Biomedical subjects
Publications and source records attributed to N J Cowen.
This article has reviewed some of the current methods of management of congenital problems in the upper extremity. Not all problems have been included in this review but some of the landmark advances in this field have been considered. The management of congenital anomalies may change significantly in the future.
A technic incorporating the simultaneous elevation of multiple adjacent thoracoabdominal pedicale flaps, based in opposite directions, has been successfully used on four patients with extensive degloving injuries of the hand. In all cases, the hand was later divided into individual digits. A five-year follow-up of three patients is presented, illustrating functional results good enough to allow the patients to return to work. The special problems of a circumferential wound and digital shortening appear to be better controlled by this technic than by a single long "wrap-around" flap. Various technics of skin coverage are reviewed.
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The causes of irreducibility of juxta-epiphyseal fractures of the proximal phalanx are illustrated in a patient with button hole rent in the periosteum and extensor hood mechanism causing trapping of the distal fragment. The entrapment, in the manner of a Chinese finger trap, was aggravted by traction on the digit. Open reduction was necessary to reduce the fracture.
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Explore the source record for details and available documents.