Application of free vein skin flap on the anterior aspect of wrist in the case of finger injury with vessel and skin defect

Objective To introduce an effective reconstruction method for the finger injured with vessel and skin defect. Methods Free skin flap with skin vein was transplanted on the site of tissue defect, connecting by anastomosis the vein with artery or vein of the finger. Results Seven cases were treated with this method,among which 5 cases have sikin defect on the palm aspect of fingers, the rest have skin defect on the dorsal aspect skin of finger. All fingers survived with good shape and function. Conclusion This is a simple and effective method of finger reconstruction for the patients with defect of vessels and skin. 6 refs.

Finger compartment syndrome due to a high-pressure washer injury:A case report

BACKGROUND Although the finger compartment syndrome is not common,it compresses the neurovascular bundles in a limited space and blocks blood flow to the fingers,causing necrosis of the fingertips.Finger fasciotomy through unilateral or bilateral midline release of the finger can achieve decompression of the finger compartment.Herein,we report a case of the compartment syndrome in a finger injury caused by a high-pressure water flow which is commonly used in car washing stations.CASE SUMMARY A 60-year-old man injured his right middle finger while using a high-pressure washer at a car washing station.The patient complained of severe pain in his middle finger and a 0.2 cm punctured open wound on the volar side of the distal phalangeal joint of the middle finger.The fingertip was pale,numb,and characterized by severe swelling and a limited range of motion.Finger radiography showed that there was no fracture in the finger.Digital decompression was performed through finger fasciotomy by bilateral midline incision.On the second day after surgery,the color of the fingertip returned to pink,swelling was resolved,and the range of motion returned to normal.The sensation of the fingertip was completely restored,and the capillary refill test and pinprick test were positive.CONCLUSION The fingertip compartment syndrome can be caused by a high-pressure water flow damage to the fingers when using high-pressure washers at a car washing station.To avoid finger necrosis,rapid diagnosis of the finger compartment syndrome and appropriate digital decompression are essential to better outcome.

Clinical Investigation and Experience with Distal phalanx Replantation

Objective： To explore the measures and methods for improving distal phalanx replantation. Methods： One hundred and forty-eight cases with distal phalanx replantation from Sep 2004 to Sep 2007 were investigated. The indication for surgery and the operative program was determined by the trauma type and the degree of injury. As many microcirculation pathways as possible were reconstructed during the operation, and postoperative tissue decompression was also performed. Results： The survival rate of distal phalanx replantation was 89.9% （169/148）. Conclusion： To improve the survival rate of distal phalanx replantation it is essential to reconstruct an effective local blood circulation, determine the degree of injury in cases with ecchymosis, and employ comprehensive postoperative measures.

High pressure paint gun injury of the index finger:a case report

Injuries to the hand secondary to high pressure paint guns are considered to be true hand emergencies.These rare injuries may have serious outcomes,and a critical step in their management is extensive debridement performed within the first six hours following injury.For this reason,their diagnosis should not be delayed,and the hand surgeon should be informed immediately to initiate appropriate treatment.In this report,the authors describe a patient who was injured with a chemical paint gun,and whose injury was not diagnosed in the emergency department.The patient subsequently developed tenosynovitis.His treatment is reported herein.

Finger pulp reconstruction with thenar flap: Aesthetic and functional outcome

Purpose:Fingertip injuries are common in industrial production activities as well as in domestic work.Loss of pulp hampers daily life activities.Functional and aesthetic aspects are important in fingertip reconstruction.The bone is usually exposed along with soft tissue loss.Therefore to reconstruct the pulp flap with adequate bulk is required.Methods:We reported a case series of 12 patients with the injury over the volar aspect of distal phalanx of the index or middle finger.In all cases,laterally based thenar flap was chosen.The flap donor site was closed primarily in most of cases,while 4 patients required skin graft.The flap was detached between 2e3 weeks.Functional assessment was done using static and dynamic 2-point discrimination and range of motion at each joint.The aesthetic outcome was assessed through questionnaire.The results were analyzed using the unpaired t-test(SPSS version 21).Results:Partial necrosis occurred in 2 cases while rest of flaps survived successfully.Static 2-point discrimination ranged from 6e10 mm,mean 8.6 mm;and dynamic 2-point discrimination ranged from 8e10 mm,mean 8.9 mm.The mean satisfaction score was(4.0±0.55).Conclusion:Thenar flap is a good choice for reconstruction of the finger pulp as it provides the bulk with good functional and aesthetic outcome.