Salvage and Reconstruction of the Mangled Hand: A Case Study Utilizing a Multi-Composite Tissue Product Reconstructive Approach
Neil Nazar Al-Saidi BSc1* and Abdalmajid Katranji MD, MBA, FACS, FICS2
1 College of Medicine, Central Michigan University, Mount Pleasant, MI, USA.
2 Katranji Hand Center, East Lansing, MI, USA.
*Corresponding Author: Neil Nazar Al-Saidi, College of Medicine, Central Michigan University, Mount Pleasant, MI, USA.
DOI: https://doi.org/10.58624/SVOAOR.2023.03.052
Received: August 25, 2023 Published: September 15, 2023
Abstract
Objective: To evaluate the efficacy of a novel reconstructive approach utilizing Multiple Composite Tissue Products (MCTPs) in severe hand injuries with risk of amputation.
Methods: A comprehensive, single MCTP operation was performed at a single institution involving three tissue products to salvage the nerves, tendons, bone, and skin. This patient case study exemplifies the successful reconstruction of a mangled hand. Results: The application of three tissue products resulted in securing the integrity of the mangled hand’s structures and preservation of basic hand and wrist function, obviating the need for amputation. The patient regained significant restoration substantiating the safety and efficacy of this approach for structural, functional, and cosmetic outcomes.
Discussion: Preoperative assessment and multi-disciplinary coordination of care was imperative in optimizing the successful outcomes. The patient’s medical history was complicated by diabetes mellitus, neuropathy, and osteonecrosis. Intensive postoperative rehabilitation, including Passive and Active Range of Motion (PROM, AROM), contributed to recovery and outcomes.
Significance: The MCTP reconstructive approach is a promising avenue for optimizing tissue viability to recover from mangled hand injuries. The amelioration of adhesion formation directs proper tissue recovery which conserves tissue that might otherwise necessitate further excision, and possibly amputation. Per patient centered outcomes, this strategy mitigated extensive pain and minimized scarring, which enhanced the cosmetic appeal of reconstructing the mangled hand. These findings underscore the reconstructive potential of a MCTP approach in complex hand salvage, contributing to the recovery of function and cosmetic appeal. Future research should aim to validate similar findings of this case study strategy in a larger cohort.
Keywords: Hand and Wrist, Salvage and Reconstruction, Tendon Repair, Nerve Regeneration, Tissue Product
Citation: Al-Saidi NN, Katranji A. Salvage and Reconstruction of the Mangled Hand: A Case Study Utilizing a Multi-Composite Tissue Product Reconstructive Approach. SVOA Orthopaedics 2023, 3:5, 108-110.