BOOK
Hand Repair and Reconstruction: Basic and Complex, An Issue of Clinics in Plastic Surgery, E-Book
(2014)
Additional Information
Book Details
Abstract
“Function” is the focus of any hand surgery, a frequently performed procedure by reconstructive plastic surgeons. The topics in this volume of Clinics in Plastic Surgery work their way through soft tissue procedures of the fingers and hand through the upper arm. The more common conditions and commonly performed surgeries are presented here along with the more difficult and complicated procedures. Topics include: Current practice of soft tissue repair of fingertip; Microsurgical soft tissue and bone transfers in complex hand trauma; Full cosmetic reconstruction of the digits by composite tissue grafting; Methods, pitfalls, and common mistakes in treatment of fractures in the digits; Venous flap and freesytle free flap in hand surgery; Management of pain in peripheral nerves; Technical difficulties of surgical treatment and salvage of treatment failure in Dupuytren's disease; Surgical treatment of cubital tunnel syndrome; Distal radius fracture: indications, treatment, controversies; Repair, autografts, conduits, and allografts for digital and forearm nerves: current guidelines. Two experts renown in hand surgery lead this issue - Dr Michael Neumeister and Dr Jin Bo Tang.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Hand Repair and Reconstruction: Basic and Complex | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Clinics in Plastic Surgery\r | xi | ||
| Preface\r | xiii | ||
| Treatment in Hand Surgery: Practical Tips to Make Complex Cases Simple | xv | ||
| Practical tips to surgeons to make complex cases simple | xv | ||
| A 10-year-old Boy with Radiographic Nonunion of a Phalangeal Shaft Fracture | xv | ||
| Infection After Internal Fixation of Compound Extra-Articular and Intra-Articular Fractures of the Metacarpophalangeal Join ... | xv | ||
| Laceration of Flexor Tendons and Digital Nerves in Zone 2 of All Five Digits of One Hand and the Thumb of the Other in a Yo ... | xvi | ||
| Tips about what to avoid in making complex cases simpler | xvi | ||
| Tips about efficient service setup | xvii | ||
| New Tendon, Nerve, and Bone Surgical Methods Impacting the Practice of Hand Surgery | xix | ||
| Wide-awake hand surgery | xix | ||
| Extension-flexion test and early active motion of the tendon | xix | ||
| Percutaneous fixation of hand bones | xx | ||
| Understanding nerve compression in the forearm | xx | ||
| References | xx | ||
| Repair and Reconstruction of Thumb and Finger Tip Injuries | 325 | ||
| Key points | 325 | ||
| Definitions | 325 | ||
| Anatomy and classifications | 326 | ||
| Basic requirements: thumb and fingertip repair | 327 | ||
| Replantation or simple suture of the amputated distal part | 328 | ||
| Regeneration potentials of digit tips | 328 | ||
| Subcutaneous Soft Tissues at the Tip | 328 | ||
| Skin | 329 | ||
| Thumb tip repair and reconstruction | 329 | ||
| Moberg Advancement Flap | 329 | ||
| V-Y Advancement Flaps: Traquilli-Leali (Atasoy), SegmĂĽller, and Venkataswami Flaps | 330 | ||
| Flag Flap from the Dorsum of the Middle Phalanx of the Index Finger | 330 | ||
| The First Dorsal Metacarpal Artery Flap (the Kite Flap) | 332 | ||
