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Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier Department of hand surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland Department of hand surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France Department of orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

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Change and role of heme oxygenase-1 in injured lungs following limb ischemia/reperfusion in rats

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Chinese Journal of Traumatology 2004年第3期7卷 131-137页

作者：周君琳朱晓光林源凌亦凌邵新中张桂生 Department of orthopaedics Department of hand surgery Department of Pathophysiology

Objective: To study the change and role of heme oxygenase-1 (HO-1) in injured lungs following limb ischemia/reperfusion in rats. Methods: A total of 96 healthy male Sprague-Dawley rats, weighing 250-300 g, were used in this study. Hind limb ischemia was made on 40 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, then limb reperfusion for 0, 4, 8, 16 and 24 hours (n=8 in each time point) was performed, respectively. Other 8 rats undergoing full surgical operation including isolation of the infrarenal aorta without occlusion were taken as the sham operation group. Lung tissues were obtained from the 48 animals and Northern blotting and Western blotting were employed to measure the changes of HO-1 mRNA and protein expression, respectively. Immunohistochemistry technique was used to determine the cell types responsible for HO-1 expression after limb ischemia/reperfusion. Then hind limb ischemia was made on other 12 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, among whom, 6 rats were given zinc protoporphyrin (ZnPP), an inhibitor of HO. Then limb reperfusion for 16 hours was performed on all the 12 rats. And other 12 rats underwent full surgical operation including isolation of the infrarenal aorta without occlusion, among whom, 6 rats were then given ZnPP. Then lung tissues were obtained from the 24 animals and lung injury markers, lung histology, polymorphonuclear leukocyte (PMN) count and malondialdehyde (MDA) content were detected, respectively. HO activity was determined through measuring the carboxyhemoglobin (COHb) level in artery blood with a CO-oximeter after limb ischemia/reperfusion. And the animal mortality was observed on the other 24 rats. Results: Northern blotting analysis showed that HO-1 mRNA increased significantly at 4 hours after reperfusion, peaked at 16 hours, and began to decrease at 24 hours. In contrast, no positive signal was observed in the sham and simple ischemia animals.

关键词： Heme oxygenase Carbon monoxide Reperfusion injury Limbs Lung

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Should aspirin be stopped before carpal tunnel surgery? A prospective study

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World Journal of Orthopedics 2013年第4期4卷 299-302页

作者： Stefania Brunetti Gianfranco John Petri Stefano Lucchina Guido Garavaglia Cesare Fusetti hand surgery unit Department of Orthopaedics and Trauma Surgery Ospedale Regionale Bellinzona e Valli 6500 Bellinzona Switzerland

AIM: To determine whether patients taking aspirin during carpal tunnel release had an increase of ***: Between January 2008 and January 2010, 150 patients underwent standard open carpal tunnel release(CTR) under intravenous regional anaesthesia. They were divided into three groups: groups 1 and 2 were made of 50 patients each, on aspirin 100 mg/d for at least a year. In group 1 the aspirin was never stopped. In group 2 it was stopped at least 5 d before surgery and resumed 3 d after. Group 3 acted as a control, with 50 patients who did not take aspirin. The incidence of clinically significant peror post-operative complications was recorded and divided into local and cardio-cerebro-vascular complications. Local complications were then divided into minor and major according to Page and Stern. Local haematomas were assessed at 2 d(before resuming aspirin in group 2) and 14 d(after resuming aspirin in group 2) postoperatively. Patients were reviewed at 2, 14 and 90 d after ***: There was no significant difference in the incidence of complications in the three groups. A total of 3 complications(2 major and 1 minor) and 27 visible haematomas were recorded. Two major complications were observed respectively in group 1(non stop aspirin) and in group 3(never antiaggregated). The minor complication, observed in one patient of group 2(stop aspirin), consisted of a wound dehiscence, which only led to delayed healing. All haematomas were observed in the first 48 h, no haematoma lasted for more than 2 wk and all resolved spontaneously. A major haematoma(score > 20 cm2) was observed in 8 patients. A minor haematoma(score surgery were satisfied with the result in terms of relief of their preoperative symptoms. Major and minor haematomas did not impair hand function or require any specific ***: Our study demonstrates that continuation of aspirin did not increase the risk of

