Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Dec 2013
Clinical Trial[Dorsal capsular imbrication for dorsal instability of the distal radioulnar joint].
To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis. ⋯ The subjective and functional outcomes of 20 patients having received capsular imbrication using this technique were good and entailed no significant complications. The postoperative DASH was 15.8 points. Of the 20 patients, 17 patients (85%) had a reduction of pain. Symptoms of DRUJ instability could be reduced in 18 patients (90%). Pronation/supination of the wrist was not restricted postoperatively.
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Open reduction and internal fixation with screw(s) for fragments with sufficient size, and resection of smaller fragments. ⋯ At a specialized orthopedic hospital with a supraregional frequented department for foot and ankle surgery, 8 patients with peripherial talar fractures were treated in 2012 (medial/posterior talar process, each n = 1, lateral talar process, n = 2, medial and lateral talar shoulder, each n = 2). One fragment was fixed with 1-3 screws, and additional cartilage reconstruction with matrix-associated stem cell transplantation was performed in 4 cases (lateral talar process, n = 2, medial and lateral talar shoulder, each n = 1). Bony fusion was registered at the 6-week follow-up in all cases. Further follow-up is not completed. Complications have not been registered so far.
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Oper Orthop Traumatol · Oct 2013
Clinical Trial[Operative management of clavicular non-union : Iliac crest bone graft and anatomic locking compression plate].
The objective in treating clavicular non-union is an anatomic reconstruction of the clavicle with an iliac crest bone graft and anatomic locking compression plates. ⋯ At our department 10 consecutive patients suffering from clavicular non-union have been treated with this technique with a minimum follow-up of 1 year. All patients showed anatomic restoration of the radiologically confirmed healed clavicle with very good patient satisfaction.
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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.