| Free Vascularized Toe Pulp Flap | 333 | ||
| Free Vascularized Partial Toe Transfer | 333 | ||
| Neurovascular Pedicle Flaps from the Fingers | 334 | ||
| Fillet Flaps | 335 | ||
| Fingertip repair and reconstruction | 335 | ||
| V-Y Advancement Flaps | 335 | ||
| The palmar V-Y advancement flap (ie, Traquilli-Leali or Atasoy flap) | 335 | ||
| Lateral V-Y flaps | 335 | ||
| Oblique V-Y flap (Venkataswami flap) | 336 | ||
| Lateral Switch Flap | 338 | ||
| Volar or Dorsal Rotational Flaps (Visor Flap, Modified Souquet Flap and Pivot Flap) | 338 | ||
| Homodigital Reverse Pedicle Digital Artery Flap | 340 | ||
| Classical Thenar and Cross-Finger Flaps | 340 | ||
| Terminalization or Finger Shortening | 340 | ||
| Creating a Protected Environment to Favor Regeneration | 340 | ||
| Practice across the world: preferred or unique methods | 341 | ||
| China and Asia | 341 | ||
| The Moberg-type and V-Y flaps: essential options for a small to moderate tip defect | 341 | ||
| Homodigital digital artery dorsal branch flaps or anterograde digital artery pedicle flaps: for a moderate fingertip or pul ... | 341 | ||
| Dorsal radial or ulnar artery flaps of the thumb: for a moderate thumb tip or pulp defect | 341 | ||
| Method selection | 343 | ||
| Italy, Germany, and Mainland Europe | 344 | ||
| Fingertip losses | 344 | ||
| Traumatic pulp losses from the thumb | 347 | ||
| United Kingdom | 349 | ||
| United States and North America | 352 | ||
| Fingertip repair | 352 | ||
| Thumb tip repair | 354 | ||
| Current treatment from a global perspective | 355 | ||
| Evidence and decision-making: from waiting for self-repair to complex microsurgery | 356 | ||
| Future challenge and perspectives | 356 | ||
| Summary | 357 | ||
| References | 358 | ||
| Microsurgical Soft Tissue and Bone Transfers in Complex Hand Trauma | 361 | ||
| Key points | 361 | ||
| Introduction | 361 | ||
| Debridement | 361 | ||
| Timing of reconstruction | 362 | ||
| Preoperative planning | 365 | ||
| Cutaneous defect coverage | 367 | ||
| Dorsum of the Hand | 367 | ||
| Palm of the Hand | 374 | ||
| Composite defect coverage | 378 | ||
| Tendocutaneous Defect | 378 | ||
| Osteocutaneous Defects | 380 | ||
| Summary | 381 | ||
| References | 381 | ||
| Replantation | 385 | ||
| Key points | 385 | ||
| Introduction | 385 | ||
| Indications and contraindications | 386 | ||
| Preoperative preparation | 387 | ||
| Intraoperative techniques | 387 | ||
| Sequence | 387 | ||
| Bone | 388 | ||
| Tendon | 388 | ||
| Nerve | 388 | ||
| Artery | 388 | ||
| Vein | 389 | ||
| Skin | 389 | ||
| Thumb | 389 | ||
| Postoperative care | 390 | ||
| Anticoagulation Therapy | 390 | ||
| Rehabilitation | 390 | ||
| Secondary Procedures | 390 | ||
| Outcomes | 391 | ||
| New directions | 392 | ||
| Summary | 394 | ||
| References | 394 | ||
| Immediate Tissue Transplantation in Upper Limb Trauma | 397 | ||
| Key points | 397 | ||
| Summary | 402 | ||
| References | 405 | ||
| Cosmetic Reconstruction of the Digits in the Hand by Composite Tissue Grafting | 407 | ||
| Key points | 407 | ||
| Digital reconstruction: current status and challenges | 407 | ||
| Our methods and goals: ideal cosmetic reconstruction | 408 | ||
| Clinical patient data | 408 | ||
