2015/01/28 by Shady A. Rehim, Evan Kowalski, Kevin C. Chung
Medicine · #Orthopedic Surgery and Rehabilitation #Reconstructive Surgery and Microvascular Techniques #Digital Imaging in Medicine
paper · doi:10.1097/prs.0000000000001069
In Brief Learning Objectives: After reading this article and viewing the video, the participant should be able to: 1. Have an in-depth understanding of the functional and aesthetic requirements of different regions of the hand. 2. Describe the anatomical blood supply and vascular territories of the hand. 3. Describe the advantages and disadvantages of different types of soft-tissue reconstructions for different anatomical regions of the hand (e.g., digits, thumb, palm, and dorsum of the hand). Summary: Hand aesthetics in general and aesthetic refinements of soft-tissue coverage of the hand in particular have been increasingly considered over the past few years. Advancements of microsurgery together with the traditional methods of tissue transfer have expanded the number of techniques available to the reconstructive surgeon, thus shifting the reconstructive paradigm from simply “filling the defect” to reconstructive refinement to provide the best functional and aesthetic results. However, drawing the boundary between what does and what does not constitute “aesthetic” reconstruction of the hand is not straightforward. The selection among the vast amount of currently available reconstructive methods and the difficulties in objectively measuring or quantifying aesthetics have made this task complex and rather arbitrary. In this article, the authors divide the hand into several units and subunits to simplify the understanding of the basic functional and aesthetic requirements of these regions that may ultimately bring order to complexity. Video Discussion by Yash Avashia, Laura Tom, and John Fischer is available online for this article.