My dear colleagues,
Prof. Dr. Rıdvan Ege our primary teacher in hand surgery, who published The Hand Surgery Book in 1991. “In my opinion, if the historical evolution of a topic is known, and if the hard working pioneers are recognized closely, that topic is loved more, and people are attracted to that topic more. With this belief in hand surgery, I attempted to recognize most of the famous personalities of the past, and the present closely...
Reconstructive microsurgery is a surgical field where specialized operating microscopes and precision instrumentation are utilized to perform intricate operations on tiny structures. Utilizing magnification up to
fifty times that produced by the naked eye and stitches finer than a hair, surgeons are able to repair transected blood vessels and nerves less than 1mm in diameter.
The ability to reestablish continuity and blood flow to small, severed nerves and vessels has made a major impact on the potential to restore form and function to individuals impaired by trauma, cancer and congenital differences. Advances in technology and surgical technique in the early 1960s for the first time allowed surgeons to successfully replant severed digits and limbs.
This innovation was rapidly followed by the development of vascularized toe transfers that allowed relocation of toes to replace missing fingers. The thumb accounts for approximately fifty percent of the hand’s function and the ability to utilize the great toe to replace a missing thumb was a major advancement in the surgical rehabilitation of the injured hand.
The dawning of the 1970s ushered in the development of the free flap where by surgeons could borrow tissues from regions of relative excess including skin, muscle, bone and intestine and transplant them, utilizing microvascular techniques, to cover wounds and restore missing structures. Free flaps, also know as free tissue transfers have provided a powerful tool for reconstructive surgeons in the treatment of cancers of the head and neck, breast and extremities. They have also proved invaluable in the salvage of complex extremity injuries and open fractures. Major strides have also been made in the microsurgical treatment of the injured nerve. Many peripheral nerve injuries once deemed hopeless can now be successfully managed allowing for the return of lost motion and sensation. The architecture of divided nerves can be precisely restored with the aid of the operating microscope. Damaged or missing nerve segments can be replaced by grafting pieces of expendable sensory nerve branches (nerve grafts) providing new hope for individuals with facial paralysis and injury to the brachial plexus.
Smaller nerve gaps can be bridged with nerve guidance tubes fashioned from various absorbable materials. Decellularized cadaveric nerve grafts provide an additional option for spanning nerve gaps. Technical advances in nerve repair have provided the opportunity to transplant functioning muscles to restore motion to paralyzed faces and extremities. Nerve transfers have also proved to be an effective new tool. Nerves that are expendable or have branches with duplicated function can be connected to injured nerves to restore motion and sensation.
Reconstructive microsurgery has witnessed major advancements in the last decade including the emergence of hand and face transplantation. These techniques are providing a new lease on life for severely injured patients whose problems cannot be solved by more traditional techniques. Advanced computing and robotics continue to foster the expansion of more precise and minimally invasive surgeries while the potential to biologically engineer missing tissues and structures (tissue engineering) offer an exciting gateway to the future.
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EMERGENCY HAND CARE and MICROSURGERY SOCIETY
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The Right to Be A Member and Membership Procedures...
I.Actual Member: The individual has to have the capacity to act, and he/she has
to adopt the goals and principles of the Society, and accept to work in their direction.
He/she has to carry the pre-
All types of dermal, subcutaneous, muscular, tendinous, nervous, vascular, articular, and osseous injuries, diseases, and problems from the tip of the finger to the shoulder constitute the basic topics of Hand Surgery.
The closed fractures and dislocations without an open injury,muscular and tendinous ruptures, and dermal lacerations of this field are in the therapeutical content of
Hand Surgery. All types of open injuries such as serious injuries of the extremities, amputations (Feet and legs included), structural abnormalities, and burns are the topics of interest of Hand Surgery.
All types of congenital defects, disorders and synostoses of the hand, wrist, and
arm, obstetric traumatic palsies, rheumatoid diseases, infections, tumors, posttraumatic
hand, and wrist sequelae (the corrections of post-
The arthroscopic treatments (Surgery with closed technique) of some of the diseases and injuries of the small articular and intraarticular structures of the hand, wrist, elbow, and arm are also included in the discipline of Hand Surgery.
The treatment context of Hand Surgery is very wide, and it is a multidisciplinary working field. The discipline is shared by Plastic Surgery, Orthopaedics, and General Surgery.
The hand surgeons pass through an educational process in one of these main branches of surgery. They gain their speciality after a long and meticulous fellowship education. The successful results of this field are obtained by a team work with many disciplines; in fact, physical medicine and rehabilitation practices are especially significant for a hand surgeon.
EMERGENCY HAND CARE and MICROSURGERY SOCIETY Valikonağı Cad. Sezai Selek Sok. Akil
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Dr. Erol KOZANOĞLU