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Amer K, Otero K, Smith B, Datiashvili R. Hand Tumors: An Individual Surgeon's Retrospective Review. Eplasty 2022; 22:e1. [PMID: 35602523 PMCID: PMC9097894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Tumors of the hand are encountered frequently and represent a variety of pathologic diagnoses, both benign and malignant. Even within a single pathologic type, presentation can vary. This study reviews hand tumors encountered by an individual surgeon and described presenting features to better aid in clinical decision making. METHODS A retrospective chart review of patients presenting with a hand tumor between January 2005 and December 2017 from an individual surgeon's perspective was performed. Pertinent data were extracted by researchers and statistical analysis was completed with GraphPad Prism (GraphPad Software, Inc). RESULTS A total of 101 patients aged 14 months to 87 years (mean age, 40.52 years) were included. Within this patient group, soft tissue tumors accounted for 97%, malignant neoplasm 2%, and bone tumors 1%. Ganglion cysts were most common (54.5%) followed by hemangiomas (9.9%), giant cell tumors (6.9%), granulomas (5.9%), and fibromas (5%). A total of 54.5% of patients reported pain and 43.5% reported decreased range of motion (ROM). CONCLUSIONS In this patient cohort, ganglion cyst was the most common tumor type and presented with pain and deficits in ROM. This is contrary to the asymptomatic presentation of such cases in the literature. Other common tumors were hemangiomas, giant cell tumors, granulomas, and fibromas. Malignant tumors were rare, as expected, and both cases presented without pain or tenderness.
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Affiliation(s)
- Kamil Amer
- Rutgers New Jersey Medical School, Department of Orthopaedics, Newark, New Jersey
| | - Katie Otero
- Rutgers New Jersey Medical School, Department of Orthopaedics, Newark, New Jersey
| | - Brendan Smith
- Rutgers New Jersey Medical School, Department of Orthopaedics, Newark, New Jersey
| | - Ramazi Datiashvili
- Rutgers New Jersey Medical School, Division of Plastic Surgery, Newark, New Jersey
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2
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Feintisch AM, Ayyala HS, Datiashvili R. An Anatomic Variant of Persistent Median Artery in Association with Carpal Tunnel Syndrome: Case Report and Review of the Literature. J Hand Surg Asian Pac Vol 2019; 22:523-525. [PMID: 29117826 DOI: 10.1142/s0218810417720388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The persistent median artery can be a rare cause of carpal tunnel syndrome. We present an anatomic variant of this artery. A 47-year-old female patient with bilateral carpal tunnel syndrome was found to have bilateral patent, functional persistent median arteries (PMA) upon operative exploration. Unlike previous reports, the PMAs were not located dorsal to the flexor retinaculum (FR). Rather, the PMAs were interposed between the palmar aponeurosis and the FR. Accompanied by two venae comitantes, the aberrant arteries were positioned directly in line with our carpal tunnel incisions on both hands. Although rare, it is important for the surgeon to be aware of this anatomic variant to prevent inadvertent injury to what may be an important vascular supply to the distal median nerve.
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Affiliation(s)
- Adam M Feintisch
- 1 Division of Plastic Surgery, Department of Surgery, Rutgers - New Jersey Medical School, NJ, USA
| | - Haripriya S Ayyala
- 1 Division of Plastic Surgery, Department of Surgery, Rutgers - New Jersey Medical School, NJ, USA
| | - Ramazi Datiashvili
- 1 Division of Plastic Surgery, Department of Surgery, Rutgers - New Jersey Medical School, NJ, USA
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3
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Li X, Viviano S, Datiashvili R. Salvage of Thumb With a Free Skin Flap From the Great Toe. Eplasty 2018; 18:ic15. [PMID: 30206463 PMCID: PMC6108156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Xingchen Li
- Division of Plastic Surgery, Department of Surgery, Rutgers University/New Jersey Medical School, Newark,Correspondence:
| | - Stephen Viviano
- Division of Plastic Surgery, Department of Surgery, Rutgers University/New Jersey Medical School, Newark
| | - Ramazi Datiashvili
- Division of Plastic Surgery, Department of Surgery, Rutgers University/New Jersey Medical School, Newark
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4
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Xue E, Bogdasarian R, Datiashvili R. A Slow-Growing Hand Mass. Eplasty 2018; 18:ic6. [PMID: 29581819 PMCID: PMC5845434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Erica Y. Xue
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark
| | - Ronald Bogdasarian
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark
| | - Ramazi Datiashvili
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark,Correspondence:
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5
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Feintisch AM, Datiashvili R. Dorsal Wrist Ganglion Associated with Extensor Digitorum Brevis Manus: Case Report and Review of the Literature. J Hand Surg Asian Pac Vol 2017; 22:355-358. [PMID: 28774243 DOI: 10.1142/s0218810417200222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aberrant accessory muscles are rare entities in the hand. The extensor digitorum brevis manus (EDBM) muscle is amongst them and may be seen in association with dorsal ganglion cysts. Distinguishing an EDBM muscle is relevant in the diagnostic consideration of a dorsal ganglion in order to facilitate and guide its proper treatment. To date, there have been only few reports of an EDBM in association with a dorsal ganglion cyst. We report our experience with an incidental intraoperative finding of an intramuscular EDBM dorsal ganglion cyst and follow with a literature review and guide to management.
