BookJörg Bahm.
Summary: This book develops and describes surgical rationales in the field of reconstructive surgery for upper limb function, both in children and adults suffering from various diseases or trauma leading to a variety of motor and sensory impairments, sometimes associated with growth-related deformities. Every surgical career is a unique living story of learning, performing, questioning, trial and error, and finally success. Every surgeon has to integrate a wealth of information regarding ongoing clinical and research work in a range of disciplines; and with time and experience, a surgical rationale is developed that serves as a baseline and support for their day-to-day work. Following a structure starting with the patients needs, the surgeon and the training, the different tissues are addressed and their pathophysiology discussed in detail, including basic research and surgical expertise. The book is not a surgical compendium, but instead focuses on the detailed baseline behind day-to-day clinical examinations, functional evaluations and surgical work. Readers will learn how the tissues interact, how pathologies change them and interfere with their functions, and how to reverse the pathophysiological sequence by surgical-technical means to improve function. Although the book presents the authors personal views, all aspects are explained and debated on the basis of past and current clinical findings, ongoing basic research and input from other disciplines: readers may disagree with certain points, but choose to implement some of the rationales and priorities, incorporate findings from fields they'd never previously explored, or investigate them further. This book offers an extensive framework of argumentation and is intended to inspire and support readers in terms of decision-making and understanding current or uncommon procedures. Practitioners in the fields of peripheral nerve surgery, reconstructive plastic surgery, upper limb orthopedics, neuropediactrics, biomechanics, physiotherapy and ergotherapy will find the book a valuable asset, and a trusted companion in the daily quest to improve patient care!
Contents:
Intro
Preface
Contents
1: Decision-Making in Reconstructive Surgery
1.1 Analysis of Patient's Story and Expectations (Anamnesis)
1.1.1 Giving Enough Time and Space for the Patient's Description
1.2 Basics of Medical and Surgical Behavior
1.3 Multi-, Inter-, and Transdisciplinarity
1.3.1 The Concept of Transdisciplinarity
1.4 Imagery and Electrophysiology
1.4.1 Electrophysiology and the Dialogue with Neurologists
1.4.2 Nerve Fascicle Torsion, Parsonage-Turner Syndrome, and Neurogenic Thoracic Outlet
1.4.3 Muscle Testing
1.5 Basic Research 1.5.1 Tissue Engineering of Nerve and Muscle Cells
1.5.1.1 Neurobiology of Peripheral Nerve Injury and Regeneration
1.5.1.2 Neurobiology of Muscle Tissue
1.5.1.3 Classification of Nerval Injuries and Clinical Impact
1.5.1.4 Tissue Engineering
1.5.1.5 Muscle Tissue Engineering
1.5.1.6 Nerve Reconstruction and Tissue Engineering
1.5.2 Living Nerve-Muscle Interaction
1.6 Experience and Psychology
1.7 Evidence-Based Practice
1.8 Discussion
References
2: Pre- and Postoperative Functional Evaluation in Reconstructive Surgery
2.1 Routine Tools 2.1.1 Motion and Strength
2.1.2 Sensibility
2.1.3 Spasticity
2.2 Expert Tools
2.2.1 Electrophysiology (See Sect. 1.4)
2.2.1.1 Video-Assisted Movement Analysis (Vicon): Movement Lab
2.2.1.2 Motion Patterns (Fig. 2.5)
2.2.1.3 Modeling
2.2.2 Further Development of Scoring
2.3 Further Directions
2.3.1 Motion Analysis
2.3.1.1 Pre- and Postoperative Multifactor Movement Analysis
2.3.1.2 Further Research: Accelerometers
2.3.2 Video Analysis, Serious Games, Virtual Reality
2.3.2.1 Augmented Reality
References 3: Biomechanics and Physiology in Reconstructive Surgery of the Upper Limb
3.1 Motion: Kinematics
3.2 Force Vectors
3.3 Use
3.4 Basics on Motor and Sensitive Function
3.5 Cortical Plasticity
References
4: Invited Contributions: Fields Outside of My Work
4.1 Surgical Techniques in Upper Limb Amputation
4.1.1 Patient Identification
4.1.2 Amputation Level
4.1.2.1 Minor Amputations
4.1.2.2 Major Amputations
Transcarpal
Transradial
4.1.2.3 Elbow Exarticulation
Transhumeral
4.1.2.4 Glenohumeral/Forequarter 4.1.3 Surgical Techniques and Indications
4.1.3.1 Nerves
Targeted Muscle Reinnervation
4.1.3.2 Neuroma and Pain
4.1.4 Emerging Surgical Concepts
4.1.5 Soft Tissues
4.1.6 Bones
4.1.7 Segmental Shortening
4.1.8 Angulation Osteotomy
4.1.9 Osseointegration
4.1.10 Secondary Indications
4.1.11 Rehabilitation
4.2 Hand Transplantation
4.2.1 First, Constitute a Good Medico-Surgical Team
4.2.2 Second, Find a Good Candidate for Hand Transplantation
4.2.2.1 You Also Need to Find a Good Donor
4.2.3 Surgical Considerations.