Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...最新文献

{"title":"[Registry Research Funding of the German Society of Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC) and Research Funding Report 2024/2025].","authors":"Benedikt Fuchs, Justus P Beier, Anja M Boos, Adrien Daigeler, Adrian Dragu, Denis Ehrl, Steffen Ulrich Eisenhardt, Leila Harhaus-Wähner, Tobias Hirsch, Raymund E Horch, Ulrich Kneser, Hans-Günther Machens, Stefan Langer, Marcus Lehnhardt, Lukas Prantl, Dirk Johannes Schaefer, Peter M Vogt, Nicholas Möllhoff, Riccardo E Giunta","doi":"10.1055/a-2934-4755","DOIUrl":"https://doi.org/10.1055/a-2934-4755","url":null,"abstract":"<p><strong>Background: </strong>University hospitals in Germany face major challenges due to structural deficits, economic constraints, and increasing demands for specialized care. These developments also affect academic plastic surgery within the German Society of Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC). This study evaluated research activities, funding structures, and national and international collaborations of university departments of plastic surgery during the 2024/2025 survey period and compared them with previous assessment intervals.</p><p><strong>Methods: </strong>A web-based survey collected data on submitted, approved, rejected, and pending research proposals from university departments of plastic surgery. Structural characteristics, including laboratory infrastructure, clinical study centers, doctoral supervision, and, for the first time, transregional and international collaborations, were also assessed.</p><p><strong>Results: </strong>During 2024/2025, 73 applications from 16 institutions were reported, of which 56 were approved. Total awarded funding reached €18.76 million, compared with €23.15 million in 2021/2022. In contrast, the average funding per project increased, particularly for German Research Foundation (DFG) grants. Although fewer applications were submitted overall, rejected funding volume increased. Research infrastructure expanded substantially: 93.75% of institutions operated dedicated research laboratories, 62.5% maintained clinical study centers, and the number of supervised doctoral candidates increased. Twenty-three international collaborations, primarily with partners in the United States and China, were identified. Major research areas included stem cell research, digitalization, and artificial intelligence. Bureaucracy, limited research time, personnel shortages, and insufficient funding were identified as the main barriers.</p><p><strong>Conclusion: </strong>Despite a decline in research applications, academic plastic surgery in Germany is undergoing structural change. Continued expansion of research infrastructure and increasing international collaboration are offset by growing administrative and financial challenges. Sustaining the long-term scientific competitiveness of the specialty will require targeted funding opportunities, reduced administrative burden, and structured transregional research networks.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Ulnar Sided Wrist Pain - from Correct Diagnosis to Therapy].","authors":"Stefan Meuser, Lisa Reissner, Gernot Schmidle, Roman Wolters, Hermann Krimmer","doi":"10.1055/a-2938-7315","DOIUrl":"https://doi.org/10.1055/a-2938-7315","url":null,"abstract":"<p><strong>Abstract: </strong>Ulnarsided wrist pain represents one of the most common problems in hand surgery. Due to the close relationship between the ulnocarpal wrist compartiment, the distal radioulnar joint and its adjacent soft tissue structures numerous pathologies can be the cause for those symptoms. An exact understanding of the anatomic structures and their specific diagnostics is inevitable. The most common sources of ulnarsided wrist pain are instability or osteoarthrosis of the distal radioulnar joint and the ulnocarpal impaction syndrome. The pathologies were addressed with a broad audience during the third web symposium of the German-speaking Working Group for Hand Surgery (DAH) on the 3rd of December 2025. This article summarizes the key messages of the websymposium and provides a guideline for the diagnostics and stage-dependent therapy of the individual pathologies.