TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER
A case in a series of nine transmetacarpal replantations was presented at the combined meeting of the 7th European congress on Prevention of Hand Traumas and the 7th congress of the Bulgarian Society for Surgery of the Hand, 19-21 October 2023, Plovdiv, Bulgaria. A male patient aged 42, a h...
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Bulgarian Orthopaedics and Trauma Association
2024-03-01
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| Series: | Journal of the Bulgarian Orthopaedics and Trauma Association |
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| Online Access: | https://jbota.org/index.php/jbota/article/view/120 |
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| author | Binka Popova Elena Mateva Kevork Kaykchian Deyan Sokolov |
| author_facet | Binka Popova Elena Mateva Kevork Kaykchian Deyan Sokolov |
| author_sort | Binka Popova |
| collection | DOAJ |
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A case in a series of nine transmetacarpal replantations was presented at the combined meeting of the 7th European congress on Prevention of Hand Traumas and the 7th congress of the Bulgarian Society for Surgery of the Hand, 19-21 October 2023, Plovdiv, Bulgaria.
A male patient aged 42, a heavy truck driver, was an ideal candidate for replantation. In February 2012 he sustained transmetacarpal amputation by circular saw through the proximal third of the left hand, with local crush of the tissues. During replantation enormous tissue edema appeared, caused by long ischemia time with cryopreservation of the amputated part for three hours. Restoration of the common digital nerves was postponed and performed 4 months later (Millesi procedure).
Eleven years later the following outcome is registered. TAM: 110 (good), ab-adduction of 2nd and 4th fingers is restored in limited range. The effect is attributed to reinnervation of some spared interosseous muscles by the motor branch of the ulnar nerve, restored during the autoplastic of the common digital nerves. The lateral pinch between the thumb and second finger is useful.
The skin sensitivity is examined by Weber static two-point discrimination test (2pdt):12 mm for 2nd and 3rd fingers, 15 mm for the 4th finger and one point for the pulps of the 5th finger and the thumb; 2pdt, carried out on the palm, in the base of the fingers, is 10 mm.
The gained useful function of the hand is 50%. Original working ability is restored, but it is forbidden for the patient to work as a professional driver. He can drive his own car.
In transmetacarpal replantations with level through the proximal part of the palm some interosseous muscles are preserved, and repair of the motor branch of the ulnar nerve is with favorable prognosis regarding functional recovery.
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| format | Article |
| id | doaj-art-3f864566c03845c6b5c600873a093004 |
| institution | Kabale University |
| issn | 0473-4378 2815-3715 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Bulgarian Orthopaedics and Trauma Association |
| record_format | Article |
| series | Journal of the Bulgarian Orthopaedics and Trauma Association |
| spelling | doaj-art-3f864566c03845c6b5c600873a0930042025-02-12T06:11:24ZengBulgarian Orthopaedics and Trauma AssociationJournal of the Bulgarian Orthopaedics and Trauma Association0473-43782815-37152024-03-016101TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATERBinka Popova0Elena Mateva 1Kevork Kaykchian2Deyan Sokolov 3Clinic of Orthopedics and Traumatology, University Hospital “Tsaritsa Yoanna-ISUL”, Sofia, BulgariaClinic of Orthopedics and Traumatology, University Hospital “Tsaritsa Yoanna-ISUL”, Sofia, BulgariaClinic of Orthopedics and Traumatology, University Hospital “Tsaritsa Yoanna-ISUL”, Sofia, BulgariaClinic of Orthopedics and Traumatology, University Hospital “Tsaritsa Yoanna-ISUL”, Sofia, Bulgaria A case in a series of nine transmetacarpal replantations was presented at the combined meeting of the 7th European congress on Prevention of Hand Traumas and the 7th congress of the Bulgarian Society for Surgery of the Hand, 19-21 October 2023, Plovdiv, Bulgaria. A male patient aged 42, a heavy truck driver, was an ideal candidate for replantation. In February 2012 he sustained transmetacarpal amputation by circular saw through the proximal third of the left hand, with local crush of the tissues. During replantation enormous tissue edema appeared, caused by long ischemia time with cryopreservation of the amputated part for three hours. Restoration of the common digital nerves was postponed and performed 4 months later (Millesi procedure). Eleven years later the following outcome is registered. TAM: 110 (good), ab-adduction of 2nd and 4th fingers is restored in limited range. The effect is attributed to reinnervation of some spared interosseous muscles by the motor branch of the ulnar nerve, restored during the autoplastic of the common digital nerves. The lateral pinch between the thumb and second finger is useful. The skin sensitivity is examined by Weber static two-point discrimination test (2pdt):12 mm for 2nd and 3rd fingers, 15 mm for the 4th finger and one point for the pulps of the 5th finger and the thumb; 2pdt, carried out on the palm, in the base of the fingers, is 10 mm. The gained useful function of the hand is 50%. Original working ability is restored, but it is forbidden for the patient to work as a professional driver. He can drive his own car. In transmetacarpal replantations with level through the proximal part of the palm some interosseous muscles are preserved, and repair of the motor branch of the ulnar nerve is with favorable prognosis regarding functional recovery. https://jbota.org/index.php/jbota/article/view/120replantationtransmetacarpalresults |
| spellingShingle | Binka Popova Elena Mateva Kevork Kaykchian Deyan Sokolov TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER Journal of the Bulgarian Orthopaedics and Trauma Association replantation transmetacarpal results |
| title | TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER |
| title_full | TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER |
| title_fullStr | TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER |
| title_full_unstemmed | TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER |
| title_short | TRANSMETACARPAL REPLANTATION. ELEVEN YEARS LATER |
| title_sort | transmetacarpal replantation eleven years later |
| topic | replantation transmetacarpal results |
| url | https://jbota.org/index.php/jbota/article/view/120 |
| work_keys_str_mv | AT binkapopova transmetacarpalreplantationelevenyearslater AT elenamateva transmetacarpalreplantationelevenyearslater AT kevorkkaykchian transmetacarpalreplantationelevenyearslater AT deyansokolov transmetacarpalreplantationelevenyearslater |