Abstract:
:Necrotizing fasciitis is a severe, fulminant infection most commonly encountered in patients with diabetes mellitus, alcohol abuse, and intravenous drug abuse. The infection can spread-unrecognized along fascial planes beneath seemingly normal skin. The relatively benign appearance of the extremity is misleading and often results in delay in diagnosis and increased morbidity or death. Immediate aggressive surgical debridement through extensile incisions in combination with antibiotic therapy is necessary for control of these limb- and life-threatening, soft-tissue infections. Gas gangrene, or clostridial myonecrosis, is encountered commonly in those extremity wounds that involve devitalized or necrotic soft tissues. Clostridial microorganisms are anaerobes that produce local and systemic toxins. Delay in treatment can lead to hemolysis, renal failure, and death. Treatment consists of immediate wound debridement, intravenous antibiotics, and hyperbaric oxygen therapy. Diabetic gangrene typically occurs in those diabetic patients with severe peripheral vascular or renal disease. The infections are usually polymicrobial. Treatment involves broad-spectrum antibiotics and multiple surgical debridements or amputation.
journal_name
Hand Clinjournal_title
Hand clinicsauthors
Gonzalez MHsubject
Has Abstractpub_date
1998-11-01 00:00:00pages
635-45, ixissue
4eissn
0749-0712issn
1558-1969journal_volume
14pub_type
杂志文章,评审相关文献
HAND CLINICS文献大全abstract::Injuries to the carpometacarpal joints are uncommon and are sometimes overlooked on initial radiographs. Their recognition depends on a careful physical and radiographic examination that may require trispiral tomograms and CT scans. Most injuries can be treated successfully by closed reduction and percutaneous fixatio...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract::The rehabilitation of patients who have sustained brachial plexus injuries is essential. Therapy is performed to maintain and increase range of motion, retard the rate of muscle atrophy, and re-educate the muscles once the reconstructive surgeries have been per-formed and reinnervation is verified. This article discus...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2004.10.003
更新日期:2005-02-01 00:00:00
abstract::PNA is one of many treatments available for the treatment of hand contractures resulting from Dupuytren’s disease. It is generally recommended for elderly patients with less severe contractures who desire a less invasive procedure, or as a first stage to delay surgery in those with more aggressive disease. The procedu...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2013.09.005
更新日期:2014-02-01 00:00:00
abstract::There are times when clinical examinations, radiographs, and computed tomography scans do not provide sufficient information to know whether a scaphoid fracture or scaphoid bone graft has united, partially united, or not united. When this problem arises, arthroscopic examination of the scaphoid fracture or scaphoid bo...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2017.07.001
更新日期:2017-11-01 00:00:00
abstract::The foremost goal of managing a mutilated hand is provision of adequate skin coverage. The most suitable method is free tissue transfer. The specific role of volar surface requires replacement tissue to have similar texture for aesthetically satisfactory and functionally acceptable outcomes. Hand surgeons must approac...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2016.07.002
更新日期:2016-11-01 00:00:00
abstract::This article reviews the assessment and management of obstetrical brachial plexus palsy. The potential role of distal nerve transfers in the treatment of infants with Erb's palsy is discussed. Current evidence for motor outcomes after traditional reconstruction via interpositional nerve grafting and extraplexal nerve ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2015.12.006
更新日期:2016-05-01 00:00:00
abstract::Since the first description of an ulnar collateral ligament (UCL) tear at the elbow 60 years ago and the first description of surgical reconstruction 20 years ago, many advances have been made in management and surgery. UCL tears at the elbow remain a disease of the overhead athlete. Various imaging studies have been ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2007.11.011
更新日期:2008-02-01 00:00:00
abstract::The primary treatment goal for Kienböck's disease remains decompression of the lunate. Although a number of treatment options are available, scaphocapitate fusion is our first choice in many cases of Kienböck's disease. Scaphocapitate fusion mechanically decompresses the lunate and prevents progressive carpal instabil...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-08-01 00:00:00
abstract::Reverse-flow pedicled radial forearm tendocutaneous flap transfers were performed to reconstruct simultaneous skin and tendon defects in the dorsum of the hand in six patients. All flaps survived and four of six patients obtained good functional results. To obtain satisfactory functional outcome, early surgical repair...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract::An appreciation of the salient clinical and radiologic presentations of osteoarthritis, as well as associated tenosynovial problems (stenosing tenosynovitis and carpal tunnel syndrome), is necessary for effective diagnosis. The treatment of osteoarthritis is predicated upon an understanding of the anatomy and pathomec...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-08-01 00:00:00
abstract::Psoriatic arthritis is a polyarthropathy distinct from rheumatoid arthritis and associated with onychodystrophy and skin lesions. Patients present with stiffness, flexion and extension contractures, digital swelling, or painful joints. Psoriatic arthritis mutilans is a rapidly progressive osteolysis resulting in sever...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract::There is no established outcome measure designated as the superior measure when evaluating the results of distal radius fracture management. Although there are many used in the literature, there are only a few that have been validated to specifically predict recovery after a distal radius fracture. Additionally, there...
