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Scientific Reports May 2024The number of amputated finger replantation has declined in the USA and Germany in recent years; however, there have been no reports on recent trends in Japan. We...
The number of amputated finger replantation has declined in the USA and Germany in recent years; however, there have been no reports on recent trends in Japan. We examined the current practices, attempts, and success factors of digit replantation in Japan. We hypothesized that the rates of digit replantation and success rates were consistently standardized in Japan. The diagnosis procedure combination database was used to analyze 14004 cases from April 2014 to March 2020, excluding multiple-digit amputations, thus focusing on 13484 patients. We evaluated replantation success rates and identified factors influencing replantation decisions using multiple logistic regression analysis. The key findings included a higher frequency of replantation in thumb cases and surgeries during overtime hours, on Sundays, and in educational institutions. Success rates were notably higher for thumb replantations and patients under 20 years of age. Patients over 65 years of age treated with urokinase showed higher failure rates, unrelated to regional or hospital case volumes. The number of amputated digit replantation surgeries in Japan was high during overtime hours, on Sundays, and in educational institutions. Region, hospital type, and hospital case volume were not associated with a low success rate across Japan.
Topics: Humans; Replantation; Japan; Male; Female; Middle Aged; Adult; Aged; Amputation, Traumatic; Finger Injuries; Databases, Factual; Young Adult; Adolescent; Treatment Outcome; Fingers; Child
PubMed: 38802545
DOI: 10.1038/s41598-024-62879-2 -
Case Reports in Plastic Surgery & Hand... 2024In hand trauma, the uninjured forearm has been touted as the ideal site for ectopic banking in digit/hand amputations. Here, we describe the temporary ectopic...
In hand trauma, the uninjured forearm has been touted as the ideal site for ectopic banking in digit/hand amputations. Here, we describe the temporary ectopic implantation and subsequent replantation of a partially amputated hand and highlight the "" - Recovery, Rehabilitation, and Revision over the first year of recovery.
PubMed: 38778864
DOI: 10.1080/23320885.2024.2350471 -
Archives of Craniofacial Surgery Apr 2024Scalp avulsion is a devastating injury. The best possible procedure is replantation. Several successful scalp replantations with anastomoses of several vessels in large...
Scalp avulsion is a devastating injury. The best possible procedure is replantation. Several successful scalp replantations with anastomoses of several vessels in large defects have been reported. In this report, we present a case of replantation of a large scalp avulsion using revascularizing with only one artery and vein. Despite the initial signs of flap congestion, we could predict the survival of the replanted scalp and terminate the procedure after detecting good perfusion and washout with indocyanine green fluorescence imaging. The procedure was successful following the patient's recovery of sensory and sweating functions without complications such as flap necrosis or infection. Several important factors for successful scalp replantation with positive esthetic and functional outcomes were considered.
PubMed: 38742337
DOI: 10.7181/acfs.2023.00122 -
Bone grafting combined with a spiral flap technique for the reconstruction of fingertip amputations.Ulusal Travma Ve Acil Cerrahi Dergisi =... May 2024Various reconstructive options exist for distal finger and pulp defects, including grafting and local or distant flaps. In addition to reconstructing the normal...
BACKGROUND
Various reconstructive options exist for distal finger and pulp defects, including grafting and local or distant flaps. In addition to reconstructing the normal anatomical structure, preserving the sensory function of the finger is crucial. This study presents the results of using bone grafting combined with a spiral flap (BGcSF) technique for reconstructing pulp defects accompanied by bone loss.
METHODS
Twenty-three patients with fingertip defects were treated using the BGcSF technique. Flap sensitivity was assessed us-ing the Semmes-Weinstein monofilament (SWM) and static two-point discrimination (2PD) tests at six months postoperatively. Cold intolerance of the affected fingers was evaluated using the Cold Intolerance Severity Score (CISS) questionnaire at one year postop-eratively. Patient satisfaction was assessed using the Michigan Hand Outcomes Questionnaire (MHQ). Range of motion (ROM) for the proximal and distal interphalangeal joints was measured with a goniometer at one year postoperatively.
RESULTS
Distal flap necrosis, affecting 10-15% of the flap area, was observed in one patient. No other complications were noted. The mean static two-point discrimination value at six months postoperatively was 5.6 mm, and the mean SWM score was 3.56. The mean CISS score at one year postoperatively was 18.8. The mean active ROM angle for the proximal interphalangeal joint was 106.7 degrees, and for the distal interphalangeal joint, it was 65.4 degrees. The mean MHQ score at one year postoperatively was 18.5.
