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[PMID]: 29191846 [Au] Autor: David M; Rangaraju M; Raine A [Ad] Endereço: The Royal Orthopaedic Hospital, Birmingham, UK michaeldavid@nhs.net. [Ti] Título: Acquired triggering of the fingers and thumb in adults. [So] Source: BMJ;359:j5285, 2017 11 30. [Is] ISSN: 1756-1833 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Deformidades Adquiridas da Mão/patologia Deformidades Articulares Adquiridas/patologia Tenossinovite/patologia Polegar/patologia Dedo em Gatilho/patologia [Mh] Termos MeSH secundário: Adulto Idoso Inglaterra/epidemiologia Feminino Deformidades Adquiridas da Mão/etiologia Deformidades Adquiridas da Mão/cirurgia Seres Humanos Injeções Subcutâneas Liberação da Cápsula Articular/métodos Deformidades Articulares Adquiridas/etiologia Deformidades Articulares Adquiridas/cirurgia Masculino Meia-Idade Estudos Observacionais como Assunto Prevalência Atenção Primária à Saúde/estatística & dados numéricos Esteroides/administração & dosagem Esteroides/uso terapêutico Tenossinovite/etiologia Polegar/cirurgia Dedo em Gatilho/tratamento farmacológico Dedo em Gatilho/etiologia Dedo em Gatilho/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Steroids) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171202 [St] Status: MEDLINE [do] DOI: 10.1136/bmj.j5285

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[PMID]: 29384844 [Au] Autor: You JP; Lu L; Li CJ; Ren B; Wang T [Ad] Endereço: Department of Emergency. [Ti] Título: Modified trapeziectomy with ligament reconstruction tendon interposition for the treatment of advanced thumb carpometacarpal arthritis: A case report. [So] Source: Medicine (Baltimore);97(5):e9665, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Thumb carpometacarpal (CMC) arthritis is a common disease. Various procedures have been described for the treatment of advanced thumb CMC arthritis. This essay shows a CMC arthritis case treated by modified trapeziectomy with ligament reconstruction tendon interposition (LRTI). PATIENT CONCERNS: A 53-year-old Chinese female complained of pain and swelling at the base of the left thumb for 10 years. Visual analog scale (VAS) for thumb was 7 points, Disabilities of Arm, Shoulder and Hand (DASH) score was 51 points, and Kapandji score was 6 points before surgery. Preoperative range of motion (ROM) for radial abduction and volar abduction were 63°and 62°, respectively. Grip power was 15.3 kg and key-pinch power was 1.8 kg before operation. Preoperative waist flexion power was 20.9 kg. Hand x-ray showed left thumb CMC arthritis in Eaton stage III and the height of the trapezial space was 10 mm. DIAGNOSES: She was diagnosed with left thumb CMC arthritis (Eaton III stage). INTERVENTIONS: The patient underwent modified trapeziectomy with LRTI. After exposing and removing trapezium, and a hole from the dorsal base to the center of the articular surface was drilled. Then we cut the whole flexor carpi radialis and divided it into 2 halves. Afterward, we passed one-half through the hole and tied it to the other part and sutured them. The rest tendon was then tied continuously and sutured. Then we rolled it up into the space where previous trapezium was located. OUTCOMES: Two years after operation, pain and swelling relieved and no recurrence of the clinical symptoms occurred. VAS, DASH, and Kapandji score were 2, 22, 7 points, respectively. ROM for radial abduction and volar abduction were 79° and 78°, respectively. Furthermore, grip power was 22.7 kg and key-pinch power was 3.8 kg. Waist flexion power was 20.0 kg. Hand x-ray showed that the height of the trapezial space was 9.8 mm. LESSONS: Modified trapeziectomy with LRTI in treatment of advanced thumb CMC arthritis had a satisfactory efficacy. This new procedure not only prevents thumb sinking, but also provides enough support for thumb. [Mh] Termos MeSH primário: Articulações Carpometacarpais Ligamentos/cirurgia Osteoartrite/cirurgia Procedimentos Cirúrgicos Reconstrutivos Tendões/cirurgia Trapézio/cirurgia [Mh] Termos MeSH secundário: Articulações Carpometacarpais/diagnóstico por imagem Articulações Carpometacarpais/cirurgia Feminino Seres Humanos Meia-Idade Procedimentos Ortopédicos Osteoartrite/diagnóstico por imagem Polegar/diagnóstico por imagem Polegar/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180221 [Lr] Data última revisão: 180221 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009665

