Handchirurgie Mikrochirurgie Plastische Chirurgie最新文献

{"title":"[Generation Z in Surgery and 'Work-Life Balance': Challenge or Opportunity?]","authors":"Riccardo E Giunta","doi":"10.1055/a-2524-0253","DOIUrl":"https://doi.org/10.1055/a-2524-0253","url":null,"abstract":"","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On occasion of the \"ESPRAS - A Day in Paris\" meeting at the 68th SOFCPRE Congress November 21st 2024.","authors":"R E Giunta, J Saboye","doi":"10.1055/a-2534-7628","DOIUrl":"https://doi.org/10.1055/a-2534-7628","url":null,"abstract":"","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Strategies for Preventing Fires and Thermal Injuries in the Operating Room].","authors":"Maximilian C Stumpfe, Raymund E Horch","doi":"10.1055/a-2513-0574","DOIUrl":"https://doi.org/10.1055/a-2513-0574","url":null,"abstract":"<p><p>Thermal injuries and operating room fires pose significant risks to patients, especially when energy-based devices like monopolar diathermy are used. A study conducted by the FDA over 20 years reported over 3,500 injuries and 178 deaths, mostly caused by burns. The main causes of operating room fires can be explained by the \"fire triangle\": ignition sources, fuels, and oxidizers. Monopolar diathermy and lasers act as ignition sources, while alcohol-based disinfectants provide fuel. As oxidizers, oxygen and nitrous oxide further increase the risk of fire.This review is based on a literature analysis and case vignettes of patients with thermal injuries. It aims to highlight the severe consequences of such injuries and outline preventive measures.The findings underscore the need for a multidisciplinary approach. Key strategies include reducing oxygen concentration and using alternative disinfectants. Targeted training for the surgical team, along with the use of \"Fire Risk Assessment Tools\", can substantially improve patient safety.In conclusion, comprehensive risk management, the development of specific protocols, and team training are essential to prevent thermal injuries and sustainably reduce patient risk in the operating room.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of Congenital Ulnar Impingement Syndrome by Corrective Osteotomy of the Distal Radius - Clinical Results].","authors":"Petr Machac, René Schandl, Roman Wolters, Hermann Krimmer","doi":"10.1055/a-2319-1047","DOIUrl":"10.1055/a-2319-1047","url":null,"abstract":"<p><strong>Background: </strong>In 2016, a new method was described to treat the painful impingement syndrome of the DRUJ: decompression corrective osteotomy of the distal radius. Clinical symptoms are based on a positive compression test; pain occurs with weight-bearing on the forearm. This phenomenon is seen in conjunction with a deformed sigmoid notch together with ulna minus-variance, which leads to increased tension in the distal oblique bundle of the interosseous membrane. The etiology of the condition can be either congenital, post-traumatic, or iatrogenic. Through the proposed osteotomy, decompression in the DRUJ is achieved. This study summarises the results of these surgical procedures performed in our hand centre exclusively in cases of congenital origin.</p><p><strong>Patients und methods: </strong>Remodelling of the DRUJ is achieved through the shortening of the distal radius together with closed wedge osteotomy. Relief of the interosseous membrane is accomplished by ulnar translation of the radial shaft. This study only included patients with congenital incongruency in the DRUJ. The results were evaluated using a visual analogue scale (VAS) and the Krimmer Wrist Score and by measuring the preoperative and postoperative range of motion as well as grip strength.</p><p><strong>Results: </strong>Within 11 years, 45 procedures were performed with our method on 38 patients, of which 17 were treated on the right side, 14 on the left side, and 7 bilaterally. In cases of bilateral incongruency, only the symptomatic side was treated. The statistical evaluation showed a significant reduction of pain on the VAS from 7.2 to 2 (p<0.001). No significant changes were seen in the range of motion (p=0.812). The Krimmer Wrist Score showed good to excellent results in almost 90% of cases.</p><p><strong>Conclusion: </strong>If the indication criteria are met, contraindications are avoided and the osteotomy is correctly performed, this technique leads to an improvement of patients' functionality and quality of life. From a preventive viewpoint, the influence on the progression of the degenerative changes is yet to be demonstrated in further studies. At any rate, this is a safe procedure, which leaves the path open for other possible options.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":"17-22"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dorsal Screw Osteosynthesis of a Scaphoid Nonunion associated with Congenital Scaphotrapezial and Lunotriquetral Coalitions: A Case Report].","authors":"Jan Wulf, Rainer Schmitt, Adrian Cavalcanti Kußmaul, Wolfgang Böcker, Boris Holzapfel, Fabian Gilbert","doi":"10.1055/a-2348-3256","DOIUrl":"10.1055/a-2348-3256","url":null,"abstract":"<p><p>We present the case of a 24-year-old man who sustained a scaphoid fracture in the presence of congenital scaphotrapezial and lunotriquetral coalitions. As the fracture progressed to a nonunion, a screw osteosynthesis was performed. The altered biomechanics caused by the two coalitions necessitated a dorso-proximal surgical approach, and two screws were implanted to prevent rotational instability. The scaphoid fracture healed entirely.