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verletzungen des lunotriquetralen Bandes Injuries of the lunotriquetral ligament.","authors":"Thomas Pillukat, Lisa Oezel, Carina Jaekel, Jörg van Schoonhoven","doi":"10.1055/a-2937-5831","DOIUrl":"https://doi.org/10.1055/a-2937-5831","url":null,"abstract":"<p><strong>Abstract: </strong>Pathological differences at the lunotriquetral junction are frequently missed and confused with other ulnocarpal complaints, as there are scarcely typical clinical and radiological signs.The aim of this manuscript is a summary of the anatomy and pathonanatomy of the lunotriquetral junction as well as of the diagnostical and therapeutical procedures. To these belong beside nonoperative measures reconstructive techniques and salvage procedures.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Electrophysiological Predictors of 12-Month Functional Recovery after Open Carpal Tunnel Release Using the Wide Awake Local Anesthesia no Tourniquet Technique.","authors":"Mehmet Yalcin, Uğur Bezirgan, Yusuf Kıratlıoğlu, Yunus Ş Gonuldenk, Osman Talha Nergizal, Semih Ergisi, Ayse A Kucukdeveci, Mehmet Armangil","doi":"10.1055/a-2920-9083","DOIUrl":"https://doi.org/10.1055/a-2920-9083","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the 12-month clinical and functional outcomes of open carpal tunnel release performed using the Wide Awake Local Anesthesia No Tourniquet technique to identify the clinical, electrophysiological, and surgeon-related predictors of postoperative functional recovery.</p><p><strong>Methods: </strong>A retrospective cohort of 55 patients who underwent Wide Awake Local Anesthesia No Tourniquet-assisted carpal tunnel surgery between 2021 and 2024 was analyzed. Clinical and electrophysiological parameters were evaluated according to the McKinnon classification, symptom duration, surgeon experience, and thenar muscle condition. Functional outcomes were assessed preoperatively and at 12 months postoperatively using the Michigan Hand Outcomes Questionnaire, Visual Analog Scale, and grip strength measurements.</p><p><strong>Results: </strong>Significant postoperative improvements were observed in Michigan Hand Outcomes Questionnaire scores (mean increase:+24 points), pain reduction, and grip strength (all <i>p</i><0.001). Patients with higher McKinnon stages, longer symptom duration, and preoperative thenar atrophy demonstrated lower functional gains, while greater surgeon experience was associated with superior outcomes. Multivariate analysis confirmed electrophysiological severity, symptom duration, surgeon experience, and thenar atrophy as independent predictors of recovery.</p><p><strong>Conclusions: </strong>Open carpal tunnel release performed using the Wide Awake Local Anesthesia No Tourniquet technique was associated with significant improvements in patient-reported function, pain, and grip strength at 12 months. However, because no comparator anesthesia group was included, these findings should not be interpreted as evidence of Wide Awake Local Anesthesia No Tourniquet-specific superiority or comparative effectiveness. Electrophysiological severity, symptom duration, thenar atrophy, and surgeon experience were associated with postoperative recovery and may help inform preoperative patient counseling.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fractures of the Triquetrum - a Frequent Cause of Post-Traumatic Ulnar-Sided Wrist Pain].","authors":"Steffen Löw, Sebastian Kiesel, Christian Karl Spies, Frank Unglaub","doi":"10.1055/a-2920-8336","DOIUrl":"https://doi.org/10.1055/a-2920-8336","url":null,"abstract":"<p><strong>Abstract: </strong>Fractures of the triquetrum are the second most common carpal fractures after scaphoid fractures and represent a frequent cause of post-traumatic ulnar-sided wrist pain. Dorsal shear fractures account for approximately 93% of all triquetral fractures and are therefore by far the most common fracture type. Two pathomechanisms have been proposed: avulsion by the dorsal ligamentous attachments to the triquetrum and impaction of the dorsal cortex by a prominent ulnar styloid. The dorsal shear/ avulsion fracture is commonly associate with a localized tenderness to palpation over the dorsal aspect of the triquetrum. The diagnosis is confirmed by a lateral wrist X-ray, and, if necessary, also by CT. Treatment is for purely osseous lesions as well as for osteoligamentous avulsion fractures conservative with immobilization in a short-arm cast for 3 weeks. Residual symptoms may persist for several months and are not uncommon. Fractures of the triquetral body are considerably much less frequent and may occur as part of more complex carpal injuries, such as perilunate fracture-dislocations. In these cases, CT is recommended in addition to standard radiographs to accurately define the fracture pattern. Palmar cortical fractures may represent an avulsion injury of the strong palmar portion of the lunotriquetral (LT) ligament. Consecutively, the diagnostic work-up should include magnetic resonance imaging (MRI) in addition to standard radiographs of the wrist. Wrist arthroscopy is the gold standard to confirm an associated LT ligament rupture, followed consecutively by a transfixation of the LT joint.