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[PMID]: 29384839 [Au] Autor: Ladny JR; Smereka J; Rodríguez-Núñez A; Leung S; Ruetzler K; Szarpak L [Ad] Endereço: Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok. [Ti] Título: Is there any alternative to standard chest compression techniques in infants? A randomized manikin trial of the new "2-thumb-fist" option. [So] Source: Medicine (Baltimore);97(5):e9386, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Pediatric cardiac arrest is a fatal emergent condition that is associated with high mortality, permanent neurological injury, and is a socioeconomic burden at both the individual and national levels. The aim of this study was to test in an infant manikin a new chest compression (CC) technique ("2 thumbs-fist" or nTTT) in comparison with standard 2-finger (TFT) and 2-thumb-encircling hands techniques (TTEHT). METHODS: This was prospective, randomized, crossover manikin study. Sixty-three nurses who performed a randomized sequence of 2-minute continuous CC with the 3 techniques in random order. Simulated systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressures (PP, SBP-DBP) in mm Hg were measured. RESULTS: The nTTT resulted in a higher median SBP value (69 [IQR, 63-74] mm Hg) than TTEHT (41.5 [IQR, 39-42] mm Hg), (P < .001) and TFT (26.5 [IQR, 25.5-29] mm Hg), (P <.001). The simulated median value of DBP was 20 (IQR, 19-20) mm Hg with nTTT, 18 (IQR, 17-19) mm Hg with TTEHT and 23.5 (IQR, 22-25.5) mm Hg with TFT. DBP was significantly higher with TFT than with TTEHT (P <.001), as well as with TTEHT than nTTT (P <.001). Median values of simulated MAP were 37 (IQR, 34.5-38) mm Hg with nTTT, 26 (IQR, 25-26) mm Hg with TTEHT and 24.5 (IQR,23.5-26.5) mm Hg with TFT. A statistically significant difference was noticed between nTTT and TFT (P <.001), nTTT and TTEHT (P <.001), and between TTEHT and TFT (P <.001). Sixty-one subjects (96.8%) preferred the nTTT over the 2 standard methods. CONCLUSIONS: The new nTTT technique achieved higher SBP and MAP compared to the standard CC techniques in our infant manikin model. nTTT appears to be a suitable alternative or complementary to the TFT and TTEHT. [Mh] Termos MeSH primário: Reanimação Cardiopulmonar/métodos Parada Cardíaca/terapia [Mh] Termos MeSH secundário: Adulto Análise de Variância Atitude do Pessoal de Saúde Pressão Sanguínea Reanimação Cardiopulmonar/educação Estudos Cross-Over Feminino Parada Cardíaca/fisiopatologia Seres Humanos Lactente Modelos Lineares Masculino Manequins Enfermeiras e Enfermeiros Polegar [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180221 [Lr] Data última revisão: 180221 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009386

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[PMID]: 29252629 [Au] Autor: Hibino N; Hamada Y; Sato R; Wada K; Kondo K; Sairyo K [Ad] Endereço: Department of Orthopedics and Hand Center, Tokushima Prefecture Naruto Hospital, Tokushima, Japan. [Ti] Título: Reconstruction of Extensor Tendon Dislocation Due to Chronic Sagittal Band Rupture of the Thumb Metacarpophalangeal Joint: A Case Report. [So] Source: JBJS Case Connect;6(3):e52, 2016 Jul-Sep. [Is] ISSN: 2160-3251 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: CASE: We report a case of recurrent dislocation of the extensor pollicis longus and extensor pollicis brevis tendons due to chronic rupture of the radial sagittal band of the metacarpophalangeal joint of the thumb. CONCLUSION: Successful restabilization of these tendons was achieved by transferring a half-slip of the abductor pollicis brevis tendon. [Mh] Termos MeSH primário: Articulação Metacarpofalângica/lesões Traumatismos dos Tendões/cirurgia Polegar/lesões [Mh] Termos MeSH secundário: Adolescente Feminino Seres Humanos [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180216 [Lr] Data última revisão: 180216 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171219 [St] Status: MEDLINE [do] DOI: 10.2106/JBJS.CC.15.00224