CONCLUSION
The BGcSF technique provides soft tissue with a texture similar to that of the fingertips and supports effective sensory repair. It can be considered a viable option for fingertip reconstruction in cases where replantation is not feasible.
Topics: Humans; Finger Injuries; Male; Adult; Amputation, Traumatic; Female; Bone Transplantation; Surgical Flaps; Plastic Surgery Procedures; Middle Aged; Young Adult; Adolescent; Treatment Outcome
PubMed: 38738672
DOI: 10.14744/tjtes.2023.05118 -
Journal of Family Medicine and Primary... Mar 2024Traumatic dental injuries (TDIs) are frequently associated with an injury pattern that requires accurate diagnosis for developing the appropriate treatment plan. When...
Traumatic dental injuries (TDIs) are frequently associated with an injury pattern that requires accurate diagnosis for developing the appropriate treatment plan. When children with special healthcare needs, i.e., Hemophilia experience TDIs, managing the situation becomes a challenging task for pediatric dentists due to the requirement of a multidisciplinary approach in their care. This case report highlights the successful management of extrusive luxation injury of a young permanent tooth with an open apex in an eight-year-old male child with severe Hemophilia A. After a follow-up of nine years, the pulp showed significant healing with physiological closure of the apical foramen. The study further emphasizes that timely management of such injuries can lead to improved tooth prognosis.
PubMed: 38736808
DOI: 10.4103/jfmpc.jfmpc_1223_23 -
European Journal of Medical Research May 2024To compare the effects of a single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple approach and traditional laparoscopic Cohen in treating... (Comparative Study)
Comparative Study
Single-port-plus-one robot-assisted laparoscopic Lich-Gregoir direct nipple ureteral extravesical reimplantation in pediatric primary obstructive megaureter, comparing to laparoscopic cohen.
PURPOSE
To compare the effects of a single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple approach and traditional laparoscopic Cohen in treating pediatric primary obstructive megaureter.
MATERIALS AND METHODS
The clinical data of 24 children with primary obstructive megaureter from January 2021 to November 2021 were analyzed retrospectively. Among them, 12 children (8 boys and 4 girls, the average age were 17.17 ± 6.31 months) treated with the laparoscopic Cohen method were defined as group C. The remaining 12 children (7 boys and 5 girls, the average age was 17.33 ± 6.99 months) underwent single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple ureteral extravesical reimplantation were defined as group L. The parameters of pre-operation, intraoperative and postoperative were compared.
RESULTS
There were no differences in the patient characteristics and average follow-up time between the two groups (P > 0.05).The obstruction resolution rate was 100% in both groups. The total operation time in group L is slightly longer than that in group C(P < 0.001),but the intraperitoneal operation time of the two groups was comparable(P > 0.05). The postoperative parameters included blood loss, gross haematuria time, indwelling catheterization time and hospitalization time in group L is shorter than group C(P < 0.05). One year post-operation, decreasing in ureteral diameter and APRPD, and increasing in DRF were remarkably observed in both two groups(P < 0.05). Ureteral diameter, APRPD, and DRF were not significantly different both in pre-operation and post-operation between Group L and Group C(P > 0.05).
CONCLUSION
Single-port-plus-one robot-assisted laparoscopic-modified Lich-Gregoir direct nipple approach and traditional laparoscopic Cohen are both dependable techniques for ureteral reimplantation in the treatment of pediatric primary obstructive megaureter. Since Lich-Gregoir can preserve the physiological direction of the ureter and direct nipple reimplantation enhances the effect of anti-refluxing, this technique is favorable for being promoted and applied in robot surgery.
Topics: Humans; Female; Male; Robotic Surgical Procedures; Laparoscopy; Ureteral Obstruction; Ureter; Replantation; Retrospective Studies; Child, Preschool; Infant; Child; Operative Time; Treatment Outcome
PubMed: 38720334
DOI: 10.1186/s40001-024-01862-z -
Cureus Apr 2024Crown-root fractures are often challenging to treat and have a poor prognosis. The present case explains the successful management of a vertically fractured tooth...
Crown-root fractures are often challenging to treat and have a poor prognosis. The present case explains the successful management of a vertically fractured tooth treated by intentional replantation in a 12-year-old child. The patient underwent a successful 12-month follow-up, which included a mobility test and measurement of the gingival sulcus depth. Additionally, a radiological assessment was performed to evaluate the root resorption, the integrity of the alveolar cortex, and the periodontal space. We suggest that intentional replantation may be an effective therapeutic approach for the treatment of cases of vertical crown-root fractures.