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[(DGH) Digitalisation in Hand Surgery - A Survey on the Current Situation among Members of the German Society for Hand Surgery (DGH)].","authors":"Marlène O'Donoghue, Stefan Weber, Peter Hahn, Markus Bock, Martin Lautenbach","doi":"10.1055/a-2920-9458","DOIUrl":"https://doi.org/10.1055/a-2920-9458","url":null,"abstract":"<p><strong>Background: </strong>Digitalisation, and in particular the use of artificial intelligence (AI), is becoming increasingly important in medicine. At the same time, there are significant ethical, legal, technical and structural challenges. The aim of this study is to assess the current state of digitalisation, as well as the expectations, opportunities and limitations of the use of AI and robotics-assisted systems in hand surgery, from the perspective of the members of the German Society for Hand Surgery (DGH).</p><p><strong>Methods: </strong>In October 2025, an anonymous online survey was conducted among members of the DGH. Participants were recruited via the DGH's email distribution list. The survey was conducted using an online tool that complies with data protection regulations, following prior information and consent from the participants. The data collected included demographic information, experiences with AI in both personal and professional contexts, current and potential applications of AI in clinical practice, research and teaching, as well as perceived drivers, barriers and ethical challenges associated with AI. The study had received ethical approval.</p><p><strong>Results: </strong>A total of 103 data sets were analysed. Participants used AI significantly more often in a private context than in a professional one. In routine clinical practice, the greatest added value of AI was seen in process and documentation optimizing, data management and the analysis of diagnostic data. Applications relating to diagnosis and treatment decisions were seen with considerably more caution. Ethical concerns were raised in particular regarding dependency, loss of competence, loss of control and data protection. Despite these reservations, 87% of respondents expected AI to improve clinical practice in the future. Structured training and continuing professional development programs were seen as a key prerequisite for successful implementation.</p><p><strong>Conclusion: </strong>The majority of DGH members surveyed see AI as a supportive assistance system designed to alleviate the burden on doctors' work and decision-making, but not to replace them. At present, robotics could be regarded as a promising field for the future, particularly in specific areas of application. For the sustainable integration of AI into hand surgery, transparent systems, legal certainty, adequate technical infrastructure and targeted training programs are essential.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Breast Implant-Associated Anaplastic Large Cell Lymphoma: Results of a Survey and Narrative Review from the 12th International Breast Symposium Düsseldorf.","authors":"Robert Jonathan Musmann, Peter G Cordeiro, Marc Daniels, Sonia Fertsch, Mazen Hagouan, Dennis C Hammond, Yves Harder, Jaume Masia, Charles Randquist, Roy De Vita, Andreas Wolter, Christoph Andree","doi":"10.1055/a-2888-2174","DOIUrl":"10.1055/a-2888-2174","url":null,"abstract":"<p><strong>Background: </strong>Breast implant-associated anaplastic large cell lymphoma is a rare but significant complication of breast implants, with persistent uncertainties regarding its etiology, incidence, and optimal management strategies, particularly regarding prophylactic explantation in asymptomatic patients with textured implants. This study aims to assess current opinions and practices related to breast implant-associated anaplastic large cell lymphoma among experts in the field.