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 · Apr 2005
Comparative Study[Does the disability of shoulder, arm and hand questionnaire (DASH) replace grip strength and range of motion in outcome-evaluation?].
Scoring systems currently used to evaluate functional disabilities in upper extremity conditions frequently combine so-called "objective" parameters such as grip strength and range of motion with "subjective" parameters such as pain. Since its introduction, the Disabilities of Arm, Shoulder and Hand Questionnaire has proven useful in the pre- and postoperative evaluation of functional limitations of the upper extremity. This study examines the relationship between DASH scores, the so-called "objective" parameters of grip strength and range of motion and those of "mixed scores" such as Krimmer and Cooney Scores. ⋯ There was no correlation between DASH scores and range of motion, however, some of the diagnostic groups showed a moderate correlation between DASH scores and grip strength. Both the Krimmer and Cooney scores showed a significant correlation with the DASH scores, indicating that these "mixed-scores" can be replaced by the DASH. Since it has been shown that grip strength and range of motion do not capture patients' functional limitations adequately, their continued use in the evaluation of upper extremity conditions should be the topic of further discussion.
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Avulsion fractures of the scaphoid tubercle (Herbert type A1) are rare. Recommendations in the literature focus on a four to six week plaster immobilization including the thumb. Surgery is recommended in case of additional injuries to the carpus. ⋯ Following our own experiences with those rare injuries we recommend a differentiation of the fracture type into extraarticular injuries where conservative treatment should still be performed and intraarticular fractures where percutaneous screw osteosynthesis should be discussed.
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Handchir Mikrochir Plast Chir · Feb 2005
Comparative Study[Early results of proximal interphalangeal joint replacement with pyrolytic carbon prosthesis (Ascension) in idiopathic and post-traumatic arthritis].
Surgical treatment of painful idiopathic and post-traumatic arthritis with joint replacement of the proximal interphalangeal joint has become increasingly important. Due to shortcomings of former constrained and partially constrained prostheses with regard to abrasion and durability we have been using an unconstrained prosthesis since April 2002. This model is an almost abrasion free, biocompatible 2-component prosthesis. ⋯ Radiological results seem to indicate an absence of osteointegration and tension forces at the prosthesis/bone interface. Further investigation will be necessary to improve surface and design to increase radiological results in long-term follow-up. Additional surveys are required to improve indications, surgical approach and intraoperative control of correct component positioning.
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Handchir Mikrochir Plast Chir · Dec 2004
Comparative Study[Clinical importance of CMV-infection in German-speaking burn centers].
Due to immunosuppression, burn patients are at risk for CMV-infection. By means of a retrospective questionnaire we evaluated the clinical rating and management of CMV-infection in German-speaking burn centers. 41 % of the participating burn centers considered the role of CMV-infection of overall minor importance, 41 % of importance only in intensive care burn patients, 18 % of overall great importance. 70 % of the participating burn centers do not perform CMV-screening at admission. ⋯ At present clinical importance of CMV-infection in burn patients can not be clearly determined. But further prospective studies utilizing recently developed diagnostics seem warranted to the potential influence of CMV-infection on morbidity and mortality in burn patients.
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Handchir Mikrochir Plast Chir · Aug 2004
Case ReportsSubcutaneous emphysema of the hand caused by the suction drain -- a case report.
Subcutaneous emphysema of the hand can be related to non-infectious causes and most commonly high-pressure injection injuries. Surgical emphysema of the hand is rare. We report a case of surgical emphysema of the dorsum of the hand following the excision of a dorsal wrist ganglion when the inserted suction drain did not work properly, accompanied by the inadvertent compression of the patient's body. Conservative management was adequate; oedema and emphysema subsided in several days.