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Introduction: Treatment of fingers tissue loss is particularly challenging as it often necessitates advanced reconstructive techniques such as flaps or grafts, with esthetic and functional results that are not always as good as hoped for, with long healing times. Recently, along with tissue engineering development, numerous types of dermal substitute have been commercialized, with promising possibilities of treatment in finger tissue loss. In the author's unit, Matriderm® is the most commonly used dermal substitute. As described by the manufacturer, this scaffold is designed to be covered with a split‐thickness skin graft. In using a two‐step procedure, the authors realized that in most cases of fingertips injuries, at three weeks follow‐up, the wound appeared in an advanced state of healing, which permitted to avoid grafting. Material And Methods: Between October 2017 and October 2018, 27 fingers have been included in this study. Patients have been divided in two groups: those treated with Matriderm® alone (15 fingers) and those who had a skin graft three weeks after the first surgery (12 fingers). At the 6‐month follow‐up, authors evaluated the esthetic results with the Vancouver Scar Scale (VSS), the functional results with Quick Disability of the Arm, Shoulder and Hand (qDASH) score, and sensibility by the mean of two‐point discrimination test (2‐PD). Results: All outcomes were overlapping in patients treated with or without skin graft: mean VSS was 2.3, mean qDASH was 13.3, and mean 2‐PD was 7.7 mm. Conclusions: The results obtained allow to consider Matriderm®, used also without skin graft coverage, as a valid solution for treatment of fingertip tissue loss. [ABSTRACT FROM AUTHOR]

Aim The Epibloc elastic-dynamic fixation has been applied for many years at several hand surgery centres in Italy. This technique has been considered safe and reliable in the treatment of distal meta- epiphyseal fractures of the radius with dorsal displacement. The aim of this study was to evaluate an alternative use of this method in the treatment of volar displaced wrist fractures in cases where an internal fixation could not be recommended. Methods The procedure consisted of two flexible pins with a trocar tip and an external plate for locking fixation with compression. The surgical technique was derived from the original procedure, modifying the placement of the pins and performing small surgical accesses to preserve the neuro-vascular structures of the volar aspect of the wrist. To achieve and preserve the reduction of the volar fragment, a third pin was inserted into the fracture with a similar procedure to Kapandji's reduction technique. Results At three-month follow-up, most patients did not experience any pain. In 14 cases, the strength grip was recovered between 75% and 90%, compared to the contralateral hand (Jamar test). In 15 patients, the wrist range of motion was restored with values greater than 100. In 17 cases, forearm pronation-supination was restored to more than 120°. Conclusion In cases of non-comminuted, one or two fragments volar displaced wrist fractures, the elastic-dynamic fixation associated with an intrafocal pinning reduction may be proposed as an alternative to open reduction and internal fixation in elderly patients. [ABSTRACT FROM AUTHOR]

Background: Recently, the Teno Fix device has been detailed in the literature. Conventional stranded cruciate repair requires splinting to protect the sutures from excessive loading, and then, active motion is strongly limited leading to a possible incomplete functional recovery.Materials and Methods: The authors report on their experience in treating 21 patients presenting primary flexor tendon injuries within the digital sheath in zone 2, in all fingers (including the thumb), at an average follow-up of 16 (range: 6-26) months.Results: There were, according to Strickland and Glogovac criteria: 12 excellent; 6 good; 3 fair.Conclusions: This new device is practical clinically and can effect strong tendon repairs that withstand early active finger motion, but the best indication is to treat only selected cases of sharp flexor tendon lesions in zone 2. Using this technique it is possible to achieve a quick functional recovery and early return to work. [ABSTRACT FROM AUTHOR]

Background/Aim of the work: Open distal radius fractures are rare compared to closed ones. They mainly affect young people with high-energy trauma and are burdened with a high number of complications, including non-union. In this case report, we describe the technique used to manage bone loss and non-union of the distal radius of a polytraumatized patient with an open Gustilo IIIB fracture of the wrist., Case Report: 58-year-old man, suffering from head trauma and open right wrist fracture after motorcycle accident, underwent emergency damage control with debridement, antibiotic prophylaxis and stabilization in an external fixator. Then, he developed infection and bone loss, associated with an injury of the median nerve.  Non-union were treated with iliac crest bone graft, open reduction and internal fixation (ORIF)., Outcomes: At the follow-up 6 months after the bone graft and ORIF procedure and 9 months after the trauma, the patient was clinically healed, with good performance status., Conclusions: Treatment of non-union in open distal radius fractures with iliac crest bone graft is a viable, safe and easy surgical choice.