Handchirurgie Mikrochirurgie Plastische Chirurgie最新文献

{"title":"[Treatment of the contracted first Commissure of the Hand: Literature Overview and own Experiences].","authors":"Elmar Fritsche,&nbsp;Dorrit Winterholer,&nbsp;Urs Hug","doi":"10.1055/a-2013-5449","DOIUrl":"10.1055/a-2013-5449","url":null,"abstract":"<p><p>The freely movable thumb is of central importance for the function of the human hand. This mobility is necessarily linked to an undisturbed function of the commissure between the thumb and the index finger or, if the index finger is missing, the middle finger. A significant contracture of the first commissure, caused by whatever genesis, inevitably results in a significant loss of function up to almost complete inability to use. The surgical treatment of the first commissure often only affects the contracted skin. In some cases, however, it requires a multi-stage approach to fascia, muscles and joints, at the end of which there is the soft tissue expansion of the interspatium between the thumb and index finger. We mention old insights on the subject, give an overview of the literature, present our own experiences based on 5 cases and - according to the severity of the contracture - make a therapy recommendation.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9547112","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":"[Medium-term Results after percutaneous Needle Fasciotomy in Dupuytren's Disease].","authors":"Emmanouil Nichlos,&nbsp;Olaf Wölfle,&nbsp;Ingo Marzi,&nbsp;Johannes Frank,&nbsp;Katharina Sommer","doi":"10.1055/a-2055-1592","DOIUrl":"10.1055/a-2055-1592","url":null,"abstract":"<p><strong>Background: </strong>Dupuytren's disease often leads to an increasing limitation in finger extension in affected patients. As the incidence rises with age, the number of cases is expected to rise in the future due to the demographic change. Therefore, an easy and patient-oriented treatment is required. In the following study, we investigated the short and medium-term results after percutaneous needle fasciotomy (PNF).</p><p><strong>Patients and methods: </strong>Overall, 65 fingers of 40 patients were treated with PNF. We evaluated the total passive deficit of extension (TPED), the passive deficit of extension of the joints (PED), the Buck-Gramcko score, rate of recurrence, DASH score and patient satisfaction. The average age of the patients was 65,9 years. Most of the patients (82%) were male.</p><p><strong>Results: </strong>Directly after the PNF, extension in the treated fingers improved significantly (TPED before PNF 74,6°±41,1 SD to 32,8°±29,0 SD after the procedure). By the time of the follow-up examination (30,2±13,9 SD months), TPED had increased again (52,7°±40,2 SD). The rate of recurrence was 29,7%, and a higher Tubiana stage before the procedure correlated significantly with a higher recurrence rate. Nevertheless, patients demonstrated a very high level of satisfaction with the procedure and almost all patients would choose to undergo PNF again.</p><p><strong>Conclusion: </strong>Although it is associated with a relatively high recurrence rate, PNF represents an effective and patient-oriented treatment of Dupuytren's contracture.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/e3/10-1055-a-2055-1592.PMC10513775.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluation of the Charlson Comorbidity Index as a prognostic tool for assessing the severity of hand infections]","authors":"Anne Sorowka, Thomas Grünewald, Thomas Kremer, Susanne Rein","doi":"10.1055/a-2108-8874","DOIUrl":"10.1055/a-2108-8874","url":null,"abstract":"<p><strong>Background: </strong>The Charlson Comorbidity Index (CCI) is used for the prognostic analysis of comorbidities. Comorbidities, especially diabetes mellitus, are a decisive factor for the development and course of hand infections. This study aimed to determine the CCI in patients with hand infections in order to examine how comorbidities influence the course and severity of hand infections.</p><p><strong>Material and methods: </strong>Ninety patients with hand infections requiring surgery but without previous antibiotic treatment were studied prospectively. The respective CCI was determined on admission to hospital. A total score of zero points was defined as \"low\", a score of one to three as \"medium\" and a score of four to nine points as a \"high\" index. Age, CRP level, duration of inpatient stay and the number of performed surgeries were documented and statistically evaluated.