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 1986
[A new method for the reconstruction of injured flexor tendons of the hand: tendons and tendon sheath reconstruction in 2 stages].
The authors have developed a new two-stage method of flexor tendon reconstruction for injuries in the critical zone of the hand. In the first phase of the secondary operation, they preserve the intact portions of tendon sheath. They replace the scarred tendon sheath: small retinacular defects with autologous vein grafts, larger pulley defects with fascial grafts. ⋯ In the second stage of the operation, after six weeks generally, an autologous tendon is placed in the reconstructed tendon sheath. The authors present their material and results: In 12 of 18 flexor tendon reconstructions they achieved excellent or good results. Therefore, they propose their method for reconstructing injured flexor tendons with an unfavourable prognosis.
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Handchir Mikrochir Plast Chir · Mar 1986
[Late results of flexor tendon sutures in a "no man's land" of the hand].
The authors studied the late functional results of primary and secondary Kleinert-Kessler flexor tendon sutures in "no man's land" in their five-year clinical material. They compared the data of preoperative prognosis and postoperative results and found good correlation. Best results were achieved after primary tendon suture. ⋯ In secondary tendon repairs mainly the preoperative state of the injured hand determined the postoperative results. In the part of their cases with the worst prognosis, late results were unfavourable because of peritendinous adhesions. In these cases new methods to improve the end results are necessary.
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Handchir Mikrochir Plast Chir · Dec 1984
Case Reports[Muscular rupture of the extensor pollicis longus].
Closed ruptures of the extensor pollicis longus tendon usually appear as a consequence of fractures of the wrist joint or the carpal bones or ensue from polyarthritic changes or result from a process of degeneration. Mechanical injury of the tendon is quite rare but can be observed after direct trauma or after operative treatment of a distal fracture of the radius. Closed traumatic ruptures of the extensor pollicis longus tendon in the absence of pathological changes are--in spite of the frequency of rotation injuries of the forearm--very rare. ⋯ Clinically distinct signs of a rupture of the extensor pollicis longus tendon could be seen. During operation a tear of the muscular portion of the long extensor tendon of the thumb was found. The function of extension was restored by transfer of the extensor indicis tendon.
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Handchir Mikrochir Plast Chir · Dec 1984
Case Reports[From the records of the forensic commission: was an injury of the deep flexor tendons overlooked?].
Following primary repair of both flexor tendons of the middle finger and suture of a wound of the index finger, the distal interphalangeal joints of the second, third and fourth finger could not be flexed actively. Therefore, tenodeses of the DIP-joints were done six months later. The possibility that an injury of the deep flexor tendon in three fingers had been overlooked is considered together with the alternative explanation that a quadriga syndrome had resulted from adhesions of the repaired profundus of the middle finger.
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Handchir Mikrochir Plast Chir · Mar 1984
Case Reports[New aspects of the treatment of dermatogenous contractures of the hand in epidermolysis bullosa].
Epidermolysis bullosa dystrophica is a rare hereditary disease of skin. There are always flexion contractures and pseudosyndactylies of all fingers and adduction contractures of the thumb. ⋯ Ultramicroscopical criteria help to choose patients for therapy with phenytoin. It is as yet too early to assess the results of the latter treatment.