Hand & Micro Surgery

OVERVIEW

The Hand & Micro Surgery unit is a sub unit of Department of Orthopaedics headed by Dr Latheesh Leo. It has OPD consultation on Tuesday, Thursday, and Saturday. The Hand & Micro Surgery unit spectrum of cases done:

  • Hand & Wrist injury
  •  Open Fracture of upper limb and lower limbs
  • Burned Hand
  • Brachial  plexus injuries
  • Vascular injury
  •  Tumour of the hand
  •  Spastic Hand
  •  Congenital Hand
  •  Amputation and replantation
  • Neuropathic foot ulcer

Procedure: Contracture Release + Excision of the bands + A1 Pulley Reconstruction + Z plasty

Traumatic loss of Right thumb at Metacarpal base with groin flap

A young man who was a driver by occupation lost his right thumb ; following an accident a year back. The lost thumb incapacitated him from doing his daily activities. He was evaluated and treated in Father Muller medical college hospital ,unit of Hand & Microsurgery under Department of Orthopaedics.

The Seven hours long surgery were the patient's own second toe was transferred from the right foot and made it as his new thumb .This unique and advanced microsurgery surgery was performed by a team of doctors lead by Dr Latheesh Leo, Unit chief of Hand & Microsurgery, Dr Sagar.S, Dr Hilda; Anaesthesiologists and the supporting staffs.

The patient is showing good recovery and is expected to be fit for work in a month's time.

Procedure: Free ALT Flap cover

History: Chronic wound over the right heel exposing the Tendoachilles

Procedure: Debridment + lateral calcaneal artery flap cover + SSG

History: Traumatic crush amputation of left ring finger at DIP joint level

Post traumatic brachial plexus palsy right side

Post traumatic crush amputation of right great ,second and third toe with avascularity

Procedure : Syndactyly separation and full thickness grafting

Post traumatic wound over the right foot dorsum

Procedure: Contracture Release + Kwire stabilisation of pip joints of little, ring and middle finger and double cross finger flap and SSG.

Contracture release + Kwire stabilisation of the joints + Cross finger flaps

Procedure: Exploration of brachial plexus and wang's procedure

findigs : spinal accessory ,phrenic nerves not ecitable
complete avulsion of C5,6,7 ,8 & T1 roots with the roots distracted to the infraclavicular region

  • AD LT
  • Ulnar
  • Median
  • MCN
  • MCNF

Procedure :

  • Anterior division of contralateral C7 connected to the anterior division of Lower trunk ( AD-LT) using a 5cm long sural nerve cables (three ) over the scalenus anterior on the left side Contalateral C7 tunnel in front of the cervical spine (length 6cm)
  • supraclavicular sensory nerves connected to the lateral cord of median nerve directly ( Lat -MED)
  • The medial cutaneous nerve of forearm (MCNF) connected to the musculocutaneous nerve (MCN).

Procedure:Debridment and sensate free anteriolateral thigh flap done

Procedure:Contracture Release + Kwire stabilisation of pip joints of little ,ring and middle finger and double cross finger flap and SSG.

Contracture release + Kwire stabilisation of the joints + Cross finger flaps

History:Post traumatic Flexor carpi ulnaris tendon injury , Aneurysm of brachial artery of left upper limb

Procedure: Exploration & FCR tendon reconstruction using Palmaris tendon graft and Excision of the aneurysm and End to end repair of brachial artery using saphenous vein graft

Procedure: Contracture Release + Excision of the bands + A1 Pulley Reconstruction + Z plasty

Procedure: Contracture release + Corrective osteotomy of the radius + External fixator application

History : Giant cell tumor of Right Distal Radius ( grade III).

Procedure : Radical excision + Articular fibula transfer + Sauve Kapanji Procedure

Diagnosis : Post traumatic avulsion amputation of Right index finger at distal PPX level and near total amputation of Right middle finger at proximal PPX level following hand getting caught inside a machine.

Procedure : Debridement + Stabilisation of PPX fracture and critical revascularisation of right middle finger + Replantation of right index finger

RTA with open type III B tibia and fibula fracture with soft tissue loss

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