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":"71-75"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effect of early versus late surgical strategies on outcomes in patients with hand enchondromas complicated with pathological fractures.","authors":"Erkan Akgün, Hüseyin Bilgehan Çevik","doi":"10.1055/a-2471-7181","DOIUrl":"10.1055/a-2471-7181","url":null,"abstract":"<p><p>This study aimed to evaluate the advantages and disadvantages of early versus delayed single-stage surgery in patients with hand enchondromas who developed pathological fractures, focusing on local tumor control and hand function, to determine the optimal timing for surgery. Delayed surgical curettage may offer advantages regarding both local tumor control and hand function outcomes.Thirty-five patients who developed pathological fractures due to solitary hand enchondromas and underwent surgical treatment between 2015 and 2021 were analysed. Patients were divided into two groups based on the timing of surgery. Patients who underwent surgical treatment immediately after a pathological fracture were assigned to the early-surgery group, and those who underwent surgical treatment after waiting for fracture union were assigned to the late-surgery group. Demographic data, lesion characteristics, and fixation methods were analysed. Parameters affecting outcome measurements were analysed, including visual pain scale, fracture healing time, recurrence, ROM, time to return to daily activities, and secondary surgical procedures.The study included 35 patients, of whom 24 were female, with a median age of 33 years. Fifteen patients were included in the early-surgery group and 20 in the late-surgery group, with a follow-up period of 36.3 and 38.9 months, respectively. The duration of surgery, time to fracture union, and total physical therapy duration during treatment were lower in the late-surgery group (p<0.05). At the final follow-up, the mean loss of ROM was 17.6˚ in the early-surgery group and 3.3˚ in the late-surgery group (p=0.00). The rate of secondary surgery was higher in the early-surgery group (p=0.040).In patients with hand enchondromas presenting with pathological fractures, early surgery resulted in higher complication rates, poorer functional outcomes, and an increased need for secondary surgeries.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":"50-56"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Good News from HaMiPla].","authors":"Kai Megerle, Marion Mühldorfer-Fodor, Riccardo E Giunta","doi":"10.1055/a-2500-4231","DOIUrl":"https://doi.org/10.1055/a-2500-4231","url":null,"abstract":"","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":"57 1","pages":"7"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical treatment after lesions of the superficial branch of the radial nerve - mid-term outcomes].","authors":"Maria Tsironis, Sandra Vossen","doi":"10.1055/a-2437-0678","DOIUrl":"https://doi.org/10.1055/a-2437-0678","url":null,"abstract":"<p><p>The treatment of lesions of the superficial radial nerve remains a challenge for surgeons and patients. For patients, such lesions are associated with a high level of suffering due to electrifying pain at the level of the injury as well as sensory dysfunction. Our data collected over a treatment period of 6 years are intended to give an overview of surgical methods, temporal progression and the corresponding outcomes.We retrospectively analysed 17 cases of patients undergoing surgery after a lesion of the superficial branch of the radial nerve between 4/2017 an 12/2022. Sixteen patients were surveyed using standardised measures with regard to regeneration, pain relief and post-surgical satisfaction. The average latency between the causal event and the surgical procedure was 13.4 months (3-60 M). Neurolysis was carried out in 4 of 16 cases in the presence of macroscopically visible cicatricial changes without the occurrence of morphological changes in the nerve and with preserved continuity. Reconstruction through suturing was performed in 12 cases, 4 being performed without and 8 with neuroprotection. In 2 of the latter, neuroprotection was achieved with a neurotube, while 6 were treated by means of wrapping veins.The performed interventions all led to a reduction of pain. Regardless of the time interval between the lesion of the superficial radial nerve and surgery, the procedure led to a relief from discomfort related to previous symptoms of pain, hypesthesia and Tinel sign. Although the reconstruction of the nerve did not lead to complete remission, the patients were satisfied with the results. In most cases, some hypesthesia remained. Neuroprotection through a vein graft led to better pain relief than treatment without a vein graft.Although symptoms remained, pain relief was crucial for the patients. After lesions of the superficial branch of the radial nerve, surgical treatment aiming to preserve or restore the continuity of the injured nerve branch should be considered as a promising option.