关键词： Carpal tunnel syndrome Aspirin Antiaggregation therapy hand surgery Carpal tunnel release

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Evaluation of bone remodeling in regard to the age of scaphoid non-unions

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World Journal of Orthopedics 2016年第7期7卷 418-425页

作者： Susanne Rein Uwe Hanisch Hans-Eberhard Schaller Hans Zwipp Stefan Rammelt Stefan Weindel Department of Plastic and hand surgery Burn UnitTrauma Center Bergmannstrost Center of orthopaedics and Traumatology University Medicine "Carl Gustav Carus" DresdenTechnicalUniversity Dresden Institute of Pathology "Carl Thiem" Hospital Deptartment of Plastic Hand Reconstructive and Burn SurgeryTrauma Center Tuebingen University Deptartment of hand Aesthetic and Plastic SurgeryHospital of Linth

AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions(SNU) with ***: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin(HE), tartrate resistant acid phosphatase(TRAP), CD 68, osteocalcin(OC) and osteopontin(OP). Histological examination was performed in a blinded ***: The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU(P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts(P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts(P = 0.008; r = 0.43). SNU older than 6 mo showed a signifi-cant decrease of the number of fibroblasts(P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in ***: Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.

关键词： Bone remodeling Histology Immunohistological staining Scaphoid non-union Scaphoid Wrist joint

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Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

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World Journal of Clinical Cases 2019年第14期7卷 1825-1836页

作者： Christoph Kolja Boese Philipp Lechler Michael Frink Michael Hackl Peer Eysel Christian Ries Department of Orthopaedic and Trauma surgery University Hospital of CologneCologne 50931Germany Clinic for Trauma and hand surgery KreisklinikenAltotting 84503Germany Center for orthopaedics and Trauma surgery University Hospital Giessen and MarburgMarburg 35043Germany

BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with immense socio-economic burden. One treatment aspect is parenteral antiinfective therapy, which usually requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)]. An alternative is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)]. To conduct a health economic cost-benefit analysis of OPAT, a detailed cost analysis of IPAT and OPAT is required. So far, there is a lack of knowledge on the health economic effects of IPAT and OPAT for PPJI. AIM To review an economic comparison of IPAT and OPAT. METHODS A systematic literature review was performed through Medline following the PRISMA guidelines. RESULTS Of 619 identified studies, 174 included information of interest and 21 studies were included for quantitative analysis of OPAT and IPAT costs. Except for one study, all showed relevant cost savings for OPAT compared to IPAT. Costs for IPAT were between 1.10 to 17.34 times higher than those for OPAT. CONCLUSION There are only few reports on OPAT for PPJI. Detailed analyses to support economic or clinical guidelines are therefore limited. There is good clinical evidence supporting economic benefits of OPAT, but more high quality studies are needed for PPJI.

关键词： Antibiotic therapy Outpatient parenteral antibiotic therapy Inpatient parenteral antibiotic therapy Cost analysis Periprosthetic joint infection Parenteral

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Metallic debris from metal-on-metal total hip arthroplasty regulates periprosthetic tissues

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World Journal of Orthopedics 2014年第5期5卷 660-666页

作者： Christoph H Lohmann Gurpal Singh Hans-Georg Willert Gottfried H Buchhorn Department of Orthopaedic surgery Otto-von-Guericke University University orthopaedics Hand and Reconstructive Microsurgery Cluster National University Health System Department of orthopaedics University Hospital Goettingen

The era of metal-on-metal(MoM) total hip arthroplasty has left the orthopaedic community with valuable insights and lessons on periprosthetic tissue reactions to metallic debris. Various terms have been used to describe the tissue reactions. Sometimes the nomenclature can be confusing. We present a review of the concepts introduced by Willert and Semlitsch in 1977,along with further developments made in the understanding of periprosthetic tissue reactions to metallic debris. We propose that periprosthetic tissue reactions be thought of as(1) gross(metallosis, necrosis, cyst formation and pseudotumour);(2) histological(macrophage-dominated, lymphocyte-dominated or mixed);and(3) molecular(expression of inflammatory mediators and cytokines such as interleukin-6 and tumor necrosis factor-alpha). Taper corrosion and modularity are discussed, along with future research directions to elucidate the antigen-presenting pathways and materi-al-specific biomarkers which may allow early detection and intervention in a patient with adverse periprosthetic tissue reactions to metal wear debris.

