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 · Nov 1999
[Clinical aspects and therapy of benign symmetrical lipomatosis--Madelung disease].
The clinical picture, diagnosis, therapy, and theories on the etiology of benign symmetric lipomatosis (Madelung disease) are outlined. Personal experience from 62 operations on 28 patients is compared to the literature. ⋯ Liposuction--a less traumatic treatment--has considerably facilitated the treatment of the circumscribed fatty hyperplasias. The surgical characteristics of different anatomical regions are pointed out.
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Handchir Mikrochir Plast Chir · Sep 1999
[Treatment of therapy refractory epicondylitis lateralis humeri by denervation. On the pathogenesis].
The pathogenesis of tennis elbow is still debated, the question of proper surgical treatment as well. Because the area of pain in tennis elbow and the concomitant spots of pain together with sensibility disorders of the hand are supplied entirely by branches of the radial nerve, we suggested a surgical procedure for complete denervation as early as 1962. The main purpose of this paper is to examine the possibilities of improving the surgical technique, thereby shedding light on the pathogenesis of tennis elbow. ⋯ The results in Group A and B prove that the temporary desinsertion of the ECRB, previously regarded as necessary for reasons of dissection, can be discontinued, without worsening of outcome, as long as the anterior and lateral portions of the supinator origin are incised directly, thereby resulting in indirect decompression of the posterior interosseous nerve simultaneously. The results of this procedure emphasize the fact that tennis elbow is the result of a compression syndrome of the radial nerve and its branches, where the pain-triggering nerve irritations are found at one or several localizations that can be treated successfully--as shown in the literature and by our own findings--by direct decompression of this nerve segment.
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Handchir Mikrochir Plast Chir · Sep 1999
[Compression syndrome of the radial nerve in the area of the supinator groove. Experiences with 110 patients].
Both radial tunnel syndrome and posterior interosseous nerve (PIN) compression syndrome are caused by compression of the posterior interosseous nerve. There is a controversy about certain features of PIN compression especially with regard to diagnostic criteria and therapy as well as differentiation from tennis elbow. From 1992 to 1997, we operated 110 patients because of PIN compression. ⋯ To avoid recompression of the PIN by scarring, we have abandoned direct decompression and now routinely use Wilhelm's denervation procedure for the treatment of tennis elbow as well as radial tunnel syndrome. This procedure indirectly decompresses the PIN by cutting the superficial origin of the supinator muscle with consecutive relaxation of Frohse's arcade. Preliminary results are promising and show improvement of preoperative neurologic status by indirect decompression.
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Handchir Mikrochir Plast Chir · Jul 1999
Case Reports[Chronic compartment syndrome of the first dorsal interosseous muscle: 2 case reports].
Chronic exercise-induced compartment syndrome of the first dorsal interosseous muscle of the hand is a rare condition. The presented complaint is a dull muscle pain which can be increased by hyperextension of the index metacarpo-phalangeal joint and by repetitive key grip. Two patients complaining of these symptoms could successfully be treated by simple fasciotomy of the first dorsal interosseous compartment.
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Handchir Mikrochir Plast Chir · May 1999
[Proximal scaphoid pseudarthrosis with avascular pol fragment: long-term outcome after reconstruction with microvascular pedicled iliac crest bone graft].
56 patients suffering from scaphoid nonunion with avascular necrosis of the proximal pole were treated by a free vascularized iliac bone graft. Follow-up examination of 27 patients at 8.8 years included evaluation of scaphoid nonunion, progression of arthrosis and clinical parameters. Union was achieved in 85% of the patients (Group A). ⋯ Grip strength was 71% and range of motion 65% of normal. Transplantation of a free vascularized iliac bone graft resulted in union of a scaphoid pseudarthrosis with avascular proximal pole in 85%. When union occurred, progression of degenerative arthrosis could be arrested and good clinical late results could be achieved.