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 · Oct 2009
[Palmar wrist arthroscopy for evaluation of concomitant carpal lesions in operative treatment of distal intraarticular radius fractures].
Fractures of the distal radius, which currently are treated with palmar locking plates, are often accompanied by carpal lesions. Tears of the scapholunate interosseus ligament (SL) can affect the outcome. Between January 2007 and May 2008, 28 patients with distal intraarticular fractures of the radius were included in a prospective study. ⋯ In this study, an assessment of ulnocarpal structures was not possible. For assessment of the ulnocarpal structures, CT-arthrography was superior to palmar wrist arthroscopy. However, the latter is an alternative during emergency treatment or when CT-arthrography is not available.
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Handchir Mikrochir Plast Chir · Oct 2009
Case Reports[Necrotising fasciitis of the hand--a rare, highly dramatic clinical entity].
The necrotising fasciitis (NF) is a rare syndrome in hand surgery which is characterized by a severe course of the illness. Different kinds of bacterial species are responsible for the pathogenetic origin of the NF. As NF can be life-threatening for the patient, immediate surgical and systemic treatment must begin as soon as there is the slightest clinical suspicion. We report about two patients with NF of the hand, whereby the patients' lives were saved by radical, serial debridements, intensive medical therapy and selective antibiotic treatment.
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Handchir Mikrochir Plast Chir · Oct 2009
[Severe side effects after Octenisept irrigation of penetrating wounds in children].
Deep penetrating wounds in children's hands are repeatedly treated in emergency wards conservatively through irrigation, antibiotic therapy and splint immobilisation. After we had seen severest phlegmonous reactions after irrigation with Octenisept followed by long troublesome histories we would like to warn against using this antiseptic agent for irrigation of wounds. We give an overview about the significance of antiseptics and the use of antibiotics in the treatment of deeper contaminated wounds. ⋯ To prevent damage, contaminated wounds should be operatively debrided and not be irrigated with an antiseptic liquid. Octenisept seems to have a toxic effect in non-distinguished tissue. Because of a slow resorption it remains for a long time in the tissue. For therapy we recommend fasciotomy of the mid-hand and probably finger compartments, followed by compression treatment, physiotherapy with lymphatic drainage, dynamic and static splints.