk","doi":"10.1080/2000656X.2022.2118756","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2118756","url":null,"abstract":"<p><p>Flexor tendon injuries of the hand have devastating consequences when primary tendon repair fails or left untreated in the first place. Flexor tendon reconstruction is a substantial treatment option to obtain functional digit. In this study, we aimed to compare the functional outcomes and technical feasibility of fingertip-to-palm and fingertip-to-forearm tendon reconstruction methods. Thirty-five patients were divided into two groups according to the proximal attachment site of the free tendon grafts. Group I consisted of 18 patients whose tendon grafts were placed from fingertip-to-palm (zone III). Group II consisted of 17 patients whose tendon grafts were placed from fingertip-to-forearm (zone V). The mean of 39.6 months (range, 6-52 months) of follow-up with complete clinical data were obtained for all the cases. The mean length of the tendon grafts used in group I and group II was 9.7 ± 1.4 cm and 15.9 ± 1.2 cm, respectively. Significantly shorter tendon grafts were needed in group I (<i>p</i> < 0.001). Both mean DASH score and mean Michigan score were significantly improved postoperatively in both groups (<i>p</i> = 0.0001, <i>p</i> = 0.0001), but there was no significant difference between two groups based on postoperative DASH score (<i>p</i> = 0.112) and Michigan score (<i>p</i> = 0.151). No statistically significant difference was observed between two groups in terms of Strickland's scores (<i>p</i> = 0.868). This study demonstrates that comparable results can be obtained with fingertip-to-palm and fingertip-to-forearm staged tendon reconstructions. Fingertip-to-palm tendon reconstruction seems to be more advantageous when multiple flexor tendon injuries aimed to be reconstructed, in which requirement of tendon graft can be fulfilled with less donor site morbidity.<b>Abbreviations:</b> DASH: disabilities of the arm, shoulder and hand.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"365-369"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10785480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}