When it comes to injuries of the collateral ligament in the metacarpal-phalangeal joint of the thumb, the best results have proved to be obtainable from primary surgery. Secondary ligament surgery according to Strandel, in its modification by B‰uerle and Reill, has its clear-cut indication and ensures restoration of thumb functionality. Arthrodesis is an alternative that should be chosen with generosity.
The successful treatment of a man with severe posttraumatic contractures of the hand using a combined psychological and physical rehabilitation approach is reported. The contractures had functional and organic components, as did the treatment, which involved teaching the patient self-hypnosis exercises and the use of a splint. The patient obtained virtually complete return of movement after 3 1/2 years of total disability. The importance of identifying and mobilizing rather than challenging the patient's motivation for recovery using a rehabilitation approach is discussed.
An experience with functional and physical and physical therapy employed postoperatively in 525 patients with injuries of 752 digital flexor tendons is reported. A primary suture on flexor tendons after the V.I. Rozov technic within the boundaries of the synovial-aponeurotic sheath was put on 252 fingers in 183 patients. Homoplasty of digital flexor tendons was performed in 342 patients (500 fingers), terms of the injury being from 2 months to 15 years.
PURPOSE: To describe a technique for covering defects of the fingertips: the innervated digital artery perforator (IDAP) flap. METHODS: A total of 17 patients were treated with an IDAP flap. The size of the flaps varied between 2 ×1 cm and 3.5 × 2 cm. Postoperative evaluation of the patients consisted of the Semmes-Weinstein Monofilament test, static 2-point discrimination, patient satisfaction, extension loss, and an investigation into complications. RESULTS: All IDAP flaps survived completely, and no patients required secondary interventions.