By A. Neil Salyapongse, Samuel O. Poore, Ahmed M. Afifi, Michael L. Bentz
Extremity Replantation is a entire textual content protecting all elements of the higher and decrease limb, with an emphasis on cutting-edge innovations within the surgical and scientific administration of amputation and avulsion accidents in addition to the present knowing of the restoration of functionality following replantation. it's geared up following anatomical zones – thumb, digits, wrist, forearm and elbow; foot, ankle and decrease leg – with designated chapters devoted to matters universal to all replants, similar to issues, scientific administration, nerve restoration and rehabilitation. moreover, the foreign group of authors demonstrates ways from the whole spectrum of replantation care experts, together with plastic and reconstructive surgeons, orthopedists, and hand therapists. Generously illustrated with intra-operative images, this ebook will function a customary reference for orthopedic, reconstructive, plastic, and hand surgeons in addition to physicians or ancillary scientific employees taking good care of the replant patient.
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Threedimensional reconstruction of fracture callus morphogenesis. J Histochem Cytochem. 2006;54(11): 1215–28. 5. Green E, Lubahn JD, Evans J. Risk factors, treatment, and outcomes associated with nonunion of the midshaft humerus fracture. J Surg Orthop Adv. 2005; 14(2):64–72. 6. Gordon L, Monsanto EH. Skeletal stabilization for digital replantation surgery. Use of intraosseous wiring. Clin Orthop Relat Res. 1987;214:72–7. 7. Gingrass RP, Fehring B, Matloub H. Intraosseous wiring of complex hand fractures.
Moriya T, Zhao C, An KN, et al. The effect of epitendinous suture technique on gliding resistance during cyclin motion after flexor tendon repair: a cadaveric study. J Hand Surg Am. 2010;35(4):552–8. 60. Kubota H, Aoki M, Pruitt DL. Mechanical properties of various circumferential tendon suture techniques. J Hand Surg Br. 1996;21(4):474–80. 61. Gelberman RH, Boyer MI, Brodt MD, et al. The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs.
For digital nerves, usually three stitches are adequate and for larger nerves more stitches might be necessary. Nerve repair should be performed using an operative microscope for two reasons. First, the operative microscope aids in carefully placing stitches in the epineurium only, thus reducing the internal scar tissue which impedes regeneration, and secondly, magnification significantly aids in identifying the superficial vessels that are visible along the longitudinal aspects of the nerve segments (vasa nervorum).