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[PMID]: 29280874 [Au] Autor: Saito S; Ueda M; Murata M; Suzuki S [Ad] Endereço: Kyoto, Japan From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University. [Ti] Título: Thenar Dysplasia in Radial Polydactyly Depends on the Level of Bifurcation. [So] Source: Plast Reconstr Surg;141(1):85e-90e, 2018 01. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Little is known about thenar dysplasia in radial polydactyly, other than that thenar hypoplasia occasionally occurs in radial polydactyly with triphalangism. In particular, the phenotype and level of duplication associated with thenar dysplasia remain unclear. METHODS: The abductor pollicis brevis and flexor pollicis brevis muscles were visualized using three-dimensional ultrasound, and their horizontal geometry was assessed using a biaxial level classification system. Subjects were categorized into three phenotypes according to the developmental condition of the radial thumb. The relationship between the level of distribution of the muscles and the level of the bifurcation of the radial thumb was investigated. RESULTS: Nineteen patients with radial polydactyly without triphalangism were included. There were 10 patients with the nonfloating type, three with the floating type, and six with the rudimentary type. All patients with bifurcation at or more distal to the metacarpophalangeal joint had normal thenar muscle distribution, but the muscles in patients with bifurcation at or more proximal to the level of the metacarpals were confined, regardless of phenotype. The level of muscle distribution was strongly correlated with the level of the bifurcation of the radial thumb. CONCLUSIONS: These findings suggest that formation of the thenar muscles in the longitudinal direction in radial polydactyly might depend on the level of bifurcation of the radial thumb. The presence of thenar dysplasia even in floating-type or rudimentary-type duplications is of clinical and etiologic importance. [Mh] Termos MeSH primário: Dedos/anormalidades Músculo Esquelético/anormalidades Fenótipo Polidactilia/diagnóstico por imagem [Mh] Termos MeSH secundário: Adolescente Criança Pré-Escolar Dedos/diagnóstico por imagem Seres Humanos Lactente Músculo Esquelético/diagnóstico por imagem Polidactilia/patologia Polegar/anormalidades Polegar/diagnóstico por imagem Ultrassonografia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180112 [Lr] Data última revisão: 180112 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003937

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[PMID]: 27772688 [Au] Autor: Bernardes Filho F; de Oliveira Alves A [Ad] Endereço: Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. [Ti] Título: Elderly Male With Mass on Right Thumb. [So] Source: Ann Emerg Med;68(5):e81-e82, 2016 Nov. [Is] ISSN: 1097-6760 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Cisto Epidérmico/diagnóstico Cisto Epidérmico/etiologia Polegar/lesões Ferimentos Penetrantes/complicações [Mh] Termos MeSH secundário: Idoso Cisto Epidérmico/cirurgia Seres Humanos Masculino Ferimentos Penetrantes/diagnóstico por imagem Ferimentos Penetrantes/terapia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171211 [Lr] Data última revisão: 171211 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE

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[PMID]: 27771214 [Au] Autor: de Almeida PH; MacDermid JC; Pontes TB; Dos Santos-Couto-Paz CC; da Mota LM; Matheus JP [Ad] Endereço: Faculdade de Ceilândia, University of Brasília, Brasília, DF, Brazil. Electronic address: pedroalmeida.to@gmail.com. [Ti] Título: Orthotic use for CMC osteoarthritis: Variations among different health professionals in Brazil. [So] Source: J Hand Ther;29(4):440-450, 2016 Oct - Dec. [Is] ISSN: 1545-004X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: STUDY DESIGN: Cross-sectional descriptive study. INTRODUCTION: Osteoarthritis (OA) is the most prevalent musculoskeletal disease in the adult and older adult populations. The use of orthoses to stabilize the thumb's articular complex is one of the most common conservative