Der Unfallchirurg
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Due to the airborne transmission of the coronavirus disease 2019 (COVID 19) via aerosols or microdroplets, this study investigated the effect of a mobile air filter system in a surgical examination room. The use of the air filter system led to a significant reduction of aerosols in the room. Therefore the use of a high efficiency air filtration device, in examination rooms with poor ventilation, e.g. lack of windows or local exhaust, is mandatory.
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Review
[Extensor tendon injuries of fingers in the region of the metacarpophalangeal joint (zone V)].
Due to the exposed situation of the extension side of the metacarpophalangeal joint when the fingers are bent, injuries in this region are not uncommon. The extensor apparatus lies directly below the skin and the various parts can be easily injured. ⋯ The alarming multitude of revision surgeries with tenolysis, arthrolysis and restoration of the balance of extensor tendons or centering show that these operations are much more demanding than the way they are appreciated in the literature and by many surgeons (beginner's operation). The article presents the surgical treatment with suture techniques and reconstruction possibilities as well as the aftercare, in addition to the special anatomy and diagnostics.
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Extensor tendon injuries of the thumb include lesions of the tendons of the extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus muscles. The latter is practically only affected in open injuries. Open injuries require a tendon reconstruction by suture followed by immobilization in the distal and an adequate aftercare depending on the zone of injury. ⋯ This injury is often misdiagnosed as a rupture of the ulnar collateral ligament of the metacarpophalangeal joint. It should be treated by refixation of the ruptured structures. Closed chronic ruptures of the extensor pollicis longus tendon go along with a defect that requires a tendon transfer or a tendon autograft.
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Closed and open injuries of the extensor mechanism at the proximal interphalangeal (PIP) joint can involve the central slip, the lateral slips or both. They are classified as zone III injuries. All open injuries on the dorsal side of the PIP joint should raise suspicion of an extensor tendon injury that is frequently overlooked. ⋯ Depending on the pattern of the injury and the resulting defects, a number of reconstructive techniques have been established that are summarized in this article. The functional results can be limited by tendon adhesions, imbalance within the reconstructed extensor apparatus and stiff joints that can all restrict the range of motion. Therefore, active rehabilitation protocols are mandatory for optimal results.
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Injuries of the extensor tendon in zone I are frequently seen. If detected early and treated appropriately they are associated with good functional results. ⋯ In cases of bone involvement the treatment procedure is determined by the articulation and the extent of fragment displacement. This article presents the current state of knowledge on the diagnostics and treatment of extensor tendon injuries in zone I with the aim of providing treatment recommendations for the clinical routine.