PROCEEDINGS

Canadian Society for Surgery of the Hand (MANUS Canada)

James H. Roth, MD, London, Ont., Canada

T he annual meeting of the Canadian So-

ciety for Surgery of the Hand (MANUS Canada) was held June 16. 1987 in London, Ontario, Canada. Fol- lowing is a summary of the 10 papers that were pre-

sented at the scientific session.

The application of laser Doppler velocimetry in the determination of blood flow in axial island flaps as a predictor of viability. C. W. MILLER, J. H. ROTH, T. LANTHIER, London, Ontario, Canada. The perfusion of axial pattern island skin haps was evaluated by use

of Laser Doppler velocimetry in 37 New Zealand white rabbits. Skin flaps based on the caudal superficial epi- gastric vessels were elevated and subjected to selective

occlusion of the vascular pedicles. The skin flaps were divided into four categories: sham operation, arterial occlusion, venous occlusion, and arteriovenous occlu- sion. The Laser Doppler readings were compared with visual assessment and histologic appearance. The Laser Doppler was able to detect acute vascular occlusion and

venous occlusion. It could not differentiate between arterial occlusion and arteriovenous occlusion. The La- ser Doppler was a statistically better predictor of skin flap survival than was visual scoring.

Palmar plate insertions of the interosseous mus- cles of the hand. B. L. CHANDRARAJAN, T. CHAY- KOWSKI, W. K. FORREST, J. T. BRYANT, U. P. WYSS, T. D. V. COOKE, Kingston, Ontario, Canada. We report novel observations of insertions of dorsal (DI) and pal- mar interosseous muscles (PI) to the metacarpophalan-

geal (MCP) palmar plate (PP). Insertions were ranked “major” or “minor” by macroscopic appearance, his- tomorphology, and mechanical strength. The frequency of major PP insertions was 90% to 100% DI and 70% to 100% PI. There was electromyographic activity in fibers to the PP during pinch and grasp. Forces acting here would stabilize the MCP against subluxation. In patients with rheumatoid arthritis with palmar sublux- ation they would limit relocation of the proximal pha- lanx. The data suggest functional and anatomical clas- sification of insertion sites as periarticular or extraar- titular.

The clinical and experimental effect of digital ar- tery sympathectomy. P. T. GROPPER, K. FAVERO, J. GRAY, K. BERRY, Vancouver, British Columbia. This study determined the effects of adventitial stripping of the digital artery in patients with Raynaud’s phenom-

enon. Electron microscopy of surgically excised ad- ventitia demonstrated adrenergic unmyelinated axons. The femoral arteries of rats were stripped over a 12 mm segment of adventitia. The vessel was excised 14 days later. Histologic examination demonstrated an inflam-

matory and fibroblastic adventitial response, with no change in media or intima. A clinical review of 20 digits with Raynaud’s demonstrated that although ischemic ulcers healed and there was a reduction in ischemic pain, there was no significant change in Laser Doppler

readings.

Human umbilical artery in the microsurgical re- construction of vascular defects. R. HORTON, P. T. GROPPER, B. PEARSON, Vancouver, British Columbia.

This study determined whether human placental arteries can function as interpositional vessel grafts in a rat model. Twenty human placental arterial grafts (HPA) were compared with 20 epigastric vein grafts (EVG). Aortic arteriograms demonstrated a 3 1% patency rate in the HPA group compared with 95% in the EVG

(p < 0.05). Histologic examination showed that HPA appeared to undergo a process of rejection, with an intense inflammatory response. Scanning electron mi- croscopy demonstrated that both the HPA and EVG

lacked endothelial cells, and that their surfaces were flat. On the basis of this study. the use of human artery in clinical microsurgery is not recommended.

Vascularized bone allografting: the effect of cy- closporine in an ortbotopic rat model. S. KESMARKY, M. A. RANDOLPH, A. J. WEILAND, M. J. YAREMCHUK, Toronto, Ontario, Canada. The effect of cyclosporine on the healing and the survival of vascularized bone allografts placed in an orthotopic position in a geneti- cally defined rat model was studied. A reliable ortho- topic model was developed transplanting the distal fe- mur with its muscle cuff and microvascular anastomes.

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