management strategies. Despite substantial research about this topic, there is insufficient evidence about the optimal use of orthoses to inform clinical practice, contributing to practice variations within and across health professionals. PURPOSE OF THE STUDY: To identify the prescription patterns, design preferences, and barriers for the use of orthotic devices among Brazilian health care professionals involved in the treatment of patients with OA of the basal thumb joint. METHODS: An electronic questionnaire was sent to occupational therapists, physiotherapists, and rheumatologists across Brazil through professional association mailing lists. Survey included questions about orthosis design, materials, and barriers to the use of orthotic interventions. Respondents indicated their use based on photographs of 25 orthoses models that were selected through bibliographic review and expert consultation. Descriptive statistics, the chi-square test for independence, and the Fisher exact test were used to compare differences among orthotic prescription preferences, barriers, and challenges observed amidst the 3 participants' professional classes. RESULTS: There was no consensus about orthotic prescription among 275 professionals who answered the survey. About 69% of participants reported the use of multiple orthosis during treatment of patients with thumb OA. Results suggest significant variations in the number of joints included and stabilization strategies adopted, with a preference for orthotics made in rigid materials and involving the wrist, carpometacarpal, and metacarpophalangeal joints (P < .001). The lack of knowledge about orthotic options, institutional regulations, and policies were the major barriers reported by respondents (P < .01). CONCLUSION: A plentiful variety of different orthoses designs were observed in this study, and the prescriptions made by 3 professional classes showed differences regarding types of stabilization, joint involvement, and positioning. Despite the existence of clinical trials suggesting benefits for specific custom-made design models, our results indicated widespread clinical variation in practices and preferences. LEVEL OF EVIDENCE: Not applicable. [Mh] Termos MeSH primário: Articulações Carpometacarpais/fisiopatologia Aparelhos Ortopédicos/utilização Osteoartrite/reabilitação Amplitude de Movimento Articular/fisiologia Inquéritos e Questionários Polegar [Mh] Termos MeSH secundário: Adulto Atitude do Pessoal de Saúde Brasil Estudos Transversais Feminino Força da Mão Seres Humanos Masculino Meia-Idade Terapeutas Ocupacionais/estatística & dados numéricos Osteoartrite/diagnóstico Fisiatras/estatística & dados numéricos Fisioterapeutas/estatística & dados numéricos Índice de Gravidade de Doença Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171128 [Lr] Data última revisão: 171128 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE

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[PMID]: 28872525 [Au] Autor: Hung ALH; Chau WW; Shi B; Chow SK; Yu FYP; Lam TP; Ng BKW; Qiu Y; Cheng JCY [Ad] Endereço: 1Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong 2The Joint Scoliosis Research Centre of The Chinese University of Hong Kong and Nanjing University, Shatin, Hong Kong. [Ti] Título: Thumb Ossification Composite Index (TOCI) for Predicting Peripubertal Skeletal Maturity and Peak Height Velocity in Idiopathic Scoliosis: A Validation Study of Premenarchal Girls with Adolescent Idiopathic Scoliosis Followed Longitudinally Until Skeletal Maturity. [So] Source: J Bone Joint Surg Am;99(17):1438-1446, 2017 Sep 06. [Is] ISSN: 1535-1386 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Accurate skeletal maturity assessment is important to guide clinical evaluation of idiopathic scoliosis, but commonly used methods are inadequate or too complex for rapid clinical use. The objective of the study was to propose a new simplified staging method, called the thumb ossification composite index (TOCI), based on the ossification pattern of the 2 thumb epiphyses and the adductor sesamoid bone; to determine its accuracy in predicting skeletal maturation when compared with the Sanders simplified skeletal