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Erschienen in: Aesthetic Plastic Surgery 6/2013

01.12.2013 | Review

Surgical Management of Digital Calcinosis in CREST Syndrome

verfasst von: Giorgio Merlino, Silvia Germano, Salvatore Carlucci

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 6/2013

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Abstract

As a limited form of sclerodermy, CREST syndrome is characterized by calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia, which determine the acronym CREST. Calcinosis is a particularly difficult entity to treat given the paucity of effective options described in the literature. Treatment of finger calcinosis has a wide range of possibilities depending on the extent of calcifications and the involvement of deep structures. From a surgical point of view, whereas simple removal is adequate in minor outpatient cases, a radical debridement in the major and more painful cases seems required. A cover flap is needed particularly in the thumb due to its great functional importance, also if the fingertip is not involved. The authors recommend the kite flap for the dimensions, the tissue quality, and the possibility of giving sensation to the reconstructed area. With this surgical option, the transferred skin is soft, sensate, and the right fit. Usually, no further operations are needed for flap remodeling. The time required for sensory integration is about 2 years, often related to the age of the patient. Debridement and flap reconstruction usually give total resolution of pain, with complete recovery of thumb motion and the thumb–index finger grip.
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Metadaten
Titel
Surgical Management of Digital Calcinosis in CREST Syndrome
verfasst von
Giorgio Merlino
Silvia Germano
Salvatore Carlucci
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 6/2013
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-013-0224-z

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