PubMed: 38716028
DOI: 10.7759/cureus.57737 -
Contemporary Clinical Dentistry 2024This case report describes a case of intention replantation in a 15-year-old patient with a mandibular permanent right second molar that had undergone root canal...
This case report describes a case of intention replantation in a 15-year-old patient with a mandibular permanent right second molar that had undergone root canal treatment previously. The tooth was tender on percussion. Radiographic evaluation showed the presence of a separated instrument and periapical radiolucency. The surgical procedure was performed under local anesthesia, and the tooth was extracted. After cleaning and disinfecting the root canal system, the tooth was reimplanted, and the socket was filled with a mixture of bone graft material and a growth factor. A stainless steel crown was then placed to protect the tooth. A follow-up examination was performed after 12 months. The clinical and radiographic examinations revealed a well-healing periapical lesion with no signs of infection. The patient was asymptomatic, and the tooth was functional. The results of this case indicate that intentional replantation can lead to a favorable outcome.
PubMed: 38707664
DOI: 10.4103/ccd.ccd_134_23 -
Cureus Apr 2024Most of the dento-alveolar trauma that occurs frequently in childhood is often linked to avulsion injuries. Two considerable elements influencing the prognosis of tooth...
BACKGROUND AND OBJECTIVES
Most of the dento-alveolar trauma that occurs frequently in childhood is often linked to avulsion injuries. Two considerable elements influencing the prognosis of tooth avulsion after replantation are extraoral dry duration and the characteristics of the storage media to support the viability of cells. The study aimed to compare and assess the effectiveness of Hanks' balanced salt solution (HBSS) (HiMedia Laboratories, Thane, India) and Placentrex (Albert David Limited, Kolkata, India) against propolis (5% and 10%) as storage media in preserving the vitality of periodontal ligament (PDL) cells.
MATERIALS AND METHODS
Four groups with 15 samples each were selected for the study. Sixty recently extracted premolars were left to incubate for 30 minutes in 15-ml falcon tubes containing 2.5 ml of collagenase 0.2 mg/ml in phosphate-buffered saline and 2.4 mg/ml of dispase in HBSS, Placentex, propolis 5%, and propolis 10%. After the addition of bovine serum, it was centrifuged for 4 minutes. Trypan blue 0.4% was utilized to recognize the cells, and a hemocytometer was employed for counting the live PDL cells under a light microscope.
RESULTS
Propolis 5% and 10%, HBSS, and Placentrex all showed statistically significant differences in PDL cell viability; however, HBSS was significantly outperformed by Placentrex and propolis.
CONCLUSION
Placentrex is a superior substitute storage medium in cases of tooth avulsion as opposed to alternatives such as propolis 5% and 10%.
PubMed: 38699086
DOI: 10.7759/cureus.57454 -
JPRAS Open Jun 2024The fingertip amputation is an amputation type of the finger beyond the proximal nail fold. There is no vein available for anastomoses on the dorsal side of the finger,... (Review)
Review
BACKGROUND
The fingertip amputation is an amputation type of the finger beyond the proximal nail fold. There is no vein available for anastomoses on the dorsal side of the finger, and the palmar vein of the finger is small and tightly attached to the skin. Therefore, it is relatively difficult to implement surgical anastomoses, which poses challenges to the clinical treatment of fingertip amputations.
CASE REPORT
A 29-year-old male was admitted to the hospital due to "the amputation of the fingertips of the right index, middle, and ring fingers caused by a heavy object compression 3 h ago". The admission examination revealed that the right index, middle, and ring fingers were completely severed at the 1/2 plane of the nail bed, with irregular sections, severe contusion, and pollution. The X-ray examination showed comminuted fractures of the distal phalanges of the right index, middle, and ring fingers. Based on these findings, the patient was diagnosed with multiple severed fingertips of the right hand (Tamai Zone 1). The patient underwent debridement, vascular exploration, and replantation of the right index, middle, and ring fingertips under emergency general anesthesia. After surgery, anti-inflammatory, spasmolytic, and anticoagulant treatment and regular dressing changes were conducted. The patient did not receive a blood transfusion, and all three fingers survived. The appearance of these fingers was favorable 3 months after surgery, and the flexion and extension of these fingers were normal. Eventually, the patient achieved excellent Chen's hand function scores.
CONCLUSIONS
To the best of our knowledge, this may be the first successful case regarding the replantation of three fingertips after amputations in Tamai Zone 1 with favorable outcomes. It can be maintained that super microsurgery can be used for the replantation of multiple fingertip amputations.
PubMed: 38694441
DOI: 10.1016/j.jpra.2024.03.008