| Technical description of our methods | 408 | ||
| Reconstruction for Grade I Defect | 408 | ||
| Method 1 - Surgical design: composite tissue transfer from one great toe | 408 | ||
| Harvesting the graft | 409 | ||
| Resurfacing the donor site wound | 409 | ||
| Preparation of the recipient site | 409 | ||
| Composite tissue transfer | 410 | ||
| Pearls and pitfalls | 410 | ||
| Method 2 - Surgical design and procedure: composite tissue from bilateral great toes | 411 | ||
| Reconstruction of Grade II and III Defects | 411 | ||
| Surgical design | 411 | ||
| Harvesting the vascularized composite tissue graft from the great toe | 411 | ||
| Donor site wound resurfacing | 411 | ||
| Transfer to the hand | 411 | ||
| Pearls and pitfalls | 415 | ||
| Reconstruction for Grade IV and V Defects | 415 | ||
| Surgical design | 415 | ||
| Harvesting composite tissue flap from the foot | 415 | ||
| Harvesting ICBG and skin graft | 415 | ||
| Vascularized composite tissue transfer | 415 | ||
| Resurfacing the donor site wound | 415 | ||
| Pearls and pitfalls | 417 | ||
| Reconstructions for Grade VI Defect | 417 | ||
| Surgical design | 417 | ||
| Harvesting the tissue graft | 417 | ||
| Harvesting composite tissue graft from two feet | 417 | ||
| Harvesting ICBG and full-thickness skin graft | 417 | ||
| Transfer to the hand | 418 | ||
| Resurfacing the donor site secondary wounds on the foot | 418 | ||
| Pearls and pitfalls | 419 | ||
| Reconstruction of Total Loss of Multiple Fingers | 419 | ||
| Coverage of the donor site on the great toe after harvesting the composite tissues | 422 | ||
| Dorsalis Pedis Flap | 422 | ||
| The First Dorsal Metatarsal Flap | 422 | ||
| The Second Dorsal Metatarsal Flap | 422 | ||
| Anterior Ankle Flap | 424 | ||
| Lateral Tarsal Flap | 424 | ||
| Medial Tarsal Flap | 424 | ||
| Plantar Metatarsal Flap or Medial Plantar Flap | 424 | ||
| Lateral or Medial Side Flap of the Second Toe | 425 | ||
| Flaps from the Lower Two-Thirds of the Leg | 425 | ||
| Free Vascularized Flaps | 425 | ||
| Key technical points and considerations in making ideal thumb and fingers | 425 | ||
| Future perspectives | 426 | ||
| Summary | 426 | ||
| References | 426 | ||
| Methods and Pitfalls in Treatment of Fractures in the Digits | 429 | ||
| Key points | 429 | ||
| Introduction | 429 | ||
| Evaluation and selection of treatment options | 430 | ||
| Treatment of phalangeal fractures: general guidelines | 430 | ||
| Fractures in Adults | 430 | ||
| Nonoperative treatment | 430 | ||
| Operative treatment | 430 | ||
| Pediatric Fractures | 431 | ||
| Distal phalanx fractures | 431 | ||
| Tuft Fractures | 431 | ||
| Intraarticular Fractures of the DIP Joint | 432 | ||
| Complications | 434 | ||
| Proximal and middle phalanx fractures | 434 | ||
| Fractures That Involve the Joint | 435 | ||
| Bicondylar fractures | 435 | ||
| Mini cannulated screw fixation | 435 | ||
| Volar articular fractures | 439 | ||
| Different options for aticular fragments | 439 | ||
| Dynamic skeletal traction device | 440 | ||
| ORIF for the large volar fragment | 441 | ||
| Chronic PIP Joint Fracture Dislocation | 441 | ||
| Fractures That Do Not Involve the Joint | 442 | ||
| Cross K-wires | 442 | ||
| A single K-wire | 442 | ||
