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  1. Article ; Online: The Role of Microsurgery in Coverage of Defects of the Hand.

    Das De, Soumen

    Hand clinics

    2023  Volume 40, Issue 2, Page(s) 221–228

    Abstract: Soft tissue defects of the hand may result from trauma, infection, vascular disease, and after resection of tumors. Microsurgery has evolved to a stage where it is relatively commonplace today but procedures such as free flaps still incur significant ... ...

    Abstract Soft tissue defects of the hand may result from trauma, infection, vascular disease, and after resection of tumors. Microsurgery has evolved to a stage where it is relatively commonplace today but procedures such as free flaps still incur significant time, manpower, cost, and material resources. The aim of this article is to articulate the specific situations in hand reconstruction when microsurgery is superior to nonmicrosurgical reconstructive options. The benefits of microsurgical reconstruction include a variety of important metrics, such as improved function, better tissue match, less donor site morbidity, and reduced downtime for the patient.
    MeSH term(s) Humans ; Microsurgery ; Plastic Surgery Procedures ; Hand/surgery ; Free Tissue Flaps ; Neoplasms
    Language English
    Publishing date 2023-11-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1315374-2
    ISSN 1558-1969 ; 0749-0712
    ISSN (online) 1558-1969
    ISSN 0749-0712
    DOI 10.1016/j.hcl.2023.10.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Aesthetic Considerations in Pollicisation Using the Buck-Gramcko Technique.

    DAS DE, Soumen / Sivakumar, Branavan

    The journal of hand surgery Asian-Pacific volume

    2023  Volume 28, Issue 5, Page(s) 590–595

    Abstract: The Buck-Gramcko (BG) technique of pollicisation has stood the test of time and provides good to excellent prehensile function in thumb hypoplasia. Proponents of the technique favour it because it provides good exposure to the palmar neurovascular ... ...

    Abstract The Buck-Gramcko (BG) technique of pollicisation has stood the test of time and provides good to excellent prehensile function in thumb hypoplasia. Proponents of the technique favour it because it provides good exposure to the palmar neurovascular structures. However, the skin flap design may occasionally lead to a 'finger-like' appearance with a sharp interdigital cleft and a triphalangeal form. In this report, we describe some of the important aspects of the operative technique so that the outcome is aesthetically pleasing in addition to providing good function.
    MeSH term(s) Humans ; Fingers/surgery ; Thumb/surgery ; Surgical Flaps ; Plastic Surgery Procedures ; Esthetics
    Language English
    Publishing date 2023-10-27
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 2848651-1
    ISSN 2424-8363 ; 2424-8355
    ISSN (online) 2424-8363
    ISSN 2424-8355
    DOI 10.1142/S2424835523710108
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  3. Article ; Online: Surgical Technique: Lateral Plate Osteosynthesis of Proximal Phalanx Fractures.

    Lim, Zhixue / Foo, Anthony Tun Lin / Das De, Soumen

    Techniques in hand & upper extremity surgery

    2023  Volume 27, Issue 1, Page(s) 38–44

    Abstract: Dorsal plate fixation of proximal phalanx (PP) fractures is a conventional approach but interferes with the extensor mechanism and results in stiffness. Biomechanical studies have shown that laterally placed plates on the proximal phalanges are equally ... ...

    Abstract Dorsal plate fixation of proximal phalanx (PP) fractures is a conventional approach but interferes with the extensor mechanism and results in stiffness. Biomechanical studies have shown that laterally placed plates on the proximal phalanges are equally stable and rigid. This technique obviates the issue of tendon adhesion and may result in better postoperative range of motion and lower secondary procedures such as removal of implant and tenolysis. The low adoption of this technique may be related to lack of familiarity with the surgical approach. We describe our surgical technique with lateral plating of PP fractures and present our case that lateral plate osteosynthesis is an acceptable surgical fixation option for PP fractures, which extends the hand surgeon's armamentarium for more challenging and comminuted fractures.
    MeSH term(s) Humans ; Fractures, Bone/surgery ; Fracture Fixation, Internal/methods ; Fractures, Comminuted/surgery ; Finger Phalanges/surgery ; Bone Plates
    Language English
    Publishing date 2023-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2075789-X
    ISSN 1531-6572 ; 1089-3393
    ISSN (online) 1531-6572
    ISSN 1089-3393
    DOI 10.1097/BTH.0000000000000407
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Revisiting the reconstructive ladder for soft tissue reconstruction in the lower extremity.

    Jeyaratnam, Shubashri / Sebastin, Sandeep Jacob / Das De, Soumen

    Annals of translational medicine

    2023  Volume 12, Issue 1, Page(s) 7

    Abstract: Soft tissue reconstruction of the lower limb has seen a paradigm shift over the past two decades. Typically, these defects arise from trauma, infection or tumor. It is no longer enough to simply achieve coverage. Factors like patient-reported outcomes ... ...

