Archives of Hand and Microsurgery最新文献

The characteristics and costs of traumatic extremity amputation versus replantation at a single center in the Republic of Korea: a retrospective observational study 大韩民国单一中心创伤性四肢截肢与再植的特点和费用：一项回顾性观察研究

Archives of Hand and Microsurgery Pub Date : 2024-07-26 DOI: 10.12790/ahm.24.0020

Dong Hee Kim, H. Jang, S. Kwak, Sung Youn Jung, C. Park, Chul Ho Lee, Kyoungwon Park, Sang Hyun Lee

{"title":"The characteristics and costs of traumatic extremity amputation versus replantation at a single center in the Republic of Korea: a retrospective observational study","authors":"Dong Hee Kim, H. Jang, S. Kwak, Sung Youn Jung, C. Park, Chul Ho Lee, Kyoungwon Park, Sang Hyun Lee","doi":"10.12790/ahm.24.0020","DOIUrl":"https://doi.org/10.12790/ahm.24.0020","url":null,"abstract":"Purpose: This study investigated the epidemiology and treatment outcomes of patients with traumatic limb amputation who visited a regional trauma center.Methods: From November 2015 to December 2021, patients with traumatic limb amputation who visited the Regional Trauma Center at Pusan University Hospital were retrospectively studied. The injury mechanism, number of operations for accompanying injuries, hospitalization period, injury severity score, insurance classification, and medical costs were investigated using medical records. We analyzed medical costs according to the injury site and treatment method. Results: We enrolled 57 patients who visited the hospital for traumatic limb amputation. The median patient age was 55 years, and there were 48 males and nine females. Seventeen patients underwent replantation, and 40 patients underwent amputation. Replantations were performed in 43.7% of cases of upper extremity injuries and in 12.0% of cases of lower extremity injuries. Six operations were performed per patient for replantation and three for amputation (p=0.027). In an analysis of the total medical costs submitted to the national health insurance system, replantation surgery was over twice as expensive as amputation surgery for the upper extremities (p=0.029). However, no significant cost difference was observed for lower limb amputations. Conclusion: As a treatment for limb amputation patients, replantation requires a higher number of operations and a longer hospital stay than amputation. There was no difference in patients’ contributions to medical costs between replantation and amputation, but from the standpoint of national health insurance coverage, upper extremity injuries cost more when treated by replantation than by amputation.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"40 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative analysis of inpatient costs for the surgical treatment of distal radial fractures in children and adults: a retrospective cohort study from a single surgeon’s experience 儿童和成人桡骨远端骨折手术治疗住院费用的比较分析：来自一名外科医生经验的回顾性队列研究

Archives of Hand and Microsurgery Pub Date : 2024-07-25 DOI: 10.12790/ahm.24.0027

Yun-Ki Kim, Seung-Ho Lee, Seung Hoo Lee

{"title":"Comparative analysis of inpatient costs for the surgical treatment of distal radial fractures in children and adults: a retrospective cohort study from a single surgeon’s experience","authors":"Yun-Ki Kim, Seung-Ho Lee, Seung Hoo Lee","doi":"10.12790/ahm.24.0027","DOIUrl":"https://doi.org/10.12790/ahm.24.0027","url":null,"abstract":"Purpose: Distal radial fractures are common in children and older adults, and numerous studies have analyzed their medical costs. However, no study has attempted to compare the medical costs of distal radial fractures in children and adults requiring surgical treatment in Korea. We therefore investigated this issue for the first time.Methods: The study retrospectively analyzed 96 pediatric and adult patients who underwent surgery for distal radial fractures performed by a single surgeon between January 2021 and January 2023. Patients were divided into adult (>16 years) and pediatric (≤16 years) groups. We examined patients’ demographic factors, surgical details, and inpatient costs.Results: The average total inpatient cost in the pediatric group was 1,640,000 Korean won (KRW), compared to 2,940,000 KRW in the adult group. The largest difference was in surgical material costs, which were approximately 700,000 KRW more expensive in adults. Kirschner wires were mainly used during surgery for pediatric patients, whereas volar locking plates were mainly used for adults. The number of C-arm fluoroscopy images obtained during surgery was higher in pediatric patients than in adults. The reoperation rate was higher in pediatric patients. Conclusion: The inpatient costs of surgical treatment for pediatric patients with distal radius fractures were lower than for adults, primarily due to differences in the costs of surgical materials. However, the reoperation rate was higher in the pediatric group, and radiation exposure was also greater. Policy adjustments may be necessary to address these unique challenges in the treatment of pediatric wrist fractures.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tetrapolydactyly: a rare presentation and review of the literature 四畸形：罕见病例和文献综述

