Extensor Laceration Repairs | Lecture Note - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

300

Pages:

3
Author:

Kyuwon J.

Extensor Laceration Repairs ● Extensor tendon injuries may be present in dorsum of hand + forearm ● surgical repairs ○ restoration of tendon continuity ○ minimizing adhesion of extensor lag ● dorsal surface lacks tight fascial compartments ○ formation of adhesion is not severe ○ allows for simpler splinting ● Outcomes ○ patients will regain complete finger extension within 8 weeks ○ long term function possible ■ minimal lag if complaint with therapy ○ patients able to gain full function and return to life(work) by 6-8 weeks ■ heavy labor ~12 weeks ■ might vary on compliances Replantations-postoperative care ● Microsurgical reattachmetns on amputated digit ○ requres ateral venous and neural repairs ● functional success is dependent on… ○ Vascular patency ○ nerve healing ○ rehabilitations ● Anticoagulations ○ 5000 units heparin IV prior to clamp release ○ Dextran 40 ■ 25ml/hr 5 times a day ● Therapy ○ hand therapy in 10 day after operations ○ need to check if bone fixation is stable ■ need to wait more if bones are not stable ○ passive => active motion progressions (gradual) ● Positioning ○ Thumb positioned 90 degree from finger ○ maintains vascular elevations ● Nerve Repairs ○ tension free environments ○ sensation critical on success ● Skin closure ○ Z-plasties- prevention on dorsal skin tension + ischmia Replantations outcomes ● Revascularization ○ critical ○ aided by vein graft between ulnar and radial digital arteries ● Functional recovery ○ pinching ○ gripping ○ depend on injury level ○ ischemia duration also impacts recovery rates ● Complications ○ Thrombosis ○ Venous congestion ○ infections ○ partial necrosis

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