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 · Aug 2005
Comparative Study[Scaphoid fractures--operative or conservative treatment? A CT-based classification].
Traditionally acute scaphoid fractures were treated by immobilization. As a consequence we have to deal with a high number of scaphoid non-unions or SNAC wrists. A study of 30 patients with scaphoid non-union showed that only 30% (9 patients) have not seen a doctor, while the majority of the patients (70%, 21 patients) were treated by a physician after trauma. ⋯ Fractures of the proximal pole of the scaphoid should be treated operatively by internal fixation, even if they are not displaced, because of the reduced perfusion. We recommend a CT scan of the scaphoid, if there is any doubt about the diagnosis or the stability of the scaphoid fracture. In any case, a CT scan has to be ordered to justify a conservative treatment.
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Handchir Mikrochir Plast Chir · Aug 2005
Comparative Study[Intraoperative three-dimensional imaging with an isocentric mobile C-arm at the wrist].
In addition to conventional radiological C-arm image amplifiers used for intraoperative imaging, now a new mobile C-arm image amplifier with an option for three dimensional imaging (Iso-C 3D) is available to visualize reduction of fractures and position of implants. In a wrist-model three titanium pins were placed and three holes of different length were drilled. ⋯ Furthermore, gantry position had no significant effect upon the results. Iso-C 3D scans are as reliable as conventional CT scans for intraoperative controlling of implant positioning.
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Handchir Mikrochir Plast Chir · Aug 2005
Comparative Study[Microsurgical reconstruction of the burned upper extremity].
Free tissue transplantation is a rarely indicated procedure in burn reconstruction. As the versatility and variability of free flaps have significantly increased during recent years, so too have the indications for these procedures expanded. ⋯ Our data demonstrate that burn and high voltage injuries are distinct entities, each requiring custom-tailored reconstructive solutions for limb salvage. Even if our flap failures all occurred during the first six weeks it should not be forgotten that this type of coverage is the only alternative to amputation in selective cases.
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Handchir Mikrochir Plast Chir · Aug 2005
Comparative Study[Predictive value of the HISS-scoring system for estimation of trauma severity and the time off work after hand injuries].
The estimation of the time off work depending on the injury pattern and severity is of major interest in the treatment of hand injuries. The predictive value of the HISS score (Hand Injury Severity Scoring System) was evaluated. ⋯ Our data confirm the predictive value of the HISS score for the early estimation of the time off work resulting from hand injuries. However, the estimation is limited to injuries distal to the wrist.
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Handchir Mikrochir Plast Chir · Aug 2005
Comparative Study[Peroneal nerve palsy caused by a recurrent proximal tibiofibular joint ganglion--a case report and review of the literature].
Compression of peripheral nerves is a well known complication of articular synovial cysts. The peroneal nerve is the most common site of intraneural ganglia (pseudocysts) originating from the proximal tibiofibular joint. The neurological deficit associated with these cysts is often severe due to delayed diagnostic and surgical treatment. Therefore, recurrence is very often seen and recovery is incomplete. ⋯ This entity needs careful, prompt preoperative evaluation to avoid neurological damage. Surgical treatment includes microsurgical decompression and complete resection of the cyst and also ligation of the ganglion stem. Early diagnosis and treatment is required to ensure recovery.