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":"57 1","pages":"44-49"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Outcomes of fingertip injury treatment with semi-occlusive dressings combined with surgical management within an expanded indication].","authors":"Polina Dimitrova-Chakarova, Karl-Josef Prommersberger, Jörg van Schoonhoven, Marion Mühldorfer-Fodor","doi":"10.1055/a-2496-2706","DOIUrl":"10.1055/a-2496-2706","url":null,"abstract":"<p><p>Since their introduction by Mennen and Wiese in 1993, semi-occlusive film dressings (SOFD) have been increasingly used in various clinical contexts, including the treatment of Allen type IV fingertip injuries, fingertip necrosis, and cases involving embedded foreign material.This study aimed to investigate whether and, if so, how the outcomes of Allen type III and IV fingertip injuries and fingertip necrosis differ from those of Allen types I and II. In addition, it aimed to investigate if the presence of embedded foreign material under a film dressing increases the risk of complications.A total of 50 patients with 44 fingertip injuries and 13 fingertip necroses were treated with an SOFD in combination with surgical intervention. In 22 out of 50 patients, foreign material was present under the film dressings. During follow-up, cold sensitivity, pain at rest and during activity, the usage of the injured finger in daily life, patient satisfaction with the aesthetic outcome, sensitivity, sweat secretion, papillary ridges, nail deformity, and mobility were assessed. The fingertips were examined for nail growth abnormalities. The results of the Allen type I-IV fingertip injuries and fingertip necrosis were compared with each other and related to findings from the uninjured fingers of the opposite hand. Clinical outcomes showed that SOFD led to good fingertip regeneration at any amputation level and in cases of fingertip necrosis. However, nail deformities increased with shorter lengths of the distal phalanx. Patients with necrosis were less satisfied with the aesthetic outcome compared to those receiving primary treatment after amputation injury. The presence of foreign material under the film dressings did not influence the healing process, and no infections were observed.SOFDs demonstrate good outcomes in Allen type III and IV fingertip injuries as well as in fingertip necrosis, comparable to those of Allen type I and II. However, it is essential to inform patients about potential risks such as nail deformities and compromised aesthetic appearance. Surgical interventions involving foreign material under an SOFD do not affect the healing of fingertip injuries, thus allowing for an expanded range of indications for SOFDs.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":"32-43"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postoperative Pain Level Following Surgery of the Hand and Wrist in the Ambulatory Setting].","authors":"Steffen Löw, Öznur Dervis, Sebastian Kiesel, Holger C Erne, Christian Karl Spies, Frank Unglaub","doi":"10.1055/a-2436-9471","DOIUrl":"10.1055/a-2436-9471","url":null,"abstract":"<p><strong>Background: </strong>Surgical procedures of the hand are increasingly performed in an ambulatory setting. Postoperative analgesia is based empirically on the painfulness of individual surgical procedures without these having been examined systematically.</p><p><strong>Patients and methods: </strong>The painfulness (visual analogue scale) of 722 surgical procedures of the hand and wrist (1 July 2021 to 30 June 2023) was assessed until day 5. Analgesia was conducted empirically in accordance with WHO principles. The primary endpoint was the pain sensation on the first postoperative day in bone and joint procedures compared with soft tissue or endoscopic procedures as well as hardware removals. Secondary endpoints were pain sensation in correlation with gender, age, duration of the procedure and preoperative analgesia.</p><p><strong>Results: </strong>Bone and joint procedures were associated with significantly (p<0.001) more pain (5.42±2.8) compared with other procedures (3.47±2.6). Female (p=0.001) and younger patients (R>0.2) as well as longer procedure duration (R>0.2) showed a weak association with higher postoperative pain, whereas preoperative consumption of opioids was moderately associated with higher opioid intake (R=0.34). Overall, pain decreased continuously from the evening of the procedure (4.4±2.8) until day 5 (3.7±2.7; 2.8±2.4; 2.1±2.1; 1.6±1.9; 1.3±1.7) CONCLUSION: This data provides a scientific basis for pain medication supply following surgical procedures of the hand and wrist in an ambulatory setting. A broad range of pain perception must be considered, even in seemingly minor surgical procedures.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":" ","pages":"23-31"},"PeriodicalIF":0.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}