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Biomedical subjects

M V Stevanovic

Publications and source records attributed to M V Stevanovic.

4 recordsLinked to original sources
PubMed1991

Avulsion injuries of the thumb.

Avulsion amputations of the thumb are generally thought to have a worse prognosis after replantation than other amputations. We report the results of 17 thumbs that had an avulsion amputation and were replanted. Fourteen of the 17 survived (82 percent). Our experience indicated that the survival rate was improved by restoring continuity of at least two veins and two arteries, using a Y-shaped vein graft and the princeps pollicis artery for the source of arterial circulation. Nerve grafts were used to bridge defects in avulsed digital nerves. When possible, avulsed tendons were reattached to their muscle. Key pinch strength was 60 percent of normal, and grip strength was always less than that of the normal hand. The age of the patients and the cold ischemia time had no significant effect on either survival or function of the replanted thumb. When excellent venous backflow occurred immediately after the vessel repair and continued for at least 20 minutes, the thumb always survived without complications.

Adolescent↗
PubMed1989

Digital replantation at the level of the distal interphalangeal joint and the distal phalanx.

Forty-two complete, single digit amputations at the level of the distal interphalangeal joint or distal phalanx are reviewed. Viability was 81%. Operative time averaged 4.6 hours. Average age of patients was 28 years and 90% were male. Forty-eight percent of the amputations involved the thumb; 79% were at the distal interphalangeal joint and 21% were more distal. One artery was repaired in 64% of replantations, two or three veins were repaired in 61%, and veins grafts were used in 19% of cases. Sixty-nine percent of the crush-avulsion injuries succeeded compared with 89% of lacerations. Two-point discrimination averaged 10 mm and proximal interphalangeal motion averaged 91 degrees. Patients returned to work an average of 2.5 months after replantation and none required additional procedures. The average total cost of treatment was $7500.00. Compared with conventional procedures, disadvantages of replantation at or distal to the distal interphalangeal joint are that it does require microsurgical training, initial operating time is longer, and it is more expensive. Advantages are that it is a one-stage procedure that gives good distal soft tissue coverage, adequate sensibility without painful neuroma, good metacarpophalangeal and proximal interphalangeal joint motion; it preserves the nail, maintains digit length, is cosmetically pleasing, and the patient is satisfied.

Adolescent↗
PubMed1986

Canine experimental free muscle transplantation.

Transplants of the cranial portion of the dog sartorius muscle were able to generate 70% of control force after 3 months if the artery, vein, and nerve were reanastomosed. Our histological and histochemical findings correlate with the functional findings. In a separate group of animals that had their muscles denervated prior to replantation, no collateral sprouting was noted and no function could be recorded when the nerve was stimulated proximally. These findings suggest that clinical application of free muscle transplantation is strongly supported by this animal model if due consideration is paid to surgical procedure and anatomical structure.

Animals↗