    Abstract Soft tissue reconstruction of the lower limb has seen a paradigm shift over the past two decades. Typically, these defects arise from trauma, infection or tumor. It is no longer enough to simply achieve coverage. Factors like patient-reported outcomes and aesthetic considerations are essential in the decision-making process. This is especially in light of increasing technological advancement, availability of dermal substitutes, microsurgical expertise and development of the field of microsurgical reconstruction as a whole with more novel flaps and techniques. Advancements in reconstructive modalities have also been equally matched by better emergency medical mobilization, transportation and access, early initiation of subspecialty care, accessibility and types of imaging, as well as oncological advances in radiotherapy and chemotherapy regimens. Yet, this has also meant that our patient profile has expanded to include older patients with more co-morbidities and other considerations such as frailty or the irradiated field which could influence what reconstructive modality is suitable and the goals of reconstruction specific to the patient. Previously deemed unsalvageable limbs are now being successfully reconstructed with good function and aesthesis. In the lower limb, this implicates the ability for early mobilization, range of motion and weight bearing which allow the patient to successfully partake in early rehabilitation. Expedient and reliable healing is also important in the oncological population where a proportion of these patients would need to go on to receive post-operative chemotherapy or radiotherapy. The reconstructive ladder has been what many reconstructive surgeons have been taught upon with regard to the basic principles of pre-operative planning and choosing the appropriate reconstructive modality. In this article, we examine the relevance of the reconstructive ladder in modern practice and the additional considerations in the approach to a soft tissue defect in the lower extremity.
    Language English
    Publishing date 2023-09-11
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm-23-1445
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Challenges and Solutions in Prosthetic Fitting of Digits after Flap Reconstruction.

    Leow, Michael E L / DAS DE, Soumen / Puhaindran, Mark E / Chong, Alphonsus K S

    The journal of hand surgery Asian-Pacific volume

    2024  Volume 29, Issue 1, Page(s) 69–74

    Abstract: Surgical reconstruction can restore length and function, but cannot adequately resolve the problem of disfigurement. Prosthetic fitting can play a complementary role in enhancing the aesthetic outcomes post reconstruction. However, complex reconstruction ...

    Abstract Surgical reconstruction can restore length and function, but cannot adequately resolve the problem of disfigurement. Prosthetic fitting can play a complementary role in enhancing the aesthetic outcomes post reconstruction. However, complex reconstruction involving flaps coupled with the surgical imperative for limb length preservation can lead to outcomes where the reconstructed stumps are challenging to fit with prosthesis. This article describes how prosthetic fitting was tackled in a case of a triple-digit amputation after reconstruction that presented with finger stumps that were bulky, long and stiff in extension contracture, compounded by the presence of substantive scar tissues. We discuss major prosthesis modifications that were unconventional but necessary to enable fitting, the techniques involved, as well as the aesthetic and functional considerations behind the modifications. The results showed that enhanced aesthetic appearance, together with a marginal improvement in hand function, was achieved post-prosthetically, meeting the patient's and the clinical team's fitting objective.
    MeSH term(s) Humans ; Surgical Flaps ; Prostheses and Implants ; Amputation Stumps ; Fingers/surgery ; Contracture
    Language English
    Publishing date 2024-01-26
    Publishing country Singapore
    Document type Case Reports ; Journal Article
    ZDB-ID 2848651-1
    ISSN 2424-8363 ; 2424-8355
    ISSN (online) 2424-8363
    ISSN 2424-8355
    DOI 10.1142/S2424835524720032
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  6. Article ; Online: Mirror hand-ulnar dimelia: a single centre experience with 13 patients.

    Kumar, Bhaskaranand / Sm, Venugopal / Chandmanne, Bhavya / Das De, Soumen

    The Journal of hand surgery, European volume

    2022  Volume 47, Issue 10, Page(s) 1045–1055

    Abstract: Mirror hand-ulnar dimelia (MHUD) is rare congenital disorder with a wide range of clinical and radiographic features. The current nomenclature is confusing and the existing classification systems focus mainly on morphology without providing much guidance ...

    Abstract Mirror hand-ulnar dimelia (MHUD) is rare congenital disorder with a wide range of clinical and radiographic features. The current nomenclature is confusing and the existing classification systems focus mainly on morphology without providing much guidance for treatment. The goal of this study was to review the clinical and radiological features in 13 children with MHUD that were treated at a single institution. Our findings support the hypothesis that MHUD typically involves the entire upper limb, and the treatment plan should consider the predictors of function at each limb segment. A logical and comprehensive management algorithm is proposed.
    MeSH term(s) Child ; Humans ; Hand Deformities, Congenital/diagnostic imaging ; Hand Deformities, Congenital/surgery ; Radiography ; Upper Extremity ; Radiology
    Language English
    Publishing date 2022-08-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/17531934221116960
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  7. Article ; Online: Outcomes Associated with Moberg and Modified Moberg Flaps in Thumb Reconstruction: A Systematic Review.

