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 1998
[Primary shortening--secondary lengthening. A new treatment concept for reconstruction of extensive soft tissue and bone injuries after 3rd degree open fracture and amputation of the lower leg].
The main problem in major limb replantation--especially of the lower extremity--is an extensive bone- and soft-tissue loss. The traditional replantation concept tries to preserve the initial limb length; only a small shortening is accepted. To avoid a more extensive shortening, often insufficient debridement at the time of replantation is carried out. ⋯ Six to twelve months after replantation, secondary limb lengthening is started using an external or internal (= programmable intramedullary nail) distraction device. Since 1985, twelve patients (six macroamputations and six third-degree open fractures of the lower leg) have been treated using the "concept of primary shortening with secondary limb lengthening". Indications, operative technique, and results are shown and discussed, comparing this new concept to the traditional "concept of staged length-reconstruction" with extensive free tissue reconstruction and secondary nerve grafting.
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Handchir Mikrochir Plast Chir · Nov 1997
Case Reports[Axillary plexus catheter block in childhood and adolescence].
During the past two years (1994 and 1995), eight patients with the average age of eleven and a half years (four to fifteen years) received continuous axillary plexus anaesthesia subsequent to severe injuries of their upper extremities. The advantage of intra-, peri-, and postoperative anaesthesia and postoperative pain management are presented as a case report.
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Vascularized bone grafting techniques are ideal for long bone defects in the extremities. The authors report on their experience in this field. ⋯ In ten cases iliac crest, in six cases fibula, and in one case a radial forearm composite flap was used. All patients have shown optimal healing and good bony consolidation, except for one case of circulatory disorder of the fibula graft.
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Handchir Mikrochir Plast Chir · Jul 1997
Review Biography Historical Article[100 years tendovaginitis stenosans de Quervain--review of the literature and personal results].
One hundred years ago, Fritz de Quervain first described the surgical treatment of tendovaginitis of the first dorsal compartment. Since then, various ways of treatment have been pointed out. In a series of 72 patients treated surgically, 82% recovered completely. Postoperative complaints included irritations of the superficial branch of the radial nerve.
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Handchir Mikrochir Plast Chir · May 1997
[Is transposition of the ulnar nerve in ulnar nerve sulcus syndrome really indicated?].
Anterior transposition of the ulnar nerve in cubital tunnel syndrome requires ligation of the segmental epineural vessels over 8 to 10 cm in order to free up and mobilize the nerve along its new course. As a result, the blood supply of ulnar nerves already compromised by entrapment is likely to be harmed even more. For the past three years we chose to perform simple decompression of the nerve with or without external/internal neurolysis on 33 patients (34 arms). ⋯ The functional outcome was rated as excellent in 26.7% (eight patients) and as good in 33.3% (ten patients). In group 3 (severe entrapment symptoms), seven patients (23.3%) showed moderate results and in four patients (13.3%) the outcome was poor. Considering that most of our patients had severe entrapment with advanced muscle atrophy, the overall outcome of decompression was satisfactory.