maturity system (SSMS); and to validate its interrater and intrarater reliability. METHODS: Hand radiographs of 125 girls, acquired when they were newly diagnosed with idiopathic scoliosis prior to menarche and during longitudinal follow-up until skeletal maturity (a minimum of 4 years), were scored with the TOCI and SSMS. These scores were compared with digital skeletal age (DSA) and radius, ulna, and small hand bones (RUS) scores; anthropometric data; peak height velocity; and growth-remaining profiles. Correlations were analyzed with the chi-square test, Spearman and Cramer V correlation methods, and receiver operating characteristic curve analysis. Reliability analysis using the intraclass correlation (ICC) was conducted. RESULTS: Six hundred and forty-five hand radiographs (average, 5 of each girl) were scored. The TOCI staging system was highly correlated with the DSA and RUS scores (r = 0.93 and 0.92, p < 0.01). The mean peak height velocity (and standard deviation) was 7.43 ± 1.45 cm/yr and occurred at a mean age of 11.9 ± 0.86 years, with 70.1% and 51.4% of the subjects attaining their peak height velocity at TOCI stage 5 and SSMS stage 3, respectively. The 2 systems predicted peak height velocity with comparable accuracy, with a strong Cramer V association (0.526 and 0.466, respectively; p < 0.01) and similar sensitivity and specificity on receiver operating characteristic curve analysis. The mean age at menarche was 12.57 ± 1.12 years, with menarche occurring over several stages in both the TOCI and the SSMS. The growth remaining predicted by TOCI stage 8 matched well with that predicted by SSMS stage 7, with a mean of <2 cm/yr of growth potential over a mean of <1.7 years at these stages. The TOCI also demonstrated excellent reliability, with an overall ICC of >0.97. CONCLUSIONS: The new proposed TOCI could provide a simplified staging system for the assessment of skeletal maturity of subjects with idiopathic scoliosis. The index needs to be subjected to further multicenter validation in different ethnic groups. [Mh] Termos MeSH primário: Determinação da Idade pelo Esqueleto Estatura Falanges dos Dedos da Mão Osteogênese Puberdade Escoliose [Mh] Termos MeSH secundário: Adolescente Criança Epífises Feminino Seres Humanos Estudos Longitudinais Valor Preditivo dos Testes Reprodutibilidade dos Testes Ossos Sesamoides Polegar [Pt] Tipo de publicação: JOURNAL ARTICLE; VALIDATION STUDIES [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170925 [Lr] Data última revisão: 170925 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170906 [St] Status: MEDLINE [do] DOI: 10.2106/JBJS.16.01078

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[PMID]: 28853594 [Au] Autor: Morris G; Evans S; Stevenson J; Kotecha A; Parry M; Jeys L; Grimer R [Ad] Endereço: Royal Orthopaedic Hospital NHS Foundation Trust , UK. [Ti] Título: Bone metastases of the hand. [So] Source: Ann R Coll Surg Engl;99(7):563-567, 2017 Sep. [Is] ISSN: 1478-7083 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Introduction The aim of this study was to identify patients with malignant hand lesions, establish the proportions of those that were metastases and review their clinical course. Methods A retrospective search of a prospective tumour database was carried out to identify all patients treated at our unit with hand metastases. Patient demographics were recorded including site of primary malignancy, region of the hand involved, management of their metastasis and clinical outcome. Results Overall, 149 patients were identified with a malignant tumour of the hand. Ten had a metastatic lesion. There were 3 women and 7 men with a median age of 68 years (range: 28-91 years) at presentation. All presented with non-mechanical hand pain while four had pain and swelling. The median interval from symptom onset to diagnosis was eight weeks. The minimum follow-up duration was four months. Three patients had no history of malignancy. Of the remaining seven patients, three had other known metastases. Six patients underwent solely palliative radiotherapy. Three patients had amputation. One was treated with surgical excision and radiotherapy. One had an amputation and