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Affiliation(s)
- Adam M Feintisch
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey, USA
| | - Ramazi Datiashvili
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey, USA
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6
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Xue EY, Schultz JJ, Datiashvili R. A Pedunculated Neoplasm of the Thigh. Eplasty 2017; 17:ic20. [PMID: 28900531 PMCID: PMC5534529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Erica Y. Xue
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark
| | - Jerette J. Schultz
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark,Correspondence:
| | - Ramazi Datiashvili
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark
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7
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Castel N, Karian L, Datiashvili R. Revision of a Hypertrophic Tracheostomy Scar. Eplasty 2016; 16:ic49. [PMID: 28077987 PMCID: PMC5189609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nikki Castel
- Division of Plastic Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark
| | - Laurel Karian
- Division of Plastic Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark
| | - Ramazi Datiashvili
- Division of Plastic Surgery, Department of Surgery, Rutgers/New Jersey Medical School, Newark,Correspondence:
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8
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Feintisch AM, Paik AM, Datiashvili R. Inferior Trapezius Myocutaneous Flap as Salvage Procedure for Large Posterior Scalp Defect. Eplasty 2015; 15:ic42. [PMID: 26240673 PMCID: PMC4522143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Adam M. Feintisch
- Division of Plastic Surgery, Rutgers UniversityUniveristy – New Jersey Medical School, Newark, NJ,Correspondence:
| | - Angie M. Paik
- Division of Plastic Surgery, Rutgers UniversityUniveristy – New Jersey Medical School, Newark, NJ
| | - Ramazi Datiashvili
- Division of Plastic Surgery, Rutgers UniversityUniveristy – New Jersey Medical School, Newark, NJ
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9
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Marano AA, Feintisch AM, Datiashvili R. Giant Congenital Melanocytic Nevus of the Buttock. Eplasty 2015; 15:ic31. [PMID: 26171106 PMCID: PMC4473815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Andrew A. Marano
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark,Correspondence:
| | - Adam M. Feintisch
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark
| | - Ramazi Datiashvili
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark
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10
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Sood A, Khamsi B, Datiashvili R, Berberian WS. Use of cross-leg flap for wound complications resulting from open pilon fracture. Am J Orthop (Belle Mead NJ) 2015; 44:131-134. [PMID: 25750947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pilon fractures and associated soft-tissue complications present treatment challenges for orthopedic surgeons. Open fractures may require additional soft-tissue coverage. When local soft tissues do not allow for viable coverage, a cross-leg flap is available as a salvage procedure with successful outcomes. To our knowledge, there have been no previous reports of using cross-leg flaps for wound complications in high-energy pilon fractures.
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Affiliation(s)
- Amit Sood
- Department of Orthopedic Surgery, Harvard-Boston Shoulder Institute, Boston, MA.
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11
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Lanteri Parcells A, Abernathie B, Datiashvili R. The use of urinary bladder matrix in the treatment of complicated open wounds. Wounds 2014; 26:189-196. [PMID: 25860538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Management of complicated open wounds represents a challenge when reconstructive options are not applicable. Urinary bladder matrix (UBM) provides a biocompatible material that allows inductivetissue remodeling. METHODS The use of urinary bladder matrix inthe treatment of 5 patients with complicated open wounds that failed toheal with conventional therapy is presented. RESULTS A 3-year old male sustained a second-degree oil burn measuring 8 cm x 4 cm to his dorsal forearm; UBM was applied weekly and the wound epithelialized in 3 weeks. A 52-year old male sustained massive second and third degree burns to his leg after a fire; UBM was applied weekly and the wound epithelialized in 28 weeks. A 61-year old female sustained a severe crushing injury to her right knee. A gastrocnemius muscle transfer and rectus abdominus muscle free flap transfer both failed, then UBM and vacuum-assisted closure therapy were applied and the wound epithelialized in 24 weeks. A 54-year old female underwent a breast mastectomy and immediate reconstruction with pedicled transverse rectus abdominus flap. The patient developed partial necrosis and the wound was managed with UBM and vacuum-assisted closure therapy. The wound epithelialized in 12 weeks. A 36-year old female sustained severe degloving injuries to both hands with exposed metacarpals. Weekly application of UBM provided tissue remodeling over the bones, which allowed successful skin grafting and closure. CONCLUSIONS These experiences show UBM to be an effective method in management of complicated open wounds in select cases. Further studies need to be implemented to confirm this conclusion.
