Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Aug 2013
Clinical Trial[Abductor digiti minimi muscle flap for defect coverage of the hand].
Defect coverage of the ulnar aspect of the hand, wrist and hypothenar with an abductor digiti minimi muscle flap and split skin graft. ⋯ In total, 9 patients showed good results with a reliable defect coverage due to a constant anatomy and easy preparation.
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Oper Orthop Traumatol · Aug 2013
Clinical Trial[Transfer of the flexor digitorum superficialis tendons of the middle and ring fingers to restore extension of fingers and thumb (Boyes' transfer)].
Restoration of extension in the metacarpophalangeal joints of the fingers as well as in the interphalangeal joint of the thumb by transfer of the superficial flexor tendons of the long and ring fingers (flexor digitorum superficialis III and IV). ⋯ From March 1999 to January 2010 a Boyes' transfer was performed in 13 patients (8 female and 5 male) and the right side was affected in 8, the left side in 5 and the dominant hand in 7 cases. The patient age at the time of surgery was an average of 47 ± 17 (13-73) years. The interval between radial palsy and tendon transfer was an average of 79 ± 144 (4-543) months. The final follow-up was performed at an average of 82 ± 35 (32-165) months. According to the Haas scoring system finger extension was excellent in 5, good in 5, fair in 3 and unfavorable in 4 cases and thumb extension was excellent in 5, good in 3, fair in 1 and unfavorable in 5 patients. The mean disabilities of the arm, shoulder and hand (DASH) score was 36 ± 24 (11-85) points. Although disability of varying degrees persisted in all patients, Boyes' transfer is considered to be a safe procedure to restore finger and thumb extension with excellent and good functional results, a high degree of patient satisfaction and few complications.
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Oper Orthop Traumatol · Aug 2013
Clinical Trial[Brachioradialis rerouting for restoration of forearm supination or pronation].
Improvement of active forearm supination or pronation. Reduction of paralytic pronation or supination posture. ⋯ Özkan et al. performed brachioradialis rerouting to restore supination in 5 children between 4 and 14 years with pronation deformity and to restore pronation in 4 children aged 5-9 years with supination deformity. Mean active gain for supination was 81° (40-140°). Active pronation improved from 28 to 49° (30-75°; Özkan et al., J Hand Surg Br 29:263-268, 2004; Özkan et al., J Hand Surg Am 29:22-27, 2004). Between April 2006 and January 2011 we used this technique in 4 patients aged 7-26 years (mean 14 years). Three patients could be followed up. One patient had preoperative a fixed pronation deformity of the forearm in 80° pronation. In this case active range of motion could be improved to 80/30/0° pronation/supination. One patient improved from preoperative 0/0/90° pronation/supination to 30/0/90° postoperatively. In one case no functional improvement of forearm rotation could be achieved in long-term follow-up. No functional loss in forearm rotation to the opposite direction or of the elbow function was observed. Mean follow-up time was 51 months (21-77 months).
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Oper Orthop Traumatol · Aug 2013
Clinical TrialMinimally invasive periprosthetic plate osteosynthesis using the locking attachment plate.
Stable fixation of periprosthetic or periimplant fractures with an angular stable plate and early weight bearing as tolerated. ⋯ In 6 patients with periprosthetic fractures and 2 patients with periimplant fractures, no surgical complications (e.g., wound infection or bleeding) were observed. The mean time to bony union was 14 weeks. No implant loosening of the locking attachment plate was observed. At the follow-up examination, all patients had reached their prefracture mobility level.
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Oper Orthop Traumatol · Aug 2013
Clinical Trial[Restoration of thumb flexion at the interphalangeal joint by transposition of the flexor digitorum superficialis tendon from the ring finger].
Restoration of active thumb flexion at the distal joint. ⋯ In this study 10 patients with FDS IV transposition to reconstruct an isolated rupture of the FPL tendon could be followed for an average of 4.1 years postoperatively. The active range of motion of the IP joint of the thumb averaged 65° (10-100°), 8/10 patients achieved an equal active and passive range of motion of the IP joint of the thumb, in 2 patients some flexion insufficiency remained, 9 patients could reach the fingertip of the small finger with the thumb and 1 patient lacked 3 mm. Contracture of the proximal thumb joint developed in two patients. After removal of the FDS IV tendon two patients developed contracture of the PIP joint of the ring finger. The grip force was reduced to 81 %, lateral grip to 83 % and pinch grip to 77 %. The DASH score averaged 18 (0-31) and 8/10 patients would choose to undergo this surgery again.