关键词： Periprosthetic tissue response Metal-on-Metal Total hip arthroplasty Metal debris Lymphocytedominated Macrophage-dominated Taper corrosion Modularity

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Analysis of Cartilage Creep Recovery Using a Highly Dynamic Closed-loop Test System

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Journal of Bionic Engineering 2018年第6期15卷 1057-1066页

作者： Josef Stolberg-Stolberg Peter Foehr Iris Pflieger Lara Kuntz Constantin von Deimling Andreas Obermeier Peter M. Prodinger Christian U. Grosse Rainer Burgkart Department of orthopaedics and Sports orthopaedics Klinikum rechts der Isar Technical University of Munich Munich 81675 Germany Department of Trauma Hand and Reconstructive Surgery University Hospital Muenster Albert-Schweitzer-Campus 1 Muenster 48149 Germany Chair of Non-destructive Testing Technical University of Munieh Munich 81245 Germany Department of Trauma surgery Trauma Center Murnau Murnau 82418 Germany

The aim of this study was to analyze cartilage creep and creep recovery after static and cyclic loading. Up to now technical limitations have hindered the measurement of creep recovery. For this reason, we developed a closed loop micro creep and creep-recovery indentation test system with active force control. Bovine osteochondral explants were tested under static （110 kPa） and cyclic （100 cycles, 350 kPa/35 kPa, 1 Hz） loading conditions and subsequently creep recovery was measured. The cartilage thickness was determined using needle indentation. For static loading, the creep and creep-recovery rates were significantly different during the first 60 seconds （p 〈 0.05）. Cyclic loading was assessed for the medial and lateral patella and resulted in a physiological patellar cartilage strain of 7.7% ± 2.6% and 8.2% ± 2.7%, respectively. We recorded a creep recovery of 97.8% ±2.1% for the medial and 98.3% ± 2.4% for the lateral patella. The advantage of this study over earlier in vitro studies is that we recorded creep-recovery profiles with an actively controlled setup. This allowed us to analyze creep recovery immediately after removing the creep load, in contrast to MRI-based in vivo studies. In future, the presented method will enable us to quantify spatial variations within articular joints.

关键词： articular cartilage indentation creep recovery arthritis regenerative tissue

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Soft tissue defects of the hand:etiology and classification

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Plastic and Aesthetic Research 2023年第1期10卷 381-388页

作者： Bruno Battiston Camillo Fulchignoni U.O.C orthopaedics Traumatology and Hand SurgeryU.O.D.MicrosurgeryC.T.O.HospitalTurin 10126Italy Orthopedics&hand surgery unit Department of OrthopedicsFondazione Policlinico Universitario A.GemelliIRCCS-Catholic University of the Sacred HearthRome 00168Italy

Soft tissue defects of the hand may result from trauma,oncological procedures,or severe *** etiologies have been *** all cases,an accurate clinical examination is mandatory to understand which structures are involved and what must be *** can be helpful to simplify the decision-making process to classify these ***,there is no consensus on which classification is best to be used among those described in the *** review presents the most common ones,differentiating those classically used to describe tissue loss consequential to a traumatic event from those used to classify soft tissue defects consequent to other events.

关键词： Soft tissue defect trauma oncological infection tissue loss

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Preparation of acellular nerve grafts with triton X-100

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Neural Regeneration Research 2006年第7期1卷 645-648页

作者： Jinbao Han1, Juwen Chen2, Baohui Zhao1, Jichun Zhang1, Dehu Tian1, Jiuhui Han1 1Department of hand surgery, the Third Affiliated Hospital, Hebei Medical University, Shijiazhuang 050051, Hebei Province, China 2Second Department of orthopaedics, the Fourth Center Hospital of Tianjin, Tianjin 300140, China Department of hand surgery Hebei Medical University Shijiazhuang 050051 Hebei Province China Second Department of orthopaedics The Fourth Center Hospital of Tianjin Tianjin 300140 China

