Der Unfallchirurg
-
Comparative Study
[Comparison of C-arm CT and standard imaging in osteosyntheses of fractured distal radius specimens].
The purpose of this study was to evaluate the value of C-arm CT imaging of the distal radius with standard patient positioning in intraoperative assessment of plate osteosynthesis. ⋯ With standard patient positioning, the performance of C-arm CT was equivalent to and not better than that of current standard procedures, i.e. intraoperative fluoroscopy and postoperative radiography. Further studies should examine whether this holds true in clinical practice with representative patient collectives when titanium implants are used and/or optimized patient positioning is practised.
-
Clinical Trial
[Functional and aesthetic refinements of free flap coverage at the dorsum of the hand and distal forearm].
Free coverage of exposed functional structures of the hand and distal forearm can be achieved using a variety of free flaps. However, there is a lack of data in the literature which tissue components are best used for defect coverage of this specific area regarding aspects such as tendon gliding and tissue elasticity. The purpose of this retrospective study was to compare and to evaluate the functional and aesthetical results using free cutaneous, fascial and muscle flaps. ⋯ Cutaneous and fascial flaps had the best functional and aesthetical results. Fascial flaps achieved the best aesthetical outcome of the donor site. We recommend free fascial flaps and cutaneous flaps as the first choice due to their advantages in the specific area of the dorsal site of the hand and distal forearm which requires pliable and thin tissue coverage.
-
Clinical Trial
[Combined latissimus dorsi-thoracodorsal artery perforator-transpositional free flap].
Reconstruction or complete cover of extended but polygonal defects is limited by the size of transplantable tissue. One of the largest composite tissue components to be transplanted is the myocutaneous latissimus dorsi flap. Under certain circumstances even this large-scale flap is not sufficient for complete defect cover. Based on experiences with the thoracodorsal artery perforator (TAP) flap, the skin island adjacent to the latissimus muscle may be raised, pedicled on the perforator vessels penetrating the underlying muscle. Thus this island may easily be transposed or rotated to enable additional defect cover. ⋯ The combined latissimus dorsi- thoracodorsal artery perforator-transpositional free flap is capable of covering very extensive polygonal as well as defects over joints in order to prevent scar contractions.
-
This study examines the postoperative stability of the Mitek Bioknotless anchor system with biomechanical draw-out pulling in human cadaver shoulders. ⋯ Regarding the high draw-out strength the Mitek Bioknotless anchor system provides enough stability for early functional treatment.