Hand amputation operation

Contraindications to the operation are:

Buerger syndrome

Buerger's disease (obliterating thromboangiitis) is a rare disease that primarily affects young and middle-aged men who smoke cigarettes. Obliterating thromboangiitis is characterized by narrowing or blockage (occlusion) of the veins and arteries of the extremities, resulting in reduced blood flow to these areas (peripheral vascular disease). The legs are more commonly affected than the arms.

In most cases, the first symptom is severe pain in the forearms and legs when at rest. When walking, cramps occur in the legs, which in rare cases can lead to limping. In addition, those affected may experience ulcerations on the limbs, numbness and tingling, and a lack of normal blood flow in the fingers and/or toes when exposed to low temperatures (Raynaud's syndrome), and/or to inflammation and blockage of certain veins (thrombophlebitis).

In severe cases, people with obliterative thrombophlebitis experience tissue death (gangrene) in the affected limbs. The exact cause of Bürger's disease is not known; however, most patients are young and adult men who smoke cigarettes.

signs and symptoms

Buerger's disease is characterized by narrowing or closure (occlusion) of the medium and/or small arteries and veins of the limbs, resulting in reduced blood supply to these areas (peripheral vascular disease). The illness usually begins suddenly (acute) and lasts 1-4 weeks. The disease has a relapsing course.

In most cases, the first symptom of Buerger's disease is severe pain in the forearms and/or legs at rest. Those affected may also experience leg cramps when walking, which in rare cases can lead to limping.

Other physical symptoms associated with Buerger syndrome can include:

• Pitting (ulceration) on arms and legs;
• pallor of the hands;
• Numbness and tingling and a lack of normal blood flow in the fingers and toes when exposed to cold temperatures (Raynaud's syndrome);
• Inflammation and blockage of certain veins (thrombophlebitis).

Dry, dark sores that often form on the tips of the fingers and toes can be very painful. The pain associated with these ulcers may worsen with elevation. In severe cases, tissue necrosis (gangrene) can occur in the affected areas.

In some cases, the arteries and veins of the intestine can also be damaged. This can lead to an extreme increase in abdominal pain and weight loss. In extremely rare cases (ie less than 2 %), neurological disorders have been identified in those affected.

Indications and contraindications

Amputations of the hand are carried out in cases of severe trauma with multiple fractures, fractures and bruises of soft tissues, malignant tumors, extensive and persistent purulent processes (with limited viability of the limb segment, danger of the process spreading, danger to the patient's life). A contraindication is a general severe condition, decompensated somatic diseases, uncorrectable blood clotting disorders.

The most important principle in hand amputations is to save and carefully preserve every millimeter of the limb. The level of amputation in traumatology depends on the condition of the skin and soft tissues, and not on the level of the fracture. If there is still enough soft tissue in the stump area to close the wound, the stump can be cut off in the middle of the fracture line, which then results in a more functional stump. To obtain the longest stump possible, local skin shifts and zigzag skin flaps are used.

In some cases, primary amputation of the hand may be considered as the first stage of treatment necessary for wound healing. In cases of soft tissue deficiencies, cosmetic defects, and impaired function, additional surgical treatment is then performed, including free flap autotransplantation, soft tissue repair with stem insertion, and bone grafting. The treatment plan is tailored to the individual, taking into account the type of original pathology, the condition of the stump, and other factors.

In the case of amputations of the hand, the traumatologist must make every effort to preserve the first finger, as it is the most important for maintaining the basic functions of the hand. The second most important finger is the index finger. All finger amputations at the metacarpophalangeal joints and proximal to them result in a loss of the hand's ability to grip. The surgical procedure aims to preserve the function of the limb as much as possible, but also to achieve the best possible cosmetic result.

How is it prepared?

Hand amputations can be lower leg amputations or the amputation of one or more fingers along with the metacarpals. For metacarpal finger amputations, the height of the incision is chosen so that a functional stump with as large a surface as possible is created. For example, if it is necessary to amputate fingers II-III proximal to the metacarpal heads, the heads are removed to create a wider interdigital space. In IV-V amputations, the V metacarpal is made shorter than the IV metacarpal to create a smoother hand contour.

Removal of one or two fingers along with the metacarpals can be performed under local anesthesia. Extensive amputations of the hand (separation of several fingers, amputations at the level of the wrist) are performed under general anesthesia or general anesthesia. The stitches are removed after 10-12 days. Rehabilitation measures are prescribed. If necessary, reconstructive surgery is performed.

Method 2: traditional brachioplasty

A standard brachioplasty usually involves making an incision on the inside of the arm from the armpit to the elbow joint - no other method can remove the significant excess skin.

The shape of the incision can vary: the surgeon selects it depending on the degree of sagging and the amount of fatty tissue.

Before surgery, it is important to understand that the incision on the inside of the arm will last a lifetime.

We know and use various techniques to conceal the scar - from thinning the skin around the stitches to laser resurfacing. Over time, the scar will lighten and become no thicker than a human hair, but the scar will still be visible.

Comment from the experts:

'Brachioplasty is a seemingly simple operation. But this simplicity is wrong.

For example, I never make an incision up to the elbow joint.

The elbow is an area of high mechanical stress, even from the inside. We bend and bend the elbow, stretch the skin in this area, wear bags on the elbow and so on.

I have been studying the peculiarities of scar formation for many years and have developed my own methodology for treating keloids. In my experience, the condition of the seams on the elbow worsens with such intense stress: the scars spread, become thicker and thicker, and there is a risk of Keloid scars».

After brachioplasty, a bandage must be worn for 2-3 weeks and the arm must not be put under any strain.