BACKGROUND: The source of nerve allograft enriches. We may choose expediently nerve allograft to repair injured nerve and the structure of choice nerve homology or similar with the injured nerve, but the immunological rejection limits the clinical application of nerve allograft. The ideal substitute of autograft never is researching. OBJECTIVE: In this experiment, Triton X-100 was used to extract the Schwann cells and myelin sheaths of allograft nerve and obtain the inartificial and eliminated antigenicity nerve-transplanter (nerve grafts). DESIGN: Controlled experiment. SETTING: Department of hand surgery, the Third Affiliated Hospital of Hebei Medical University; Second Department of Orthopedics, Fourth Center Hospital of Tianjin. MATERIALS: Thirty health New Zealand big ear white rabbit, of either sex (gender), weighing 2000-3000 g, were provided by the Center of Experimental Animal of Hebei Medical University. TritonX-100 was offered by SIGMA Company. METHODS: The experiment was carried out at the Central Laboratory of the Third Affiliated Hospital of Hebei Medical University from December 2003 to December 2004. Sixty pieces of sciatic nerves, 10-mm-long nerve segment, which were taken from 30 rabbits, were incised. They were randomly divided into chemical extraction group (n =50) and control group (n =10). In the chemical extraction groups, the nerves were put into 3% Triton X-100 solution. They were treated with Triton X-100 for 12 hours, 24 hours, 48 hours, 96 hours and 1 week, respectively. They were examined in every period. The control groups did not treated with anything. ① Respectively two segments of nerve by 2 mm length were taken from each nerve in the every periods. ② The laminin immunohistochemical stained sections were performed with image acquisition and analyzed with multicolor pathological image analysis system. Measured the laminin antibody reaction part of each section and computed laminin average gray degrees of the unit area. All dates were

关键词： cell Preparation of acellular nerve grafts with triton X-100 ECM Figure

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Assessment of palmar subcutaneous tissue vascularization in patients with Dupuytren's contracture

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World Journal of Orthopedics 2018年第9期9卷 130-137页

作者： Nathalia Shchudlo Tatyana Varsegova Tatyana Stupina Tamara Dolganova Michael Shchudlo Nathalia Shihaleva Vadim Kostin Clinics and Experimental Laboratory for Reconstructive Microsurgery and hand surgery Russian Ilizarov Scientific Center "Restorative Traumatology and Orthopaedics" Laboratory of Morphology of Federal State Budget Institution Russian Ilizarov Scientific Center "Restorative Traumatology and Orthopaedics"

AIM To investigate the structural and functional characte-ristics of palmar hypodermal tissue vascularization in Dupuytren's contracture patients of different *** Eighty-seven Dupuytren's contracture patients underwent partial fasciectomy. Twenty-two of them were less than 55 years old(Y-group, n = 22); the others were 55 and older(O-group, n = 65). In surgically excised representative tissue samples, a histomorphometric analysis of the perforating arteries of the palmar aponeurosis and stereologic analysis of hypodermis vascularity were performed. The method of laser flowmetry estimated the microcirculation of the skin of the *** Frequency of cases with rapid development of contracture(less than 5 years) was 13.6% in the Y-group and 40% in the O-group, P < 0.05. The external and luminal diameters of perforating arteries in palmar fascia were decreased more severely in Y. The thickness of intima increased three times compared with healthy control, and the intima/media relation also increased, especially in O. Increased numerical and volumetric micro-vessel densities in hypodermis, percentage of large vessels(more than 12 μm in diameter), and percentage of vessels with signs of periadventitial inflammatory infiltration were noted in Y. The percentage of vessels with adventitial fibrosis was greater in O than in Y. Base capillary flow in Y was increased compared to healthy control subjects and to O, and peak capillary flow was increased in comparison with *** Compared to the O-group, Y-group patients exhibited more severe constrictive remodeling of palmar fascia perforating arteries supplying hypodermis but more expressed compensatory changes of its capillarization.

关键词： Dupuytren’s contracture Laser Doppler flowmetry Hypodermis Histo-morphometry Palmar fascia

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