    Elsewify, Omar / Barone, Natasha / Elhawary, Hassan / DAS DE, Soumen / Efanov, Johnny I

    The journal of hand surgery Asian-Pacific volume

    2023  Volume 28, Issue 2, Page(s) 252–265

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Humans ; Thumb/surgery ; Activities of Daily Living ; Plastic Surgery Procedures ; Surgical Flaps ; Joint Dislocations/surgery
    Language English
    Publishing date 2023-04-17
    Publishing country Singapore
    Document type Systematic Review ; Journal Article
    ZDB-ID 2848651-1
    ISSN 2424-8363 ; 2424-8355
    ISSN (online) 2424-8363
    ISSN 2424-8355
    DOI 10.1142/S2424835523500297
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  8. Article ; Online: Secondary Procedures after Severe Upper Extremity Injury.

    Ng, Nathan / Das De, Soumen / Chong, Alphonsus K S

    The journal of hand surgery Asian-Pacific volume

    2021  Volume 26, Issue 2, Page(s) 152–157

    Abstract: Upper extremity trauma is one of the most common types of injuries, accounting for 20 to 40 percent of injured patients presenting to the emergency department. In severe upper extremity injury, the likelihood of secondary procedures to improve function ... ...

    Abstract Upper extremity trauma is one of the most common types of injuries, accounting for 20 to 40 percent of injured patients presenting to the emergency department. In severe upper extremity injury, the likelihood of secondary procedures to improve function and resolve outstanding clinical problems is high. Secondary procedures are performed later than initial primary surgery, usually after wound healing and with a discernible time gap of days, weeks or occasionally longer. They should be considered as separate procedures from the primary surgery, with due diligence given to planning for it. When approaching secondary procedures, the key principles are anchored in early preparation, patient engagement, optimal timing and sequencing, reviewing and considering alternatives, and finally knowing when to stop. Although secondary procedures after upper extremity injuries can be a complex undertaking, the careful application of these principles and considerations will optimise outcomes.
    MeSH term(s) Decision Making, Shared ; Humans ; Orthopedic Procedures ; Patient Participation ; Time Factors ; Upper Extremity/injuries ; Upper Extremity/surgery
    Language English
    Publishing date 2021-04-29
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 2848651-1
    ISSN 2424-8363 ; 2424-8355
    ISSN (online) 2424-8363
    ISSN 2424-8355
    DOI 10.1142/S242483552140004X
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  9. Article ; Online: Management of Tendon and Bony Injuries of the Distal Phalanx.

    Liao, Janice C Y / Das De, Soumen

    Hand clinics

    2020  Volume 37, Issue 1, Page(s) 27–42

    Abstract: Acute tendon and bony injuries of the distal phalanx are challenging injuries because they may result in chronic pain, hypersensitivity, stiffness, and deformity if they are not adequately treated. Flexor tendon avulsions require early surgical repair. ... ...

    Abstract Acute tendon and bony injuries of the distal phalanx are challenging injuries because they may result in chronic pain, hypersensitivity, stiffness, and deformity if they are not adequately treated. Flexor tendon avulsions require early surgical repair. Conversely, most extensor tendon injuries and fractures heal well with nonoperative treatment. However, surgery is indicated in selected patients, and meticulous technique is required to achieve good postoperative outcomes. In this article, we outline the pertinent clinical anatomy of the distal phalanx, review the current literature regarding treatment options, and highlight key management points to ensure good clinical outcomes while minimizing complications.
    MeSH term(s) Finger Injuries/surgery ; Finger Phalanges/diagnostic imaging ; Finger Phalanges/surgery ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Humans ; Tendon Injuries/surgery ; Tendons
    Language English
    Publishing date 2020-11-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1315374-2
    ISSN 1558-1969 ; 0749-0712
    ISSN (online) 1558-1969
    ISSN 0749-0712
    DOI 10.1016/j.hcl.2020.09.005
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  10. Article ; Online: Letter to the Editor: Can Sural Fasciocutaneous Flaps Be Effective in Patients Older Than 65?

    Das De, Soumen / Liang, Zhen Chang

    Clinical orthopaedics and related research

    2020  Volume 478, Issue 7, Page(s) 1699–1700

    MeSH term(s) Humans ; Soft Tissue Injuries ; Surgical Flaps
    Keywords covid19
    Language English
    Publishing date 2020-06-09
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000001332
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