上臂高位断肢再植一例初步报告

目的报告一例上臂高位断肢再植的治疗结果。方法对1例左上臂高位断肢患者的病史,术后功能的恢复进行分析。结果本例患者术后再植肢体肿胀不明显,创面一期愈合。139d后,手指出现轻微的屈指运动,6个月后,左手出现触觉痛,8个月后,骨折线模糊,主动运动肩关节外展30°,前屈20°,肘关节屈75°,伸0,腕关节背伸0,掌屈15°,大小鱼际肌及手内在肌轻度萎缩,呈爪形手,被动屈曲时指尖能接近掌指关节,伸指受限,被动活动度达正常范围,腕关节近端痛觉,触压觉及温冷觉明显恢复,左手感觉尚未恢复。结论上臂高位离断再植的适应症是肢体完整,缺血时间短,神经非根性撕脱伤,且患者年轻,全身情况良好,应尽量给予再植。     

San Antonio military and civilian hand transplantation program: a case report

Presented is a report on the first female hand allotransplantation performed in the USA. The patient sustained a dominant hand amputation at the level of the wrist as a result of a bomb explosion while on active duty in the United States Air Force. A hand allotransplantation was performed at a military treatment facility by a team of physicians composed of representatives from private practice, academia, and military medical institutions.     

锁骨慢性骨髓炎切除术后对侧锁骨10年后再发1例报告及文献复习

[目的]探讨锁骨骨髓炎的临床特点、诊断鉴别、复发因素及治疗经验.[方法]观察和分析1例锁骨骨髓炎锁骨切除术后10年对侧锁骨再发的病例临床特点,并结合文献复习,总结锁骨骨髓炎的诊断鉴别要点.[结果]锁骨骨髓炎临床症状不典型,多发生于血源性细菌播散,诊断及鉴别需借助X线、CT等影像学资料及病理检查,治疗上应坚持足量、联合抗炎治疗.[结论]锁骨骨髓炎临床比较少见,可出现迁移不愈及远处复发,应结合影像及病理检查等才能较好诊断及鉴别诊断.     

Accidental radiation injury to the hand: a case report

A 46-year-old patient with severe radiation injury of his hand was presented to our clinic. Five months previously, the patient had repaired a piece of metallic equipment which was later discovered to belong to a gammagraphy machine. The fifth ray of his left hand, having ulceration of the volar–ulnar side of the palm, was resected, and the resulting defect was repaired with a posterior interosseous flap. However, owing to the progressive nature of the disease, the patient developed further necrosis around the flap, and the third and fourth fingers. Therefore, further amputations were needed. Hyperbaric oxygen therapy with sympathectomy was used postoperatively. A radiation ulcer on the abdominal area developed in the tenth postoperative month, this was due to contact of his abdomen with the table on which he put the radiation source. This ulceration was excised and closed primarily. We would like to emphasize in the light of this case that all radiation sources and their management during all phases of application, transport and disposal should be strictly controlled.     

Chondrolipoma of the hand: a case report

The authors present the case of a chondrolipoma which was excised from the left hand's palm of an 83-year old woman. Chondrolipomas are rare neoplasms; their terminology and pathogenesis have been controversial in the past. Chondrolipoma in the hand does not seem to have been reported so far. The present case thus expands the spectrum of neoplasms known to arise at this anatomical site.     

Leiomyoma of the hand: a case report

We report a case of leiomyoma of the finger in the right hand of a 12-year-old boy: a rare site for localization and unusual for age. This is a benign tumor originating from non-striated muscle that is very uncommon in the hand. The uterus is considered the most common location for leiomyoma and when it occurs in the extremities, it is more common in the leg, ankle and foot. It usually occurs in the third and fourth decades of life and it is rarely diagnosed before surgery as the diagnosis can only be confirmed histologically.     

Extramedullary plasmacytoma of the hand: a case report

Plasmacytoma commonly occurs as an interosseous lesion. The soft tissue variant of plasmacytoma has been found infrequently in the feet but not in the hands. We describe a 47-year-old man with extensive involvement of the flexor tendons by a plasmacytoma.     