| Percutaneous compression wire | 442 | ||
| Lag screws | 443 | ||
| Plates | 444 | ||
| External fixator (dynamic or static) | 446 | ||
| Open Fractures | 446 | ||
| Complications | 446 | ||
| Summary | 448 | ||
| References | 448 | ||
| Non-surgical Management of Metacarpal Fractures | 451 | ||
| Key points | 451 | ||
| Introduction | 451 | ||
| Outcomes and summary | 458 | ||
| Summary | 460 | ||
| References | 460 | ||
| Surgical Treatment, Hardware Removal, and the Wide-Awake Approach for Metacarpal Fractures | 463 | ||
| Key points | 463 | ||
| Decisions on treatment options | 464 | ||
| Nonoperative Treatment with Casting or Splinting | 464 | ||
| Surgical Fixation After Close or Open Reduction | 465 | ||
| Management of second to fifth metacarpal fractures | 465 | ||
| Metacarpal Head Fractures | 465 | ||
| Metacarpal Neck Fractures | 465 | ||
| Metacarpal Shaft Fractures | 467 | ||
| Metacarpal Base Fractures | 470 | ||
| Management of thumb metacarpal fracture | 470 | ||
| Fractures of the Shaft of the First Metacarpal | 470 | ||
| Bennett Fracture | 470 | ||
| Rolando Fracture (Comminuted First Metacarpal Base) | 472 | ||
| Other Fractures of the Thumb Metacarpal | 473 | ||
| Postoperative care: early intermittent active motion | 473 | ||
| Complications | 474 | ||
| Malunion | 475 | ||
| Infection | 475 | ||
| Hardware removal | 475 | ||
| Wide-awake approach | 475 | ||
| Patient Materials | 475 | ||
| The Advantages of This Technique | 476 | ||
| Contraindications | 476 | ||
| Injection of Lidocaine and Epinephrine | 476 | ||
| Future perspectives of minimally invasive approaches | 477 | ||
| Fluoroscopic Imaging Is Reliable | 477 | ||
| Cost-Effective Approaches | 477 | ||
| A Conservative or Minimally Invasive Approach Is Generally Preferred | 478 | ||
| General guidelines in treatment: what to do and what to avoid | 478 | ||
| Summary | 478 | ||
| References | 478 | ||
| Distal Radius Fracture | 481 | ||
| Key points | 481 | ||
| Volume of practice | 481 | ||
| Incidence | 481 | ||
| How does the author handle these patients? | 482 | ||
| Diagnosis | 482 | ||
| Indications of Treatment | 482 | ||
| Concomitant injuries are common | 483 | ||
| DRUJ Instability or Subluxation | 483 | ||
| Ulnar Styloid Fracture Through Tip, Body, or Base | 483 | ||
| Carpal Ligament Injury and Triangular Fibrocartilage Complex Injury | 483 | ||
| Fractures in the Carpal Bones, Metacarpus, or Phalanges | 483 | ||
| Conservative treatment | 484 | ||
| Surgical treatment | 484 | ||
| CRPP | 484 | ||
| Open Reduction and Internal Fixation | 484 | ||
| Plate fixation | 484 | ||
| Segment-specific fixation | 485 | ||
| External fixator | 485 | ||
| Multiple K-wires | 485 | ||
| Emerging methods | 485 | ||
| Arthroscopy | 489 | ||
| Indications | 489 | ||
| Role 1: Guiding Intraarticular Fracture Reduction | 489 | ||
| Role 2: Diagnosis/Treatment of Accompanied Injuries | 490 | ||
| Treatment of ulnar wrist ligaments | 491 | ||
| Indications | 491 | ||
| Early Treatment: At the Time of Distal Radius Surgery | 491 | ||
| Delayed (Soon After Fracture Healing) or Late (a Period of Time After Fracture Healing) | 491 | ||
| Methods | 491 | ||
| Surgery 1 (early): transverse pinning of the DRUJ (without opening the DRUJ or performing surgical ligament repair) | 491 | ||
