RESUMEN
Self-injection of household insecticide into the upper extremity in 5 patients is reported. All patients had mental problems, such as depression, substance abuse, or both. Four of the 5 cases were suicide attempts. Household insecticides can be divided into 3 categories based on the main chemical component. The hydrocarbon vehicle used in these insecticides, however, is poorly cleared by the local tissues and is responsible for fever, leukocytosis, and liquifaction necrosis. The focus for the hand surgeon is recognition and early and frequently repeated debridement. Psychiatric treatment and hand therapy are required.
Asunto(s)
Brazo/patología , Insecticidas/envenenamiento , Intento de Suicidio , Adulto , Femenino , Humanos , Insecticidas/administración & dosificación , Masculino , Persona de Mediana Edad , Necrosis , Autoadministración , Intento de Suicidio/psicologíaRESUMEN
With mastery of conventional methods, free flaps are indicated in selected cases for coverage of the hand and fingers. Careful preoperative planning, delicate intraoperative management, and postoperative physiotherapy are the mainstays for success in functional recovery and aesthetic result. Thin flaps of good vascularity are favored for coverage of the hand and finger. For hand surgeons, the lateral arm fasciocutaneous or fascia flap, toe flaps, and the latissimus dorsi flap seem to be the easiest and most useful free flaps applicable to most situations.
Asunto(s)
Traumatismos de la Mano/cirugía , Mano/cirugía , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos , Contractura/cirugía , Traumatismos de los Dedos/cirugía , Dedos/cirugía , Humanos , Microcirugia , Complicaciones Posoperatorias/prevención & controlRESUMEN
Previous studies of trigger digits in children have been limited to gross morphology and light-microscopic histology. Nine children with 11 trigger thumbs formed a preliminary study group for electron-microscopic evaluation of tendon nodules and A-1 pulleys. This pathoanatomic investigation was not previously reported. Comparison was made with light-microscopic sections. Large amounts of mature collagen was observed. Fibroblasts with prominent rough endoplasmic reticulum were present. No degenerative or inflammatory changes were noted in either tendon or sheath. We believe that although the etiology of trigger digits is still uncertain, an infectious, inflammatory, or degenerative process is unlikely.
Asunto(s)
Tendones/ultraestructura , Pulgar/anomalías , Preescolar , Fibroblastos/ultraestructura , Humanos , Microscopía ElectrónicaRESUMEN
Phialophora richardsiae was discovered in an index finger mass which was thought to be a residual of a steroid injection for tendinitis of the extensor tendon. A case report is presented.