الفهرس 
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Abstract
253
Summery and conclusion
Summery And Conclusion
Various types of hand problems result in complex
situation of disturbed function and aethetics. The
development of microsurgical techniques makes it possible to
repair these complicated defects.
Hand reconstruction by microsurgical techniques has
become in certain cases a well established technique as it
showes superior results to those obtained with previous
method of reconstruction.
In cases of replantation of the amputated hand defects,
microsurgical techniques have the upper hand in regaining a
high percentage of the hand function and giving the patient a
chance to live a semi normal life if not completely normal
according to the severity of the defect. It even gave some
patients who are workers the chance to continue in their
professions which had a positive influence on their
psychological aspect and made them greatly satisfied.
Also, microsurgical nerve repair techniques gave almost
the same influence on regainig the function of the hand by
improving the motor activities and improving sensation to a
high percentage and thus improving the physiological aspect
254
Summery and conclusion
of the patients and making them highly satisfied.
The choice of donor sites for nonreplantable hand
defects has been frequently determined by the familiarity of
the surgeon with particular technique. However, each patient
presents a unique problem, and donor site should be
determined by the bone and soft tissue requirements of the
defect .
A clinical study was conducted where the application
and the efficacy of microsurgical techniques; whether
replantation of the amputated parts , revascularzation of an
ischemic hand or digit, or neural repair of a traumatized nerve
immediately or delayed, to reconstruct the deformity in the
hand were studied .In the current study, all microsurgical
techniques were used.
Morbidity of the replanted and donor sites was
evaluated ,functional evaluation, functional rehabilitation and
aethetic outcome was also evaluated ,three patients had digit
replantations, one patient had toe to hand transfer ,one patient
did bilateral digital artery revasculatization and seven patients
had nerve repair of various types.
255
Summery and conclusion
The results of the replantation and toe to hand transfer
and revascularization procedures showed excellent outcome
but only in young and healthy patients with no other medical
problems. But in cases that complained of diabetes mellitus or
hypertension ,the results were faint.
Also in cases of nerve repair, the microsurgical
procedures showed improvement in the motor and sensory
functions of the hand with an obvious improvement of the
electro myogram (EMG) of the patients after 6 months follow
up.