Archives of Hand and Microsurgery Pub Date : 2024-07-25 DOI: 10.12790/ahm.24.0025

Dongkyung Seo, Rikuto Ishii, Keisuke Tada, Kunihiro Kawashima, Katsumi Horiuchi

{"title":"Tetrapolydactyly: a rare presentation and review of the literature","authors":"Dongkyung Seo, Rikuto Ishii, Keisuke Tada, Kunihiro Kawashima, Katsumi Horiuchi","doi":"10.12790/ahm.24.0025","DOIUrl":"https://doi.org/10.12790/ahm.24.0025","url":null,"abstract":"Polydactyly is a common congenital anomaly characterized by the presence of extra digits on the hands and/or feet, potentially involving all four limbs simultaneously. The terminology used to describe polydactyly involving all four limbs varies in the literature, with terms such as “tetrapolydactyly,” “polydactyly 24,” and “hexadactyly of all limbs” being used interchangeably. We encountered a case of tetrapolydactyly in a female neonate with postaxial polydactyly involving all four limbs. Our patient had an extra digit on the ulnar side with a bony component on the left hand and a similar extra digit without a bony articulation at the base of the right hand. The right foot showed postaxial polydactyly, and the left foot exhibited both preaxial polysyndactyly and postaxial polydactyly. A review of the literature shows that this combination of anomalies is extremely rare. A family history is present in approximately 30% of cases, asymmetric patterns are rarer than symmetric patterns, and heptadactyly is particularly uncommon. This report summarizes the information on tetrapolydactyly in the literature and discusses the clinical implications as well as management strategies.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"105 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical and wound management for hand-localized kaposiform hemangioendothelioma: a case report 手部局部卡波状血管内皮瘤的手术和伤口处理：病例报告

Archives of Hand and Microsurgery Pub Date : 2024-07-18 DOI: 10.12790/ahm.24.0021

Seung Jun Lee, Jong-Min Won, Jong Won Hong

引用次数: 0

An osteolytic lesion of the proximal ulna in a patient with Maffucci syndrome: a case report 马夫奇综合征患者尺骨近端溶骨性病变：病例报告

Archives of Hand and Microsurgery Pub Date : 2024-06-04 DOI: 10.12790/ahm.24.0019

Hyeon Jun Kim, Sung Youn Jung, Ji Woong Kim, Min Gyung Park

引用次数: 0

Paraffinoma of the hands: a case report 手部石蜡样瘤：病例报告

Archives of Hand and Microsurgery Pub Date : 2024-06-03 DOI: 10.12790/ahm.23.0056

Jinil Choi, HuiBeom Hwang, Sung Tack Kwon, Byung Jun Kim

{"title":"Paraffinoma of the hands: a case report","authors":"Jinil Choi, HuiBeom Hwang, Sung Tack Kwon, Byung Jun Kim","doi":"10.12790/ahm.23.0056","DOIUrl":"https://doi.org/10.12790/ahm.23.0056","url":null,"abstract":"Paraffin injection has been widely used to improve body contouring or to augment various body parts, although it has now been abandoned owing to serious complications. Paraffin injection may lead to complications after a long latency period, ranging from several years to several decades. Here, we present the rare case of a 77-year-old woman who suffered from recurrent wound problems after a bilateral paraffin injection into her hands 40 years ago. Initially, conservative debridement was carried out due to the patient’s reluctance to undergo extensive surgery and cost concerns. However, this resulted in recurrent wound dehiscence and infection. After serial debridement procedures, a skin graft was performed on her right hand. The patient complained of a depressed contour and numbness at the skin graft site, and tightness and discomfort of her right hand during flexion of the metacarpophalangeal joint. Three years later, the patient presented with a highly similar wound on her left hand. Thorough excision of the soft tissue infiltrated by paraffin was performed, followed by reconstruction using a sensate free anterolateral thigh flap. The patient responded well postoperatively without complications, displaying a fair range of motion without discomfort, sensory restoration of the flap, and satisfaction with the contour of the dorsum. This case report highlights the importance of complete excision of soft tissues infiltrated by paraffin for definitive treatment. Among the various reconstruction options, a sensate free flap is a good choice for achieving favorable functional and esthetic outcomes in hand reconstruction after radical excision of a paraffinoma.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"120 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141272124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of distal ulnar morphology on symptomatic extensor carpi ulnaris (ECU) subluxation and the clinical outcomes of anatomic ECU subsheath reconstruction: a retrospective observational study 尺骨远端形态对有症状的尺骨伸肌（ECU）半脱位的影响以及解剖性尺骨伸肌腱膜下重建术的临床效果：一项回顾性观察研究