| Surgery 2 (early or delayed surgery): direct suture repair of dorsal capsule (ie, dorsal capsuloplasty) | 491 | ||
| Surgery 3 (early, delayed, or late surgery): TFCC repair for type 1B and 1D injury | 492 | ||
| Surgery 4 (delayed or late surgery): ligament reconstruction with a graft | 495 | ||
| TFCC avulsion with ulnar styloid fracture through the tip, body, or base | 495 | ||
| Complications treated after the distal radial fracture heals | 496 | ||
| Ulnar Impaction | 496 | ||
| Wafer procedure | 496 | ||
| Ulnar shortening | 497 | ||
| Malunion and Nonunion | 497 | ||
| Ulnar Nerve Compression | 497 | ||
| DRUJ Arthritis | 497 | ||
| Controversies | 497 | ||
| A Full Cast or a Dorsal Slab? | 497 | ||
| Criteria of Acceptable Reduction Before Cast Immobilization | 497 | ||
| 3D Images and Arthroscopy for Complex Intraarticular Fracture: for All or Selective Patients | 497 | ||
| Repeated Attempts of the Closed Reduction or Proceed to Surgery? | 497 | ||
| Percutaneous Pinning Versus Plating | 498 | ||
| Intraarticular Fracture, Reduced but with a 1- to 2-mm Articular Step-off: Surgery or No? | 498 | ||
| DRUJ Instability: Early Versus Delayed Surgical Treatment | 498 | ||
| Elderly Patients Tolerate More Displacement (Angulation)? | 498 | ||
| Future perspectives | 498 | ||
| Low-Profile Plates and Segment-Specific Plates | 498 | ||
| Bone Substitutes | 498 | ||
| Modifications of Ligament Repair and Reconstruction | 498 | ||
| Distal Radius Fracture After High-Energy Trauma | 498 | ||
| Summary | 498 | ||
| References | 498 | ||
| Management of the Stiff Finger | 501 | ||
| Key points | 501 | ||
| Introduction | 501 | ||
| Anatomy and classification | 501 | ||
| Precaution | 504 | ||
| Nonoperative intervention | 504 | ||
| Operative intervention | 505 | ||
| MCP Joint Extension Contracture | 505 | ||
| PIP Joint Contracture | 507 | ||
| Flexion contracture | 507 | ||
| Extension contracture | 510 | ||
| DIP Joint Contracture | 510 | ||
| Summary | 510 | ||
| References | 510 | ||
| Evidence-based Flexor Tendon Repair | 513 | ||
| Key points | 513 | ||
| Overview | 513 | ||
| Anatomy | 513 | ||
| Surgical techniques | 514 | ||
| Timing of Surgical Repair | 514 | ||
| Partial Tendon Laceration | 514 | ||
| Anesthesia | 515 | ||
| Surgical Procedures | 515 | ||
| Zone 1 | 515 | ||
| Zone 2 | 516 | ||
| Zone 3, 4, and 5 | 517 | ||
| The Common Core Sutures | 517 | ||
| Preferred Surgical Technique | 518 | ||
| Gliding resistance and tendon healing | 518 | ||
| Flexor pulley repair or venting | 519 | ||
| Complications and management | 519 | ||
| Post-operative care | 519 | ||
| Early Active Motion Protocols | 519 | ||
| Preferred Flexor Tendon Motion Protocol | 520 | ||
| Evidence and clinical results in the literature | 520 | ||
| Recent advances | 520 | ||
| Summary | 520 | ||
| References | 520 | ||
| Extensor Tendon Repair and Reconstruction | 525 | ||
| Key points | 525 | ||
| Anatomy | 525 | ||
| Extensor Muscles | 525 | ||
| Extensor Tendon Compartments | 525 | ||
| Dorsal Hand | 526 | ||
| The Extensor Mechanism of the Digits | 526 | ||
| Intrinsic Muscles | 526 | ||
| Extensor tendon injuries | 526 | ||
| Zones of Injury | 526 | ||
| Assessment of Extensor Tendon Lacerations | 526 | ||