</p><p><strong>Results: </strong>The median CCI was 0,5 points with a range of 0-9 points. The most common comorbidity was diabetes mellitus without end-organ damage, followed by heart failure and chronic lung disease. Patients with a low total score (median 51 years) were significantly younger than those with a medium score (median 60 years; p=0,018) or a high score (median 66,5 years; p=0,018). In addition, patients with a low or medium score had a shorter hospital stay (median 6 vs. 11,5 days; plow=0,003; pmean=0,005), required fewer surgeries (median 1 vs. 3 surgeries; plow=0,002; pmean=0,003) and had a lower CRP level (median 8,3 mg/l vs. 7,1 mg/l vs. 86,25 mg/l; plow=pmean=0,001) than those with a high index. A significant positive correlation was found between the CCI and patient age (Spearman's ρ=0,367; p<0,001) as well as the length of hospital stay (Spearman's ρ=0,261; p=0,013), the number of surgeries (Spearman's ρ=0,219; p=0,038) and the CRP level (Spearman's ρ=0,212; p=0,045).</p><p><strong>Conclusions: </strong>The CCI is an appropriate questionnaire for the prognostic assessment of the course and severity of hand infections, particularly with regard to the length of hospital stay, the number of surgeries and the CRP level.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161723","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":"[Protracted Course with Finger Amputation Following Stonefish Envenomation].","authors":"Jakob Richard Schnegg,&nbsp;Jörg Först,&nbsp;Jörg van Schoonhoven,&nbsp;Karl-Josef Prommersberger,&nbsp;Marion Mühldorfer-Fodor","doi":"10.1055/a-2010-7353","DOIUrl":"10.1055/a-2010-7353","url":null,"abstract":"Fallbericht Eine 53-jährige Frau stellte sich 2,5 Wochen, nachdem sie sich auf Mauritius eine Steinfischstichverletzung am rechten Kleinfinger zugezogen hatte, in unserer Notfallambulanz vor. Sie hatte im Urlaub beim Schwimmen am Meeresufer versehentlich auf einen im Sand vergrabenen Steinfisch gegriffen ( Abb. 1 ). Sofort war es neben massiven Schmerzen am gesamten Arm zu einer Rötung am Kleinfinger und einer Schwellung der Hand gekommen. Nach notfallmäßigem Transport in das nächste Krankenhaus wurde der Patientin dort aufgrund einer starken systemischen Reaktion ein Antidot im Rahmen eines kurzzeitigen intensivmedizinischen Aufenthaltes verabreicht. Bei Blasenbildung wurde eine oberflächliche Wundrevision und eine Kompartmentspaltung palmar an der rechten Hand am Folgetag durchgeführt. Die Narben ließen allerdings auf eine nur minimale Eröffnung der Stichwunde und der Intermetakarpalräume schließen. Eine Antibiotikatherapie erfolgte während des 4-tägigen Krankenhausaufenthaltes mittels Ampicillin/Sulbactam intravenös, welche bei Entlassung oralisiert und bis zur Vorstellung in unserer Klinik fortgesetzt wurde.","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9169809","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":"Schmerzen nach Verwendung eines Chitosan-Neurotubes bei Medianusverletzung.","authors":"Laura Anna Schneider,&nbsp;Verena Kassiopeia Horner,&nbsp;Bastian Bonaventura,&nbsp;Filip Simunovic","doi":"10.1055/a-2013-5400","DOIUrl":"10.1055/a-2013-5400","url":null,"abstract":"Falldarstellung Die Erstvorstellung der 29-jährigen Patientin ohne relevante internistische Vorerkrankungen erfolgte dreieinhalb Jahre nach einem Stolpersturz in eine Glasscheibe. Hierbei zog sie sich eine Schnittverletzung beugeseits distal am rechten Unterarm zu. Bei der Erstversorgung wurde lediglich die durchtrennte Flexor-carpi-radialis-Sehne adressiert. Die vollständige Durchtrennung des N. medianus, der langen Daumenbeugesehne und der oberflächlichen Beugesehne des Mittelfingers (FDS III) wurden erst nach zehn Wochen erkannt, als die Patientin nach der Ruhigstellung bei der ergotherapeutischen Beübung eine persistierende Asensibilität im Medianusgebiet einhergehend mit Neuromschmerzen sowie eine Bewegungseinschränkung des Daumens beklagte.","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9132715","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":"[Accessorry and joint-forming os paratrapezium]","authors":"Fabrizio Fiumedinisi, Elvira Bodmer, Urs