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Hand Trauma – Soft Tissue
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
Assessment of damage to the Ulnar nerve, Median nerve and superficial branch of the Radial nerve due to more proximal penetrating trauma is as per the steps and anatomy described in Hand Assessment chapter. Bear in mind the likelihood of associated injuries due to the close anatomical relationships between: (1) the Median nerve and flexor tendons to the digits + palmaris longus tendon (2) the Ulnar nerve and the Ulnar artery + FCU tendon. If damage to the Median or Ulnar nerve is suspected admit the patient and discuss the case urgently with a senior.
Miscellaneous Topics
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Prateek Behera, Karthick Rangasamy, Nirmal Raj Gopinathan
A superficial branch of the radial nerve can be traced by connecting the following points: Mark the first point at 1 cm on the lateral side of the biceps brachii tendon slightly below the lateral epicondyle.Mark the second point on the lateral border of the forearm at the junction of the superior two-thirds and inferior one-third, just slightly on the lateral side of the radial artery.Mark the third point on the anatomical snuff box.
Arteriovenous Fistulas for Chemotherapy
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
The radial artery is exposed under the superficial aponevrosis, after section of the small tributaries. As for the vein, a tape is used to mobilize the vessel. The superficial branch of the radial nerve is preserved.
Reverse homodigital dorsoradial flaps for thumb coverage obtained good sensory recovery after a long time follow up
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Qiaoyun Zhang, Wenyi Li, Qingzhong Chen
The superficial branch of the radial nerve is a constant anatomic landmark going under the flap to the first web and dorsal area of the thumb [10]. Nerve coaptation in the flap with the stump of the digital nerve in the injured thumb could be achieved by including the superficial branch of the radial nerve into the flap when dissecting the flap. In this study, nerve coaptation was not performed, and the sensory recovery of the flap depended on the periphery or nether nerve fibers growing into [6]. Masuda Tetsuo et al. suggested that nerve coaptation could improve sensory recovery after reconstruction of thumb soft-tissue defect by using a wrap-around flap [7]. Santanelli Fabio et al. also suggested that major plantar foot reconstruction with free fasciocutaneous flap could repair the nerves and thus improve sensory recovery in long-term results [11]. Blondeel et al. found that nerve repair in free DIEP flaps restored sensation early after surgery, increased the quality and quantity of sensation in the flap and showed a high chance of providing erogenous sensation [8]. However, in this study, the sensory recovery of RHDF of the thumb without nerve coaptation was comparable with that of the contralateral uninjured hand after long-term follow up, indicating excellent sensory recovery. Some authors reported spontaneous sensory recovery of the flap without nerve repair after a longer time recovery [2,12]. However, no article reported the extent of the sensory recovery of the flap and its duration. This study shed light on these questions and provided some evidence.
Free neurosensory flap based on the accompanying vessels of lateral sural cutaneous nerve: anatomic study and preliminary clinical applications
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Weichao Yang, Gen Wen, Feng Zhang, William C. Lineaweaver, Chunyang Wang, Kyler Jones, Yimin Chai
The size of the flaps ranged from 12 × 6 cm to 25 × 8 cm, and the length of the pedicle was 5.5 cm on average. All six flaps survived completely without complications. In three patients, the superficial lateral sural vessels were anastomosed to medial plantar vessels, and the LSCN was coapted to the medial plantar nerve in an end-to-end fashion. In two patients, the pedicle vessels were anastomosed end-to-end to a branch of radial vessels, and the LSCN was coapted to the superficial branch of the radial nerve. In one patient, the vessels of the flap were anastomosed end-to-end to a branch of ulnar vessels, and the LSCN was coapted to the medial cutaneous nerve. Follow-up ranged from 6 to 18 months with 11 months in average. No additional debulking was necessary, and the overall contour after resurfacing was satisfactory. No epithelial breakdown occurred in patients with sole injuries. The donor sites healed without complications and the skin grafts healed uneventfully. The main donor site morbidity was the scar after grafting over the posterolateral leg, which can be concealed by pants. No painful neuroma of LSCN recorded.
Update on complications and their management during transradial cardiac catheterization
Published in Expert Review of Cardiovascular Therapy, 2019
Joe Aoun, Laith Hattar, Khabib Dgayli, Gordon Wong, Tariq Bhat
Neurological injury is a rare complication of transradial catheterization because the anatomic position of the radial artery is distinct from the major nerves innervating the hand. Presenting as numbness or tingling of the hand, superficial radial neuropathy after transradial catheterization can be the result of compression of the superficial branch of the radial nerve and is reported at an incidence of 1.52% [16]. This is typically transient and self-limiting. Nerve damage, which may be more limiting for patients, can occur as a result of acute arterial occlusion or direct penetrating trauma, though this is exceedingly rare, with an incidence of 0.16% [16].