Archives of Hand and Microsurgery Pub Date : 2024-05-10 DOI: 10.12790/ahm.23.0043

Sung Jin Kang, Ji Nam Kim, Yun Seop Kim, Seoung Joon Lee

{"title":"Effects of distal ulnar morphology on symptomatic extensor carpi ulnaris (ECU) subluxation and the clinical outcomes of anatomic ECU subsheath reconstruction: a retrospective observational study","authors":"Sung Jin Kang, Ji Nam Kim, Yun Seop Kim, Seoung Joon Lee","doi":"10.12790/ahm.23.0043","DOIUrl":"https://doi.org/10.12790/ahm.23.0043","url":null,"abstract":"Purpose: This study aimed to evaluate the association between distal ulnar morphology and symptomatic extensor carpi ulnaris (ECU) subluxation and assess the results of anatomic ECU subsheath reconstruction.Methods: To investigate the effects of distal ulnar morphology on symptomatic ECU subluxation, we compared distal ulnar morphology using magnetic resonance imaging among three groups: group 1 (symptomatic ECU subluxation, 12 cases), group 2 (non-symptomatic ECU subluxation, 24 cases), and group 3 (no ECU subluxation, 24 cases). Distal ulnar morphology was evaluated using ulnar variance, ulnar styloid length, and ECU groove depth. Clinical outcomes were evaluated using the Patient-Related Wrist Evaluation (PRWE) score, the Disabilities of the Arm, Shoulder, Hand (DASH) score, grip strength, and the range of motion of the wrist joint.Results: Ulnar variance showed a statistically significant difference between groups 1 and 2, and ECU groove depth showed statistically significant differences between groups 1 and 2 and between groups 2 and 3. Ulnar styloid length showed no statistically significant between-group differences. In patients with symptomatic ECU subluxation, there was a significant increase in the range of motion in supination and grip strength, and a significant decrease in the DASH score (from 40 to 9) and PRWE score (from 48 to 12). Conclusion: Negative ulnar variance was associated with symptomatic ECU subluxation, and shallow ECU groove depth was correlated to asymptomatic ECU subluxation, but unrelated to symptoms. Anatomic ECU tendon sheath reconstruction was identified as an effective surgical method.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A novel finger brace for preventing finger stiffness after trauma or surgery: a preliminary report with a case series 一种用于防止创伤或手术后手指僵硬的新型手指支架:病例系列的初步报告

Archives of Hand and Microsurgery Pub Date : 2023-11-10 DOI: 10.12790/ahm.23.0033

Dae-Geun Kim, Hyo Jun Park

{"title":"A novel finger brace for preventing finger stiffness after trauma or surgery: a preliminary report with a case series","authors":"Dae-Geun Kim, Hyo Jun Park","doi":"10.12790/ahm.23.0033","DOIUrl":"https://doi.org/10.12790/ahm.23.0033","url":null,"abstract":"Purpose: Finger stiffness is a common complication following hand trauma or surgery. Early finger range-of-motion (ROM) exercises have proven to be the most effective method for preventing finger stiffness. In this paper, we introduce a novel finger brace designed for safe and early active exercises and present preliminary results from a small case series.Methods: Our innovative brace is designed for direct insertion into the finger, ensuring enhanced comfort during use. This brace features hinges that facilitate unrestricted movement in the proximal and distal interphalangeal joints, with each phalangeal component having a rounded shape to prevent rotation. Furthermore, grooves are integrated at the top of the phalangeal components for inserting bars; a straight bar to immobilize and a silicone band to provide elastic resistance exercises within a limited range.Results: Among 26 patients, 17 presented with fractures, five had extensor tendon injuries, and three had dislocations. For patients not requiring surgery, we applied the brace as early as possible. In cases involving surgery, the brace was applied step by step. When fixation was necessary for the first time, a straight bar was applied, and when starting finger movement, a silicone band was applied. The silicone band was then released to allow free finger movement. Except for one patient necessitating extensor tendon reconstruction due to a neglected rupture, all patients achieved full ROM without any complications.Conclusion: Our novel ROM finger brace represents a safe and user-friendly option for effectively initiating finger ROM exercises.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"99 23","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Various hand tumors: over 20 years of clinical experience in Korea 各种手部肿瘤:在韩国有超过20年的临床经验