Special equipment and instruments in the Platinatal operating room prevent damage to lymphatic vessels and nodes. This has a positive effect on the recovery time - rehabilitation is much faster and without complications.

Photos before and after surgery

Brachioplasty – hand lift. This surgery removes excess loose skin and fat from the arms. It eliminates sagging and excessive fullness. A thin scar on the inside of the arms is the necessary payment for a beautiful appearance of the arms at any age! Surgeon: Maxim Vasiliev.

Possible complications

Amputation of a tooth root can cause a number of complications manifested by various symptoms:

• Damage to neighboring teeth.
• Disruption of soft tissue integrity.
• Inflammation.
• Swelling of the soft tissues.
• Loss of sensitivity in the operated jaw area.
• Increased bleeding.

If the wound at the surgical site becomes infected, immediate medical attention is required. In some situations, the diseased tooth has to be extracted anyway, as it is not always possible to stop the destruction of the tooth tissue from the inside.

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Description of the procedure

Seam removal should be carried out in a well-lit place so that even the smallest nuances can be clearly seen.

First, don't lift the first knot too high with tweezers. Then, use scissors to cut the base of the thread and begin to pull it out carefully, being careful not to get the outer pieces caught in the fabric. Continue in this way until the last thread leaves the scar.

The knot should not be pulled through the skin or it will get stuck and cause bleeding. At the end of the procedure, which is relatively painless (apart from a slight discomfort and tingling sensation when pulling the thread through), make sure that no residue of the suture material remains in the wound. To speed up skin healing and prevent infection, treat the scar with a mild iodonate solution and apply a fixation bandage.

How can I remove scalp stitches at home? It is not advisable to remove the stitches yourself from hard-to-reach areas of the head after a major procedure, as this is associated with the risk of infection. Do not wet or soap the seams. Do not try to remove surgical staples at home: doctors do this in the hospital using a special instrument. If the wound suddenly begins to bleed, stop the operation yourself and urgently contact a doctor who will help you finish the job. The appearance of the wound and its healing depend on the accuracy of the sutures and the timeliness of their removal. It is therefore advisable to have the stitches removed by a professional doctor.

signs of injury

A bone fracture can cause bone fragments to change position. Such a condition is called a displaced humerus fracture. It can be single or multiple, open or closed. The clinical picture emerges depending on these findings. The most characteristic symptom is increasing, stabbing or dull but intense pain. Loss of consciousness can also occur. Immobility or abnormal mobility of the limb may occur. In all cases, movement of the limbs should be avoided to prevent further dislocation. Other symptoms of the disease include:

• hematoma;
• visible deformation of the hand;
• excessive swelling, swelling;
• Increased pain on palpation;
• Impairment of motor function.

A characteristic symptom of a displaced fracture, in which an artery is severed and a nerve is damaged, is a feeling of cold and numbness in the hand. This condition suggests disruption of blood supply and significant intramedullary hemorrhage. If this type of fracture also has an open wound, these symptoms may be observed:

The clinical picture can have different characteristics depending on the accompanying complications. In any case, you should not attempt to treat the fracture alone. Therapy should take place under the guidance of a specialist immediately after the injury.

Causes of a displaced hand fracture

The structure of the bone is disrupted by an external force that exceeds the strength and elasticity of the bone. The most common cause of a sprain is the trauma of a fall onto an outstretched arm, but there are other causes as well. Apart from the frequency of fractures in athletes, it is most often diagnosed by traumatologists at the onset of the cold season. Pedestrians fall on slippery roads, as well as traffic accidents. Other possible causes include:

• Fall from a height;
• work-related injuries;
• as a result of a natural disaster;
• movement-related disorders;
• systemic and chronic diseases.

Certain pathological conditions such as rheumatoid arthritis or osteoporosis affect the structure of bones, making them more susceptible to various injuries. There are also risk factors that increase the likelihood of symptoms, such as: E.g.:

• older age;
• menopausal women;
• certain sporting competitions;
• Extreme sports;
• lack of weight bearing.

A dislocated fracture is a complex and very painful condition that is difficult to predict. The only thing a person can do is not to neglect safety rules when playing sports and at work and to be more careful on slippery roads.

What type of doctor treats a stress fracture?

An injury such as a stress fracture of the hand with displacement requires immediate medical attention. Therefore, if you notice any of the above symptoms, you should consult a doctor of the following specialty:

Rheumatic diseases

The most common rheumatic diseases:

• osteoarthritis,
• Rheumatoid arthritis,
• reactive arthritis,
• Osteoporosis,
• systemic lupus erythematosus,
• gout, etc.

Reactive arthritis and systemic connective tissue diseases are more common in young people, rheumatoid arthritis and gout in adulthood, and osteoporosis and osteoarthritis in older people.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune rheumatic disease. It is characterized by the progressive breakdown of joints, ligaments and tendons.

Causative factors for rheumatoid arthritis include:

Systemic connective tissue diseases

Systemic connective tissue diseases are autoimmune diseases of unknown cause. In this pathology, increased production of autoantibodies leads to immuno-inflammatory damage to internal tissues and organs.

osteoarthritis

In osteoarthritis, the large joints are more often affected and the cartilage is affected.

gout

Gout is a chronic disease associated with the accumulation of uric acid salt crystals in the joints, soft tissues and internal organs.

Gout can be hereditary, but it can also be caused by factors such as:

osteoporosis

Osteoporosis is a disease in which bones lose their strength and become more brittle. With osteoporosis, fractures occur with even minor stress or trauma, such as a fall from your own height.

• As a woman (especially after menopause),
• Vitamin D deficiency,
• low calcium intake,
• certain endocrine diseases,
• gastrointestinal diseases,
• low physical activity,
• Smoke,
• alcohol abuse,
• genetic predisposition.

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