journal_title:Hand clinics
pub_type: 杂志文章
doi:10.1016/j.hcl.2012.03.003
更新日期:2012-05-01 00:00:00
abstract::Although carpal fractures other than of the scaphoid are uncommon, vigilance in diagnosing these potentially serious fractures is paramount to early and effective treatment. Physical examination and standard plain radiographs may reveal only subtle findings. Use of special radiographic views and computed tomography ma...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2006.07.007
更新日期:2006-11-01 00:00:00
abstract::Although the overall patterns of deformity may be repetitive in cerebral palsy patients, it is extremely important to recognize that nothing replaces a careful examination of the individual patient and an individualized plan of approach. Our mistakes are rarely caused by technical errors, and we should not attribute o...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract::Dupuytren's contracture nodules, but not cords, contain myofibroblasts. These cells, which combine many electron microscopic, physiologic, and immunohistochemical characteristics of fibroblasts and smooth muscle cells, are probably the active force of contraction. Prominent myofibroblasts and intracellular microtubule...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-11-01 00:00:00
abstract::Arthroscopy of the first carpometacarpal (CMC) joint has become routine. Similar techniques can be applied to fracture dislocations involving the fifth CMC joint. This situation is one whereby arthroscopy is definitely of benefit, because the articular fracture fragment is often volar, and difficult to visualize and r...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2011.05.010
更新日期:2011-08-01 00:00:00
abstract::The standard treatment for delayed union or nonunion of the scaphoid is operative management. Electrical stimulation has been employed in these clinical situations in patients unable or unwilling to undergo surgical intervention. Recent interest has also focused on the use of low-intensity ultrasound as an adjunct to ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-11-01 00:00:00
abstract::A multidisciplinary approach often is needed, especially at the acute phase. Indeed, resuscitative treatment is first indicated. [figure: see text] Optimal time for surgery depends on the patient's status. Surgical management should be more aggressive than previously thought. Debridement of necrotic tissue must be per...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract::Fractures of the capitellum and trochlea account for a small proportion of elbow trauma. Clinicians need to be vigilant in their assessment as they are commonly associated with other injuries about the elbow. To optimize outcomes, the goals of management include a stable, anatomic reduction and early range of motion. ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2015.07.001
更新日期:2015-11-01 00:00:00
abstract::Midcarpal instability has been well described as a clinical entity but the pathokinematics and pathologic anatomy continue to be poorly understood. This article presents a comprehensive review of the existing knowledge and literature-based evidence for the diagnosis and management of the various entities comprising mi...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2015.04.004
更新日期:2015-08-01 00:00:00
abstract::There are many nonsurgical treatment options for patients with upper limb spasticity. This article presents an algorithmic approach to management, encompassing evidence-based rehabilitation therapies, medications, and promising new orthotic and robotic innovations. ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2018.06.003
更新日期:2018-11-01 00:00:00
abstract::This discussion has attempted to outline a fundamental approach to the radiographic analysis of solitary lesions of the hand and wrist skeleton. The initial evaluation invariably relies on the routine radiograph, using the conventional film-screen combination to obtain a sense of the lesion in its gross anatomic setti...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::The unique and collaborative relationship between hand therapists and surgeons is invaluable in meeting the unique functional needs of clients with upper extremity conditions and injuries. Current legislative issues and research items that directly affect hand therapy and hand surgery practice include the opioid epide...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2020.01.005
更新日期:2020-05-01 00:00:00
abstract::Many factors influence the development of CTS; therefore, nonoperative treatment should not be limited to only one intervention. Nonoperative treatment is most effective in the early stages, prior to irreparable damage to the nerve. Early intervention combined with a comprehensive treatment plan can help improve effec...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0712(02)00023-9
更新日期:2002-05-01 00:00:00
abstract::Cortical mapping and relearning are key factors in optimizing patient outcome following motor nerve transfers. To maximize function following nerve transfers, the rehabilitation program must include motor reeducation to initiate recruitment of the weak reinnervated muscles and to establish new motor patterns and corti...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2008.06.001
更新日期:2008-11-01 00:00:00
abstract::Whether it is a primary or a delayed flexor digitorum profundus (FDP) repair, no general consent has been found, and no perfect treatment has been imposed. The authors utilize 2 new techniques for FDP reconstruction that allow immediate postoperative mobilization and excellent functional outcome. Harvesting of the don...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2013.02.006
更新日期:2013-05-01 00:00:00
abstract::Rheumatoid arthritis commonly affects the thumb. Deformity does not require surgical intervention unless pain is present or a functional deficit exists, but if bony erosion develops and surgical treatment may be compromised in the future, earlier intervention may be indicated. When the pathogenesis and pathoanatomy of...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-05-01 00:00:00
abstract::Proximal humerus fractures and fractures of the humeral shaft are relatively rare in children. The incidence of the former is about 1 to 3 cases/1000 population per year, comprising fewer than 3% of all pediatric fractures. Fractures of the humeral shaft represent fewer than 10% of all humerus fractures in children. B...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2007.09.002
更新日期:2007-11-01 00:00:00
abstract::Fractures of the trapezial ridge, hamate hook, and pisiform are often due to isolated, direct injury, but other carpal bone fractures are seldom isolated injuries. Midcarpal fractures should stimulate a search for associated perilunate injury; distal carpal row fractures suggest carpometacarpal fracture--dislocations ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract::Injuries involving foreign bodies in the hand are common. Index of suspicion should be high in any hand injury, particularly with a proper history. Plain radiographs should be obtained liberally and multiple views always taken. Xeroradiography, if available, is helpful if the plain radiographs are normal and a foreign...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00