Archives of Hand and Microsurgery Pub Date : 2023-11-10 DOI: 10.12790/ahm.23.0026

Jeonghun Kim, Kanghee Lee, Sangho Oh, Jaehoon Choi, Daegu Son

{"title":"Various hand tumors: over 20 years of clinical experience in Korea","authors":"Jeonghun Kim, Kanghee Lee, Sangho Oh, Jaehoon Choi, Daegu Son","doi":"10.12790/ahm.23.0026","DOIUrl":"https://doi.org/10.12790/ahm.23.0026","url":null,"abstract":"Purpose: Although the hand only constitutes 2% of the body, it is a site where a wide variety of tumors occur, and the results of surgery substantially impact its function. Therefore, an accurate diagnosis and appropriate selection of individual treatment strategies are very important. This study reviewed the diagnostic characteristics and clinical features of surgically treated hand tumors at our facility.Methods: We retrospectively reviewed 65 patients who underwent surgery for suspected hand tumors at our institution between 2003 and 2020. Data, including patient demographics, diagnosis, pathology, type of surgery, comorbidities, and tumor characteristics (e.g., location and tumor size), were collected from medical records.Results: In total, 59 (90.7%) and six patients (9.3%) were diagnosed with benign and malignant tumors, respectively. Ganglion cysts were the most common tumors (n=11), followed by vascular anomalies (n=10), epidermoid cysts (n=7), and glomus tumors (n=4). There were four cases of bone tumors (6.2%), including one chondroma, one chondrosarcoma, and two giant cell tumors. In 53 cases with an imaging workup, the pathological diagnosis was concordant in 44 cases. Of the nine cases with inconsistent results, eight were tumors located in the finger; this association was significant (p=0.048).Conclusion: In this study, ganglion cyst and squamous cell carcinoma were the most common benign and malignant tumors, respectively, and four cases of bone tumors were found. Radiologic misdiagnosis was more frequent in finger tumors than in other tumors. Thus, hand tumors, especially those suspected to be malignant, should be assessed using a multidisciplinary approach.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"107 28","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reconstruction of extensive scalp defects of oncologic origin using thoracodorsal artery perforator free flaps 应用胸背动脉穿支游离皮瓣重建肿瘤源性大面积头皮缺损

Archives of Hand and Microsurgery Pub Date : 2023-11-10 DOI: 10.12790/ahm.23.0025

Sang-Hun Lee, Kyeong-Tae Lee

{"title":"Reconstruction of extensive scalp defects of oncologic origin using thoracodorsal artery perforator free flaps","authors":"Sang-Hun Lee, Kyeong-Tae Lee","doi":"10.12790/ahm.23.0025","DOIUrl":"https://doi.org/10.12790/ahm.23.0025","url":null,"abstract":"Purpose: Ablation of malignant neoplasms of the scalp usually leaves extensive defects. Free musculocutaneous transfer using the latissimus dorsi muscle with a skin graft has been the gold standard for restoring such defects; however, this approach may be limited by potential functional morbidity and delayed healing of the grafted skin. This study presents a case series of microsurgical reconstruction with thoracodorsal artery perforator (TDAP) flaps for extensive scalp defects after radical oncologic resection.Methods: Consecutive patients with malignant scalp tumors who underwent wide local excision and defect coverage with TDAP free flaps between April 2019 and January 2023 were evaluated. Operation-related data and surgical outcomes, including donor- and recipient-site complications, postoperative shoulder function, and aesthetic results, were thoroughly assessed. As an oncologic outcome, local recurrence was also recorded.Results: Eleven patients who underwent reconstruction with an average flap size of 223.2 cm<sup>2</sup> (range, 160.0–406.0 cm<sup>2</sup>) were identified. The flaps were based on an average of 2.4 perforators. The donor-site wound was closed primarily in all cases. All flaps achieved complete wound healing within an average of 2 weeks and presented stable resurfacing of the scalp with satisfactory morphological outcomes. No functional shoulder disability was observed in the postoperative period. Five patients exhibited local recurrence but were appropriately treated in a timely manner.Conclusion: The free TDAP flap could be a potential, effective reconstructive tool for extensive scalp defects of oncologic origin and can overcome the recipient- and donor-site complications associated with the conventional procedure.","PeriodicalId":475952,"journal":{"name":"Archives of Hand and Microsurgery","volume":"95 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0