The application of a dressing marks the end of surgery and is in itself an art form. The dressing is the only part of surgery that the patient can visualize and immediately appreciate. For the patient it is the immediate…
Multidigit injuries are common. An amputated finger that is not replantable becomes a privileged donor site for harvesting tissue for the reconstruction of neighboring fingers. This is a unique opportunity that must be seized at the time of the emergent…
Komatsu and Tamai performed the first successful replantation of a fully severed thumb in 1965. Since then, the field of digital replantation has evolved considerably. There has been extensive progress in terms of the development of suture materials, microsurgical instruments…
Anatomy and Physiology Physiology Although the nail no longer has a defensive role in humans, it nevertheless retains an important function. It is the only rigid element stabilizing the distal pulp of the fingers beyond the distal phalanx tuft. It…
Whatever the level of mutilation and finger concerned, carrying out a digital amputation is a significant surgical procedure with functional consequences. We speak of “temporary” amputation when a subsequent reconstruction is planned. This is most often a microsurgical reconstruction by…
Small Finger and Hand Soft Tissue Defects Small soft tissue defects affecting the digits are common. The method of coverage should be carefully selected and based on the following criteria: the topography of the defect, the affected finger, the associated…
The diagnosis of a finger devascularization, single or multiple, should be made upon admission of the patient because it defines the degree of urgency. Revascularization consists of restoring arterial inflow and venous return. It is undertaken once the skeleton has…
The practice of hand surgery requires appropriate instrumentation. The instruments used should be adapted in size to the tissue structures themselves, and the instruments should have an ergonomic handle for precision and comfort. Handles should be short because this surgery…