Ewing's sarcoma of the hand: a case report

Ewing's sarcoma of the hand is rare. This tumor was first described in 1921, since then, only a few cases with hand involvement have been reported. We report a case of Ewing's sarcoma of the left hand, presenting as a swelling of the hand gradually enlarging over six months. Plain radiographs showed marked osteolysis of the second, third and fourth metacarpals. Histological confirmation was made following biopsy. Despite amputation and post-operative chemotherapy, death occurred two months later due marrow aplasia.     

Nodular fasciitis of the hand: a case report

Nodular fasciitis is a benign, reactive fibroblastic soft tissue tumor. Involvement of the hand is exceedingly rare. A case of nodular fasciitis involving the dominant hand of a 38-year-old woman is reviewed, and its clinicopathologic features are presented. Because of its rapid growth and aggressive histologic appearance, nodular fasciitis can be mistaken for a soft tissue sarcoma, despite its benign clinical behavior. For this reason, aggressive surgical resection should be avoided.     

离体组织块19 h原位桥接再植存活一例报告

利用游离皮瓣修复肢体组织缺损早已被临床广泛应用。2002年9月14日，我院收治1例右前臂完全离断伴尺侧组织大面积缺损、失血性休克的患者．在积极抢救休克的同时，利用尺侧大面积离体的组织修复创面获得成功。     

Giant lipoma of hand: a case report

Lipomas are one of the commonest benign soft tissue tumors but occurrence in hands is rare. They can cause mechanical dysfunction, pain and altered sensibility in hand. Complete resection may not be required.     

Perichondrial arthroplasty in the hand: a case report

A two-stage arthroplasty technique was used to treat an isolated fibrous ankylosis that developed in the index metacarpophalangeal joint of a 14-year-old boy after a rattlesnake bite. The first stage consisted of a minimal joint resection combined with rib perichondrial grafts to resurface the joint. The second stage, performed 5 months later, consisted of a capsulotomy and removal of a silicone membrane left within the joint to separate the grafts. Biopsy of the joint surfaces revealed the presence of hyaline-like cartilage. Nearly normal pain-free motion was restored. Follow-up now exceeds 30 months.     

左下肢高位断肢再植1例体会

患者,男,40岁,已婚,因车祸致双侧大腿离断伴疼痛出血8h入院。入院查体:推入病房,急性痛苦貌,右下肢大腿上段离断伤,宽约4cm挫伤坏死皮肤相连,伤口深达骨质,皮肤、皮下组织、深筋膜、肌肉及骨膜不规则挫伤,毁损严重,骨折端毁损。左下肢大腿中上段不全离断伤,仅股外侧肌群、坐骨神经及后外侧部分皮肤相连,伤口深达骨质,皮肤、皮下组织、深筋膜、肌肉及骨膜不规则挫伤、毁损严重,骨折端粉碎伴大段骨质缺损。伤口创缘不整齐,创缘颜色暗淡血运欠佳,伤口周围轻微红肿,伴活动性出血,皮肤肌肉挫伤毁损严重,伤口周围压痛不适,伤口内污染严重,左下肢肢端颜色苍白,足背动脉未扪及搏动。左侧会阴部见一长约6cm皮肤挫裂伤,深达皮下,伴活动性渗血,伤口周围轻微红肿,压痛明显。辅助     

Mycobacterium chelonei tenosynovitis of the hand: a case report

We report an unusual organism, Mycobacterium chelonei, which causes digital tenosynovitis. Atypical mycobacterial infections of the hand are uncommon. The diagnosis should be suspected when there is persistent swelling or tenosynovitis, inconsistent with other inflammatory processes such as rheumatoid arthritis. Synovial biopsy specimen and appropriate cultures are necessary to confirm the diagnosis.     

Congenital fibrous hamartoma of the hand: a case report

A patient with a rare localization of a congenital fibrous hamartoma of the hand is described, and the differential diagnosis is discussed. A review of the literature shows the rare frequency of localization of this lesion on the limb extremities.     

Low-grade fibromyxoid sarcoma of the hand: a case report

We report a case of low-grade fibromyxoid sarcoma with giant collagen rosettes in the hand of a 21-year-old female. This is a clinically and radiological benign appearing tumor that has a high rate of recurrence and metastasis.