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Osseointegrated Finger Prostheses Using a Tripod Titanium Mini-Plate
Manrique, Oscar J.,Ciudad, Pedro,Doscher, Matthew,Torto, Federico Lo,Liebling, Ralph,Galan, Ricardo Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.2
Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.
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Vimbai Mhuka,Simiso Dube,Mathew Muzi Nindi,Nelson Torto 한국고분자학회 2013 Macromolecular Research Vol.21 No.9
We report the fabrication and characterization of electrospun nanofibres from Gonometa postica and Gonometa rufobrunnae silk fibroin indigenous to Southern Africa. Nanofibres were electrospun from regenerated silk fibroin (RSF) powders obtained by freeze drying or via rotary evaporation using methanol as a desiccant. Optimal electrospinning conditions employed trifluoroacetic acid as a solvent. The solution of RSF powder prepared by rotary evaporation was electrospun at a lower concentration (27% w/v) than that of freeze dried RSF powder (40%w/v). Concentration of the fibroin solution had the most influence on electrospinnability whereas voltage and flow rate mainly affected the fibre morphology. Scanning electron microscopy (SEM) showed that nanofibres from freeze dried and rotary evaporator dried RSF powders had diameters ranging from 300-760 and 400-1,000 nm respectively. Fourier transform infrared (FTIR) analysis revealed that the RSF powders were mainly composed of β-sheets, similar to degummed silk fibroin. The nanofibres, however, exhibited predominantly random coil/α-helical structure showing degradation of the native silk structure. β-sheet structure in the nanofibres was restored upon solvent treatment resulting in improved water stability. The extent of structural transformation was dependent on the type of solvent used. This study confirms the feasibility of fabricating Gonometa fibroin into stable nanofibrous structures that could be used as scaffolds in biotechnological and biomedical applications.
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Osseointegrated Finger Prostheses Using a Tripod Titanium Mini-Plate
Oscar J Manrique,Pedro Ciudad,Matthew Doscher,Federico Lo Torto,Ralph Liebling,Ricardo Galan 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.2
Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.
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