| Primary extensor tendon repair | 527 | ||
| General Considerations | 527 | ||
| Surgical Techniques | 527 | ||
| Postoperative Management | 527 | ||
| Reconstruction of extensor tendon function | 528 | ||
| Tendon Lengthening | 528 | ||
| Tendon Grafts | 528 | ||
| Tendon Transfer | 528 | ||
| Coverage of Large Defects | 529 | ||
| Summary | 530 | ||
| References | 530 | ||
| Clinical Applications of Autografts, Conduits, and Allografts in Repair of Nerve Defects in the Hand | 533 | ||
| Key points | 533 | ||
| Introduction | 533 | ||
| Autografts | 534 | ||
| Synthetic conduits | 535 | ||
| Biologic conduits | 539 | ||
| Allografts | 540 | ||
| Clinical decision making: guidelines and authors’ preferred methods | 540 | ||
| Controversies and clinical questions | 542 | ||
| Reported clinical evidence of different repair options: a summary | 543 | ||
| Future investigation and expectations | 543 | ||
| Summary | 546 | ||
| References | 548 | ||
| Nerve Transfers | 551 | ||
| Key points | 551 | ||
| Introduction | 551 | ||
| Principles of nerve transfer | 551 | ||
| Indications | 552 | ||
| Preoperative planning | 552 | ||
| Technique for nerve transfer | 552 | ||
| Motor Transfers | 552 | ||
| Sensory Transfers | 554 | ||
| Outcomes | 555 | ||
| Elbow Flexion | 555 | ||
| Shoulder Function | 556 | ||
| Distal Nerve Transfers | 556 | ||
| Nerve injuries distal to the brachial plexus | 556 | ||
| Median nerve palsy | 556 | ||
| High ulnar nerve injuries | 557 | ||
| Obstetric Brachial Plexus Palsy | 557 | ||
| Summary | 557 | ||
| References | 558 | ||
| Entrapment Neuropathy of the Wrist, Forearm, and Elbow | 561 | ||
| Key points | 561 | ||
| Introduction | 561 | ||
| Median nerve compression at the wrist: carpal tunnel syndrome | 561 | ||
| Diagnosis: Carpal Tunnel | 562 | ||
| Treatment: Carpal Tunnel | 562 | ||
| Complications in Carpal Tunnel | 566 | ||
| Prognosis and Recovery: Carpal Tunnel Release | 567 | ||
| Revision Surgery for Carpal Tunnel Release | 567 | ||
| Median nerve compression at the forearm and elbow | 567 | ||
| Pronator Syndrome | 567 | ||
| Diagnosis: Pronator | 568 | ||
| Treatment: Pronator | 568 | ||
| Anterior Interosseous Nerve Syndrome | 568 | ||
| Diagnosis: Anterior interosseous nerve | 568 | ||
| Treatment | 569 | ||
| Ulnar nerve compression at the elbow: cubital tunnel syndrome | 570 | ||
| Diagnosis: Cubital Tunnel | 570 | ||
| Treatment: Cubital Tunnel | 571 | ||
| In Situ Decompression for Cubital Tunnel | 571 | ||
| Subcutaneous Anterior Transposition for Cubital Tunnel | 573 | ||
| Intramuscular Anterior Transposition for Cubital Tunnel | 575 | ||
| Medial Epicondylectomy for Cubital Tunnel | 575 | ||
| Endoscopic Decompression for Cubital Tunnel Line | 575 | ||
| An Approach to Surgical Decision Making | 575 | ||
| Functional Outcomes | 577 | ||
| Complications in Surgery of the Ulnar Nerve Line | 580 | ||
| Revision Surgery for Cubital Tunnel Surgery | 580 | ||
| Ulnar nerve compression at the wrist: ulnar tunnel syndrome | 580 | ||
| Diagnosis: Ulnar Tunnel | 581 | ||
| Treatment: Ulnar Tunnel | 581 | ||
| Functional Outcomes and Prognosis | 581 | ||
| Association of Ulnar Tunnel Syndrome and Carpal Tunnel Syndrome | 581 | ||
| Radial nerve compression in the forearm | 582 | ||