axillary node clearance. All but one patient had died by the time of the latest follow-up appointment. The median time to death following identification of acrometastases was 18 months. Sites of primary disease were skin (n=4), lung (n=3), kidney (n=2) and neuroendocrine system (n=1). The thumb was the most commonly affected location. Conclusions This study demonstrates that patients presenting with non-mechanical hand pain should be considered to have a malignant process until proved otherwise, particularly in patients with thumb symptoms and a history of prior malignancy. [Mh] Termos MeSH primário: Neoplasias Ósseas/secundário Ossos da Mão [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Amputação Neoplasias Ósseas/diagnóstico por imagem Neoplasias Ósseas/radioterapia Neoplasias Ósseas/cirurgia Feminino Ossos da Mão/diagnóstico por imagem Ossos da Mão/cirurgia Seres Humanos Masculino Meia-Idade Radiografia Estudos Retrospectivos Polegar/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170913 [Lr] Data última revisão: 170913 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170831 [St] Status: MEDLINE [do] DOI: 10.1308/rcsann.2017.0096

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[PMID]: 28841616 [Au] Autor: Feng SM; Sun QQ; Cheng J; Wang AG; Li CK [Ad] Endereço: Xuzhou, Jiangsu, People's Republic of China From the Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College. [Ti] Título: Superficial Radial Nerve Transection Improves Sensory Outcomes in First Dorsal Metacarpal Artery Flaps. [So] Source: Plast Reconstr Surg;140(3):558-564, 2017 Sep. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: This article reports the operative technique and clinical effect of repairing thumb pulp defects using a modified first dorsal metacarpal artery flap method. In this method, the dorsal branches of the radial and ulnar proper digital nerves of the index finger were preserved but the superficial branches of the radial nerve were transected. METHODS: Data obtained from 121 patients with thumb pulp defects who were admitted to the authors' hospital from June of 2011 to December of 2014 were retrospectively analyzed. Patients were divided into two groups based on whether the superficial branches of the radial nerve were transected. The dorsal branches of the radial and ulnar proper digital nerves of the index finger and the proper digital nerves in the wound were coapted using the end-to-end style. Static two-point discrimination, Semmes-Weinstein monofilament scores, pain, cold intolerance of the reconstructed finger, allachesthesia, and patient satisfaction were compared between the two groups. RESULTS: The authors observed significant differences in static two-point discrimination, Semmes-Weinstein monofilament flap score, pain of finger pulp, allachesthesia duration, and patient satisfaction (p < 0.05). The transection group presented slightly better discriminatory sensation in the flap and higher patient satisfaction. In addition, the duration of allachesthesia in the transection group was significantly shorter than that in the preservation group. CONCLUSION: In the repair of thumb pulp defects using a modified first dorsal metacarpal artery flap carrying the dorsal branches of the radial and ulnar proper digital nerves of the index finger, transecting the superficial branches of the radial nerve achieved better clinical outcome compared with preserving them. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. [Mh] Termos MeSH primário: Traumatismos dos Dedos/cirurgia Transferência de Nervo/métodos Nervo Radial/cirurgia Procedimentos Cirúrgicos Reconstrutivos/métodos Transtornos das Sensações/cirurgia Retalhos Cirúrgicos/irrigação sanguínea [Mh] Termos MeSH secundário: Adolescente Adulto Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos Transtornos das Sensações/etiologia Polegar/cirurgia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170918 [Lr] Data última revisão: 170918 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170826 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003582

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2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde