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 · Jan 2002
Review Case Reports Historical Article[Digital nerve block anaesthesia: historical development and two cases of finger-tip necrosis, a rare complication].
Two cases of finger-tip necrosis following digital blocks are presented. These are rare complications of this technique. Pathogenesis and treatment options are discussed and the literature reviewed. Circulatory problems can be avoided by using adrenalin free anaesthetics, infiltrating at the metacarpal level with small volumes, and using upper-arm tourniquets instead of rubber bands at the phalangeal level.
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Handchir Mikrochir Plast Chir · Nov 2001
[Dorsal V-ligament reconstruction in scapholunate instability].
In dynamic and static scapholunate instability after trauma, the repair of the scapholunate ligament is important to avoid scapholunate advanced collapse of the wrist. Direct suture even of fresh-torn ligaments can be technically demanding and occasionally unreliable, thus reconstruction may require additional tissue beside the ligament. ⋯ X-ray films documented no significant loss of scapholunate reduction. Using local tissue only, this method is always possible, very reliable and easy to perform.
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Handchir Mikrochir Plast Chir · Nov 2001
[Possible applications of pedicled vascularized bone transplants of the distal radius].
Reverse-flow pedicle vascularized bone grafts (VBGs) from the distal radius may be used for the surgical treatment of carpal fracture nonunions and avascular necrosis. Such grafts remain viable with quantifiable blood flow as demonstrated in a recent canine experiment. In this paper, the vascular anatomy of the distal radius is demonstrated and the surgical technique of VBG harvest is described. ⋯ The results of treating scaphoid nonunions are promising. The use of vascularized bone graft facilitates rapid, reliable union of established scaphoid nonunion, even with proximal location and/or avascular changes. Clinical results in Kienböck's disease have been gratifying as well, with MRI evidence of gradual revascularization on follow-up studies.
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Handchir Mikrochir Plast Chir · Nov 2001
[Functional results of medio-carpal partial arthrodesis with excision of the scaphoid].
Midcarpal arthrodesis with excision of the scaphoid for the treatment of painful carpal collapse has been performed in our hospital since 1993. A clinical study was carried out to evaluate the results and determine special factors, which might influence the results. 26 out of 29 patients operated until 1999 were reexamined after an average follow-up of 27 months. The results were evaluated according to the Mayo-modified wrist score. ⋯ Midcarpal arthrodesis with scaphoid excision is a reliable method for treating radioscaphoid arthrosis caused by carpal collapse. Correction of the hyperextended position of the lunate is important to obtain optimum results. In our hospital, a wrist arthrodesis is only rarely performed nowadays, except in the rheumatoid patient.
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Handchir Mikrochir Plast Chir · Sep 2001
[High-pressure injection injuries of the hand. Pathogenesis, problems and therapy].
Summary. High-pressure injection injuries are rare and the extent of tissue damage is often underestimated. They usually have devastating effects on tissues and result in poor functional outcome of the involved hand. ⋯ Reconstructive surgery is reserved for the late stage.43 patients were treated surgically in our department over the last 28 years (1972 to 2000). 12 of them (28 %) required amputation at different levels of the involved finger. Only nine patients healed without any functional loss. Most frequent injuries were of the paint or paint-solvent and grease-gun type.