</p><p><strong>Methods: </strong>A survey was submitted to faculty members (<i>n</i> = 37) and attendees (<i>n</i> = 75) of the 12^th International Breast Symposium Düsseldorf in April 2024. The questionnaire captured personal experiences, diagnostic practices, and opinions on the prevention and management of breast implant-associated anaplastic large cell lymphoma.</p><p><strong>Results: </strong>Results indicated that 89% of both faculty members and attendees do not recommend prophylactic explantation of macrotextured implants in asymptomatic patients, aligning with current guidelines. While 62% of faculty members and 68% of attendees believe that the actual incidence of breast implant-associated anaplastic large cell lymphoma is higher than reported due to either underdiagnosis or under-reporting, 97% of faculty members and 96% of attendees routinely inform patients about the risks prior to surgery. Notably, 35% of faculty members and 73% of attendees had not encountered any cases of breast implant-associated anaplastic large cell lymphoma, despite heightened awareness.</p><p><strong>Conclusions: </strong>This study reflects a conservative approach to managing breast implant-associated anaplastic large cell lymphoma among practitioners. The findings underscore the need for standardized implant registries and global reporting protocols to improve risk assessment and patient safety. Further research is essential to clarify the multifactorial etiology of breast implant-associated anaplastic large cell lymphoma and determine the efficacy of prophylactic explantation. Until more definitive evidence is available, individualized patient care with informed discussions and shared decision-making remains paramount.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Between the Clinical Gold Standard and Economic Challenges: A Case-Cost Analysis of the Cost-Effectiveness of Autologous Breast Reconstruction].","authors":"Denis Ehrl, Konrad Karcz, Nikolaus Wachtel, Tim Nuernberger, Moritz Billner, Maximilian Stumpfe, Celena Sörgel, Vadym Burchak, Martin Bauer","doi":"10.1055/a-2924-3028","DOIUrl":"10.1055/a-2924-3028","url":null,"abstract":"<p><strong>Background: </strong>Autologous breast reconstruction using the Deep Inferior Epigastric Perforator (DIEP) flap is considered an established standard procedure due to its preservation of the rectus muscles, natural aesthetic results, and high patient satisfaction. At the same time, it is resource-intensive. Case-specific health economic data on cost-effectiveness within the German DRG system have been limited to date.</p><p><strong>Materials and methods: </strong>A retrospective, single-center case-cost analysis of 18 female patients who underwent unilateral DIEP flap reconstruction in 2023 without perioperative complications or DRG-relevant secondary diagnoses. The study captured directly attributable medical costs for the preoperative, perioperative, and post-hospitalization phases. Revenue analysis was performed using the aG-DRG J01Z, with nursing fees considered separately. In addition, five expert interviews were qualitatively evaluated.</p><p><strong>Results: </strong>The average total direct costs amounted to €9829.07 per patient. The largest share of costs was attributable to the perioperative phase, particularly the surgical phase, which accounted for €5792.27. When considering direct costs, the average DRG revenue of €14,017.05 resulted in a positive contribution margin of €4192.65. Assuming indirect costs of up to 50%, total costs rose to €14,738.94, resulting in a deficit of €721.89 when DRG reimbursement was the sole source of revenue. Only with the additional nursing fee of €1606.85 did a small positive overall balance of €884.97 per case result.</p><p><strong>Conclusion: </strong>Under the conditions described, unilateral DIEP flap surgery may barely break even in the German DRG system, assuming a selected best-case scenario. However, its economic viability remains fragile and is significantly influenced by indirect costs, nursing fees, process standardization, and structural overhead costs. Future reimbursement models should take greater account of process complexity, center structures, and patient-specific long-term outcomes.