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Hand Clin 23 (2007) 137-141


Note: Page numbers of article titles are in boldface type.

Amputation(s), digital, classification of, 2-3 guillotine, of distal ulnar digits, 3, 4

Amputation stumps, of fingers, cruciate incisions on, 124, 125

Anterolateral thigh flap, 41-42, 43

Arm, biceps function of, functioning free muscle transfer to, operative technique for, 69-70

Arm flap, lateral, 40-41 free, 28-29

surgical anatomy of, 39

Arterial occlusion, in digital replantation, 8

Biceps and brachialis muscle, reinnervation of, 77

Bone(s), fixation of, following radical debridement in soft tissue injury, 27, 28, 29 upper limb, massive defects of, reconstruction by vascularized bone transfer, 49-56

Bone transfer, microvascular, history of, 49 vascularized, reconstruction of massive bone defects by, 49-56 donor sites for, 51 indications for, 50-51 surgical technique for, 51-55

Brachial plexus avulsion injury, free muscle transfer for, neurotization and, 91-104

Brachial plexus palsy, birth, 87-88

complete (global) palsies in, 87-88 lesions of upper plexus in, 87 complete, conventional versus microneurosurgical treatment of, 84-85

in adult, microneural reconstruction in, candidates for, 83-84 incomplete, in lower lesion in adult, 86-87

in upper lesions in adult, 85-86 restoring shoulder function in, conventional means of, 85

microsurgical means of, 85-86 microsurgical treatment of, is it better than conventional treatment? 83-89 upper, incomplete, restoring elbow flexion in, by conventional means, 86

by microsurgical means, 86

Constriction ring syndrome, congenital, 130

Cruciate incisions, on amputation stumps of fingers, 124, 125

Debridement, adequate, 38 delayed, results of, 24 dirty wound requiring, 24-25, 26 prior to free flap soft tissue reconstruction, 37-38

radical, and bone fixation, in severe soft tissue injury, 27, 28, 29 in upper extremity, 23 principles of, 24-25 techniques of, 26 versus serial, 23-24 wound before and after, 38 serial, advantages and disadvantages of, 24

Digital replantation, 1-12 anticoagulation for, 10 arterial occlusion in, 8 bleeding associated with, 8 cold sensitivity and vascularization associated with, 10 complications of, 7-8 contraindications to, 4-5 digit for, 5 distal replants, 6-7 dorsal repair for, 5-6 evaluation and exposure for, 5 failure of, 8 function following, 9 history of, 2

in avulsion injuries, 7 indications for, 3 infection in, 8

multiple digits/heterotopic replantation and, 7

operative sequence for, 5-7

palmer repair for, 6

patient factors and, 4

postoperative care in, 6

prolonged ischemia and ''no reflow''

phenomenon in, 7-8 range of motion following, 9-10 rejection and, 4 results of, 8-10 sensation following, 10 skeletal complications of, 8 skeletal shortening and fixation for, 5 skin closure in, 6 survival rates for, 8-9 technique of, 5 thumb replants in, 7 venous occlusion in, 8

Elbow, flaps for coverage of, 27

Ewing's sarcoma, nonunion in, following radiation for, 52

Fascial flaps, 43

Fasciocutaneous flaps, 40-42

Fibula, as donor site for microvascular bone transfer, 49

osteocutaneous free flap of, 42, 44, 45, 46

Finger(s), absence of, in congenital constriction ring syndrome, 130

amputation stumps of, cruciate incisions on, 124, 125

amputation(s) of, classification of, 2-3 multiple, reconstruction in, 119-120 nonreplantable, initial management of, 117-118

distal ulnar, guillotine amputation of, 3, 4 posttraumatic reconstruction of, with microsurgical transplantation of toes,


single, amputation of, reconstruction in,


Foot, dorsum of, dissection of, 107, 108 first interspace of, dissection of, 109-110

Forearm, circumferential degloving injury of, 43-44, 46

extensor aspect of, functioning free muscle transfer to, operative technique for, 69, 70 one-bone forearm construct for, 50

Forearm-carpal defect, vascularized fibula transfer in, 54-55

Forearm flap, radial, 40, 42

Free flap(s), emergency, 26-27 donor sites for, 28-30 for immediate reconstruction, 30-35 requirements of, 26 results of, 28 size of defect and, 28 for coverage and immediate reconstruction, following debridement in upper extremity, 23-36

for soft tissue coverage, indications for, 38-39 and selection of, 37-48 initial requirements for, 37-38 postoperative care in, 45 reconstruction using, timing of, 39 selection of, 39-45 groin flap, 29-30 lateral arm flap, 28-29 osteocutaneous fibular, 42, 44, 45, 46

Free muscle transfers, for brachial plexus avulsion injury, neurotization and, 91-104 functioning, 57-72, 99-100 criteria for, 58

for elbow or finger function, 102 in Volkmann's ischemic contracture. See under Volkmann's ischemic contracture. indications for, 58-59 muscle selection for, 59 nerve transfer for, 102-103 postoperative management and rehabilitation following, 102-103 recipient site preparation for, 59-60 results of, 70-71

Gracilis flap, 45

Gracilis muscle, dissection of, and muscle insertion, 100-102

preparation of, for functioning muscle transfer in Volkmann's ischemic contracture, 64-65 transfer of, in Volkmann's ischemic contracture, 65-67

Great toe, pulp reconstruction with hemipulp flap from, 119

-to-thumb, microvascular transplantation of, after traumatic amputation, 105-115 vascular anatomy of, 108 wrap-around flap of, in degloving injury of thumb, 42, 44

Groin flap, free, 29-30

Guillotine amputation, of distal ulnar digits, 3, 4

Gunshot wound, infected nonunion of humerus following, 51

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