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Partial Hand Transplant: Lessons Learned From Cadaveric Dissection Studies.
Shubinets, Valeriy; McAndrew, Christine; Mauch, Jaclyn; Glennon, Alyssa Ricker; Kovach, Stephen J; Gray, Benjamin L; Steinberg, David R; Bozentka, David J; Lantieri, Laurent; Chang, Benjamin; Levin, L Scott; Lin, Ines C.
Afiliação
  • Shubinets V; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA.
  • McAndrew C; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Mauch J; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Glennon AR; Materialise, Plymouth, MI.
  • Kovach SJ; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Gray BL; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Steinberg DR; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Bozentka DJ; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Lantieri L; Department of Plastic, Aesthetic and Reconstructive Surgery, Hôpital Européen Georges Pompidou, Paris, France.
  • Chang B; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Levin LS; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Lin IC; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA. Electronic address: ines.lin@uphs.upenn.edu.
J Hand Surg Am ; 43(7): 634-640, 2018 07.
Article em En | MEDLINE | ID: mdl-29807842
As the field of vascularized composite allotransplantation continues to expand, new upper extremity transplant candidates are being considered. We recently evaluated a bilateral amputee who had a mid-forearm amputation and a contralateral metacarpal hand amputation. In the latter limb, a "partial" hand transplant that preserved the majority of the patient's existing hand, including a partially severed thumb with intact thenar muscle function, was proposed. The feasibility of this partial hand transplant was studied in fresh-frozen cadaver limbs. This report details the proposed approach, the cadaveric dissections, and the lessons learned from these dissections. Issues of osteosynthesis, microvascular planning, and intrinsic muscle recovery are discussed, all of which are critical considerations for partial hand transplant candidates. Ultimately, the partial hand approach was felt to be inferior to a more conventional distal forearm transplant in this particular candidate. Practical, functional, and ethical implications of such decision are presented.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Mão Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans Idioma: En Revista: J Hand Surg Am Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Mão Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans Idioma: En Revista: J Hand Surg Am Ano de publicação: 2018 Tipo de documento: Article