| Radial Tunnel Syndrome | 582 | ||
| Diagnosis | 582 | ||
| Treatment | 582 | ||
| Prognosis | 583 | ||
| Complications | 583 | ||
| Posterior Interosseous Nerve Syndrome | 583 | ||
| Diganosis | 583 | ||
| Treatment | 583 | ||
| Surgical Management of Painful Peripheral Nerves | 589 | ||
| Key points | 589 | ||
| Introduction | 589 | ||
| A language to discuss nerve pain | 589 | ||
| Description of Pain | 589 | ||
| Documentation of the Degree of Pain | 590 | ||
| Preoperative discussion and local anesthetic assessment | 590 | ||
| Decision on proper surgical methods | 591 | ||
| Surgical treatment of end-neuromas | 591 | ||
| Relocation: Indications and Procedures | 591 | ||
| Zone I (Digital Nerves) | 592 | ||
| Relocation of digital nerves | 592 | ||
| Burying nerve ends in bone | 593 | ||
| Nerve tenderness after nerve relocation | 593 | ||
| Surgical procedure | 594 | ||
| Outcomes of digital nerve relocation | 595 | ||
| Zone I (Dorsal Innervation of the Digits) | 596 | ||
| Zone I (Ray Amputations) | 596 | ||
| Zone II | 596 | ||
| Zone III | 598 | ||
| Identification of nerves for relocation | 599 | ||
| Surgical procedure | 599 | ||
| Relocation of radial nerve | 600 | ||
| Surgical procedure | 600 | ||
| Outcomes of radial nerve relocation | 601 | ||
| Treatment of the Neuroma Bulb | 602 | ||
| The Results of Relocation | 602 | ||
| Failure to Relieve End-Neuroma Pain | 602 | ||
| Hypersensitivity | 602 | ||
| Surgical treatment of painful nerves in continuity | 603 | ||
| Nerve Grafting | 604 | ||
| Division and Relocation of Small Painful Nerves in Continuity | 604 | ||
| Autologous Tissue Wraps That We Have Not Used or Do Not Use | 604 | ||
| Vein wrapping | 605 | ||
| Free fat grafting | 605 | ||
| Local muscle flaps | 606 | ||
| Autologous Tissue Wraps That We Recommend: Vascularized Fascial Flap | 606 | ||
| Local vascularized fascial flaps: our routine options | 606 | ||
| The Becker fasciocutaneous flap | 606 | ||
| Anterior forearm fascial flap | 606 | ||
| Outcomes of flaps | 606 | ||
| Protection of nerve at the wrist with distant vascularized fat flap: used occasionally, for severe cases | 607 | ||
| Postoperative management | 610 | ||
| Failure to relieve nerve pain by local surgery | 610 | ||
| Nonsurgical methods of relief of peripheral nerve pain | 610 | ||
| Complicating neurologic conditions | 611 | ||
| Nerve Compression | 611 | ||
| Complex Regional Pain Syndrome Type 1 (Reflex Sympathetic Dystrophy) | 611 | ||
| The Central Nervous System | 611 | ||
| Summary | 611 | ||
| References | 612 | ||
| Techniques and Outcomes for Hand Surgery | 615 | ||
| Amadio PC (Mayo Clinic, Rochester, MN) | 616 | ||
| J Bone Joint Surg Am 94:569-573, 2012 | 616 | ||
| Background | 616 | ||
| Updates | 616 | ||
| Conclusions | 616 | ||
| Early Practice in Hand Surgery | 625 | ||
| Hand surgery view from PGY6 | 625 | ||
| Be an Active Learner | 625 | ||
| Learn About Our Past | 626 | ||
| Learn from Others | 627 | ||
| There is Opportunity to Learn Even on Routine Cases | 627 | ||
| Learn Anatomy | 627 | ||
| Be Present – Both Mentally and Physically | 627 | ||
| Never Complain | 627 | ||
| Last Words from Dr Michael W. Neumeister | 627 | ||
| References | 628 | ||
| Index | 631 |