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Affiliation(s)
| | - Brenon Abernathie
- Rutgers, The State University of New Jersey, Biomedical and Health Sciences, Newark, NJ
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12
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Feintisch AM, Datiashvili R. Head and neck reconstruction. Eplasty 2013; 13:ic30. [PMID: 23457656 PMCID: PMC3578375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Adam M. Feintisch
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark,Correspondence:
| | - Ramazi Datiashvili
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark
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13
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Feintisch AM, Datiashvili R. Lower extremity reconstruction. Eplasty 2013; 13:ic31. [PMID: 23457657 PMCID: PMC3579430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Adam M. Feintisch
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark,Correspondence:
| | - Ramazi Datiashvili
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark
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14
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Abernathie B, Datiashvili R. Zone II Flexor Tendon Injury. Eplasty 2013; 13:ic20. [PMID: 23409211 PMCID: PMC3558848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Brenon Abernathie
- Division of Plastic Surgery, Department of Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark
| | - Ramazi Datiashvili
- Division of Plastic Surgery, Department of Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark
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15
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Celestin RN, Datiashvili R. Penetrating injury to the upper extremity. Eplasty 2013; 13:ic9. [PMID: 23359854 PMCID: PMC3554259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ruth N. Celestin
- New Jersey Medical School, Division of Plastic Surgery, University of Medicine and Dentistry, NJ
| | - Ramazi Datiashvili
- New Jersey Medical School, Division of Plastic Surgery, University of Medicine and Dentistry, NJ,Correspondence:
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16
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Abstract
BACKGROUND Soft tissue and bony tumors of the pelvis are rare, but when they occur, treatment presents both an oncologic surgical and a reconstructive challenge. After reconstruction, soft tissue defects can be large and there is usually exposed bone and/or joint. A retroperitoneal abdominal wall defect may also be present. Flap mobilization is generally necessary to eliminate dead space and cover the exposed bone, viscera, and/or prosthetic orthopedic material. We performed immediate reconstruction on 11 patients after radical pelvic resections for tumor. PATIENTS AND METHODS Eleven cases of radical pelvic resection and immediate reconstruction were identified during the period from 1992 to 2002 at University Hospital, Newark, New Jersey. All patients were treated by both the orthopedic oncology and plastic surgery teams. A retrospective review of office charts and hospital records was performed. Data were gathered regarding the following: tumor type and oncologic history, extent of resection, reconstructive modality, complications, and outcome. RESULTS All patients underwent radical resection of pelvic masses depending on the tumor type and location. Tumor types included chondrosarcoma (6), Paget osteosarcoma (1), giant cell tumor (1), metastatic uterine carcinoma (2), and invasive squamous cell carcinoma arising in a chronic decubitus ulcer (1). The reconstructive procedures performed were the following: rectus abdominus flaps (6), gluteus maximus musculocutaneous flaps (3), and thigh fillet flaps (2). The retroperitoneal defects were repaired with primary tissue approximation of the surrounding available musculature. Additionally, Gore-Tex mesh was used in 2 cases, tensor fascia lata was used in 2 cases, and acellular dermal matrix in 1 case. Blood loss for the combined procedures ranged from 400 mL to 1400 mL. The follow-up period in this series ranged from 24 to 114 months. Complications included skin flap loss with subsequent infection (1), local cellulitis controlled with antibiotics (1), regional recurrence (2). The postoperative course was uneventful for the remainder of the cases. CONCLUSION Soft tissue reconstructions after extensive pelvic resections always present as complex reconstructive problems. Reconstruction is dictated by the size of the defects and by tissue availability. The extent and type of resections vary according to tumor size and location. In our experience, local pedicled muscle-based flaps, if available, usually provide adequate tissue mass to eliminate dead space, cover the extent of the wound, and close the retroperitoneal defect. Microvascular tissue transfer is always an option but was reserved in our series for cases with no suitable local alternative.
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Affiliation(s)
- Kevin Knox
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School - University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA
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17
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Abstract
Between 1990 and 2002, 76 patients underwent 102 muscle flap reconstructions for extremity sarcomas. The patients had radical resection with immediate reconstruction. Reconstructions were performed by the Musculoskeletal Oncology and Plastic Surgery services. The mean age of our patients was 39.1 years. Patients were studied for a mean of 25.4 months. There were 79 pedicle flaps and 23 free flaps. Complications occurred in 23.7% of patients, including wound necroses, seromas, postoperative bleeding, postoperative infections, and flap loss. Five patients required a secondary flap procedure. The overall flap survival rate was 98%. Three patients had local recurrences. Sixteen patients (21.1%) have died of their disease. Five patients are alive with metastases. In 54 patients, Musculoskeletal Tumor Society (MSTS) functional evaluation scores averaged 27.1 (range, 12-30). In this large series of patients, we have demonstrated that, although minor complications are common, functional limbs can be salvaged following oncologic resection from the extremities.
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Affiliation(s)
- Erik Hoy
- Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, UMDNJ, Newark, NJ, USA
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