Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen
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Handchir Mikrochir Plast Chir · Feb 2004
Case Reports Comparative Study[Surgery of post-traumatic brachial plexus lesions (personal approach in 2003)].
The surgery of traumatic brachial plexus lesions has developed extensively. At present (in the year 2003), five different approaches are utilised: A simple nerve transfer to restore elbow flexion without exploration of the brachial plexus is still recommended. In contrast to this technique, in many centres an extensive exploration of the brachial plexus is performed, to clarify an exact anatomical diagnosis. ⋯ In elected cases, a C7 transfer might be indicated in a second stage. Surgery on the brachial plexus is followed by a period of intensive physiotherapy. When the result of the surgery on the brachial plexus can be evaluated, all possibilities of reconstructive surgery have to be applied to maximise the result.
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Handchir Mikrochir Plast Chir · Feb 2004
[Clinical experiences and dosage pattern in subcutaneous single-injection digital block technique].
100 patients with injuries to their fingers were treated using the subcutaneous digital block as described by Low et al.. Different dosages ranging from 2 to 3 millilitres of a local anesthetic were required to obtain appropriate anesthesia according to the location of injury. 108 finger injuries were treated, 18 thumb injuries, 90 finger injuries. The anesthetic was administered using a 0.55 x 25 mm needle and injected strictly subcutaneously into the flexor crease at the base of the finger or thumb. ⋯ Additionally, we performed a deep local nerve block (Oberst), if the patient still felt discomfort or pain. The severity or type of injury did not play a role according to our findings. The subcutaneous finger block as described by Low et al., therefore, is the method of choice treating injuries to the fingers and to the palmar aspect of the thumb, since it offers a decrease in the amount of anesthetic required and increases patient comfort.