Research Projects in Hand Surgery, supported by the National Research Foundation
Prof. Antal Renner, MD
National Institute of Traumatology,
National Institute of Traumatology and Emergency (from 2001)
I have had the opportunity to take an active part in the introduction and teachi
ng of up-to-date hand surgery from the very beginning at the first Department of Hand Surgery in Hungary, established by professor Jenõ Manninger in 1959 in the National Institute of Traumatology. I actively participated in the organisation of this new field of specialties.I have got an indispensible help to my activity by the supports obtained from the National Reasearch Foundation by submitting applications. I was able to conduct scientific researches - according to a systematically designed project - i.e. to develop hand surgery and publish the achievements.
Research projects and results:
1991-1994 / T 971
Biomechanics, pathology and treatment of hand injuries and affections, with special regard to the microsurgical technique
1995-1998 /T 016898
Late comparative study of different treatment methods of hand injuries and affections, with special regard to the microsurgical technique
We continued to further develop our microsurgical technique. Elaborated an original method for revascularisation of os lunatum, and our double flap transplantation in one sitting is a rarity in the literature. The vascularised bone block has become a common technique in everyday practice of locomotor trauma care. The limits of using alloplastic materials have been determined: total endoprosthesis is recommended for replacement of the carpal joint, while prosthesis is not used anymore for replacement of the first CMC joint. Due to lack of financial means we were unable to design a new type of prostheses. We introduced the VILKKI type method in our country: creating a hand with grasping capacity, when there is a congenital or posttraumatic lack of all the 5 fingers. In cases of Volkmann’s ischemic contracture we have successfully used the latissimus dorsi, and proposed its use in our publications as a vascularised muscular flap. We have determined and published the indications for internal fixation elements (ethipine), which do not show opacity on the radiograph, but provide the required stability.
1999-2001 /T 030660
Improvement and reconstruction of grasping capacity after severe mutilations of the hand in congenital anomalies
1. We accomplished definitive treatment of acute hand injuries according to the most up-to-date principles and practical facilities: modern tendon sutures, fracture stabilizing techniques, skin replacement procedures (with microsurgical techniques), etc.
2. We introduced and disseminated surgical treatment of congenital anomalies in early childhood.
3. Based on Entin’s theory: "The Basic Hand" we succeeded in developing hands with grasping capacity - even in formerly hopeless cases (thumb reconstruction, finger transfers, toe transplantation - in proximal amputation into the radius, surgical replacement of lost sensation).
4. We developed a new method for the management of sterile bone necrosis: in lunatum malatia change of cancellous bone + arterial graft.
5. In congenital anomalies we develop hands with grasping capacity using up-to-date techniques, even before school age!
2002-2005 ./T 37803
Etiology, pathology of contractures of the upper extremities and of the hand
(posttraumatic, ischemic, Dupuytren’s, cerebral spastic and congenital)
Contractures of the upper extremities and of the hand may be caused by various factors, however, all of them are accompanied by gradual worsening of functions on the hand. Possibilities of their management - in almost each case -have an influence on the continuation of the patient’s profession. In cases of congenital malformations - almost without exception - there is an already existing functional problem, and in more severe cases there is an absolute lack of grasping capacity of the hand. We are using the current methods of up-to-date surgery of the hand for trying to develop the possibly best form of grasping even in most serious contractures in order to provide the injured or sick patient with the best obtainable quality of life.