title: Forearm transplantation osteosynthesis using modified ulnar shortening osteotomy technique.
abstract: One of the challenges of forearm-level hand transplantation surgery is the achievement of osseous union of the ulna given the substantial soft tissue dissection, the use of immune modulating medications, and the diaphyseal level of osseous coaptation. Modification of the conventional surgical technique for an elective ulnar shortening osteotomy provides the advantages of precise osteotomy alignment, a large contact surface oblique osteotomy, and lag screw and compression plating technique. A step-by-step description of the developed modification is provided with a case example.
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: anne.mattson@medstar.net.
authors.forename: James P
authors.initials: JP
authors.lastname: Higgins
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Jaimie T
authors.initials: JT
authors.lastname: Shores
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Katz
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: W P Andrew
authors.initials: WP
authors.lastname: Lee
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Wolock
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery*; D001132:Arm / Q000637:transplantation*; D001860:Bone Plates; D001863:Bone Screws; D005543:Forearm Injuries / Q000601:surgery*; D017102:Fracture Healing / Q000502:physiology; D006230:Hand Injuries / Q000601:surgery*; D063987:Hand Transplantation / Q000379:methods*; D006801:Humans; D008866:Microsurgery / Q000379:methods; D008953:Models, Anatomic; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D013525:Surgical Instruments; D014457:Ulna / Q000601:surgery
keywords: Hand transplantation; compression plating; ulnar nonunion; ulnar shortening osteotomy