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Garlic (Allium sativum)-Induced Chemical Burns-A Current Review of Treatment Techniques and a Case Report.","authors":"Alexander Hach, Yanic Jost, Helena Häuser, Jan Warszawski, Julian Ernst, Benjamin Ziegler, Christoph Hirche, Albrecht Heine-Geldern","doi":"10.1055/a-2862-1764","DOIUrl":"10.1055/a-2862-1764","url":null,"abstract":"<p><strong>Introduction: </strong>Garlic (<i>Allium sativum</i>) is widely known for its cardiovascular, antimicrobial, and potential anticancer properties. Despite these benefits, topical application may lead to adverse effects, including allergic reactions, anticoagulant effects, and chemical skin burns. Such burns are rare and under-recognized. This systematic review synthesizes the available clinical evidence on garlic-induced skin burns and complements it with an illustrative case to support clinical decision-making.</p><p><strong>Methods: </strong>A systematic PubMed search was conducted to identify clinical reports of garlic-induced skin burns with documented treatment and outcomes. Inclusion criteria comprised case reports or clinical studies on cutaneous garlic burns with available clinical intervention and outcome data. Exclusion criteria included studies published before 2000, non-English publications, mucosal or oral burns, animal or in vitro studies, review articles and editorial texts without patient data. In total, 45 studies were screened and 18 studies met the inclusion criteria. Extracted variables included patients' demographics, burn depth, treatment modality, and healing course. Additionally, a case of a woman with deep dermal, circumferential burns of the knee following the self-application of crushed garlic under occlusion is presented.</p><p><strong>Results: </strong>Most reported cases involved superficial to deep dermal burns caused by prolonged or occlusive garlic application. Conservative treatment-topical antimicrobials, corticosteroids, and advanced dressings-was effective for superficial burns. However, deeper injuries often required surgical intervention including debridement, and in selected cases, split-thickness skin grafting. Healing times ranged from 7 to>56 days, with surgical management associated with faster recovery in deep lesions.</p><p><strong>Conclusions: </strong>Garlic-induced burns represent an uncommon but clinically relevant chemical injury. Prolonged occlusion increases risk for deep dermal necrosis. Early recognition and appropriate surgical management may optimize outcomes and prevent complications. Increased clinician awareness and patient education are essential. Due to heterogeneous case-based evidence, further research is warranted to inform standardized treatment guidelines.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Popliteal Pterygium Syndrome (PPS): A Multimodal Treatment Approach and Long-Term Outcomes in 4 Cases].","authors":"Andrea Wenger, Michael Schäfer, Hildegunde Piza-Katzer","doi":"10.1055/a-2854-5510","DOIUrl":"https://doi.org/10.1055/a-2854-5510","url":null,"abstract":"<p><strong>Background: </strong>Popliteal pterygium syndrome (PPS) is a rare, autosomal dominant congenital disorder characterized by the presence of a skin and soft-tissue web in the popliteal region. Functional impairment due to knee flexion contractures, equinus deformity, and hip malalignment is common. The existing literature is dominated by isolated case reports, while robust long-term outcome data are lacking.</p><p><strong>Patients and methods: </strong>In a retrospective case series, four patients with popliteal pterygium and functionally relevant knee flexion contractures were treated surgically. The operative approach included complete resection of the fibrous band, multiple Z-plasties, microsurgical neurolysis of the sciatic nerve, and Achilles tendon lengthening. The mean follow-up period was 16 years (range: 5-23 years). Postoperatively, individualized orthoses were used, and in two cases custom-built stretching devices were applied.</p><p><strong>Results: </strong>Knee extension improved by a mean of 30° (from 45° preoperatively to 15° postoperatively). At final follow-up, all patients were able to ambulate without assistive devices. A growth-related recurrence occurred in one case. No neuropathic pain or secondary paresis was observed.</p><p><strong>Conclusion: </strong>In functionally relevant popliteal pterygia, a single-stage surgical approach consisting of complete band resection, neurolysis, and multiple Z-plasties, combined with consistent postoperative stretching and orthotic management, can achieve sustained functional improvement. This case series presents long-term outcomes extending over more than two decades for the first time.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}