Hug","doi":"10.1055/a-2055-1698","DOIUrl":"10.1055/a-2055-1698","url":null,"abstract":"","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10063403","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":"[Acute soft Tissue Infection with impending Loss of Finger in amniotic Band Syndrome of a 22-years-old Patient with palmoplantar Keratoderma congenital Alopecia Syndrome Type II].","authors":"Moritz Gugelmeier,&nbsp;Arthur Kostron,&nbsp;Thomas Poser,&nbsp;Lisa C Schneider,&nbsp;Wiebke K Peitsch,&nbsp;Thomas Fuchs","doi":"10.1055/a-2013-2131","DOIUrl":"10.1055/a-2013-2131","url":null,"abstract":"<p><p>We report on the treatment of a 22-year-old female patient with an acute soft tissue infection in the area of an amniotic band due to palmoplantar keratoderma congenital alopecia syndrome (PPKCA) type II, a very rare genodermatosis with less than 20 cases described in literature. An acute soft tissue infection distal from the pre-existing constriction ring with hyperkeratosis on the right small finger led to a decompensation of the venous and lymphatic drain with imminent loss of the finger. Due to urgent surgical treatment with decompression and debridement of the dorsal soft tissue infection, microsurgical circular resection of the constriction ring and primary wound closure the finger could be preserved. After soft tissue consolidation and hand therapy, the patient achieved free movement of the small finger with subjective freedom of symptoms and good aesthetic results.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246965","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":"Buchbesprechung","authors":"","doi":"10.1055/a-2111-1382","DOIUrl":"https://doi.org/10.1055/a-2111-1382","url":null,"abstract":"Die zweite Auflage des bemerkenswerten Buchs von Donald Lalonde, das schon damals die Handchirurgie nachhaltig beeinflusste, ist nun wesentlich ausführlicher gestaltet. Der Herausgeber konnte internationale und führende Spezialisten für dieses Werk gewinnen.","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135390036","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":"[Successful microsurgical Replantation of a completely amputated Finger Pulp frozen in Ice: Case Report and Literature Review].","authors":"Dorrit Winterholer,&nbsp;Elmar Fritsche,&nbsp;Elif Kulakli,&nbsp;Thomas Giesen","doi":"10.1055/a-1992-5755","DOIUrl":"10.1055/a-1992-5755","url":null,"abstract":"<p><p>The microsurgical replantation of incorrectly stored and transported amputates is generally considered impossible and without prospects of success. In particular, this applies to amputates that show cold damage due to the freezing of tissue. We present a case of successful replantation of an amputated finger pulp frozen in ice. We provide an overview of the literature on the subject of incorrect storage of amputates and the prospects of success for replantation.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10618764","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":"[Relevance of Early Structured Diagnosis to Successful Nerve Reconstruction: A Case Report of an Alpine Professional Skier with an Axillary Nerve Injury].","authors":"Elisabeth Maria Haas-Lützenberger,&nbsp;Mortimer M Hladik,&nbsp;Konstantin Christoph Koban,&nbsp;Riccardo Giunta","doi":"10.1055/a-2055-1642","DOIUrl":"10.1055/a-2055-1642","url":null,"abstract":"<p><p>Among high-speed sports, an increased number of high-speed injuries have been observed in alpine downhill racing. We report the case of a young professional ski racer who sustained a shoulder dislocation with an avulsion of the axillary nerve during a World Cup race. After initial treatment was provided for the shoulder dislocation, the patient was left with abduction weakness and a sensory deficit in the region of the deltoid muscle. She underwent electrophysiological and clinical examinations and visited our centre with delay. We immediately performed surgical treatment with a nerve transfer and nerve transplantation. After only 11 months following her fall, she was able to resume her training program. This case report shows the importance of early diagnostic investigation, a visit to a centre of plastic surgery and the good outcome after surgical treatment in patients with peripheral nerve injuries.</p>","PeriodicalId":55075,"journal":{"name":"Handchirurgie Mikrochirurgie Plastische Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045390","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}