For the most part we use single axial Kirschner drill wires for the stabilization of fractured bones in the replantation surgery on the hand. The results of a re-examination of 102 patients with 176 replanted parts of the hand are reported and discussed.
Using the technique of dynamic treatment of flexor tendons gives the chance of successful primary tendon suture even in zone II. A description of indication, operative procedure and postoperative care is given and the working mechanism is shown by measurement of gliding amplitudes.
The osseous tear of extensor tendon is to be seen as a intraarticular fracture. The exact anatomical reduction is not only necessary for the reconstruction of extensor tendon but also for the recovery of the articular surface. The tension band wiring which is used in avulsion fractures of bigger joints is also the method of choice for the treatments of the osseous tear of extensor tendon. An accurate carrying out is very important. The result of six cases is reported.
Anastomosis of A. carotis and of N. ischiadicus of the rat were carried out by microsurgical technique in comparison to the nonabsorbable suture material Ethilon and the absorbable Vicryl, both 0,2 metric. There occurred no suture insufficiencies with either sutured nerves or vessels. After 70-84 days the Vicryl sutures were completely absorbed. In particular with nerve sutures Vicryl proved to be superior to Ethilon, as the displacement of axons in the area of granuloma decreased with progressing absorption of the suture and thus also resulting less renewed and thus also resulting less renewed degeneration of the axons.
Microsurgical techniques have influenced the transplantation of tissue decisively. In case of loss of hair bearing skin a complete repair is possible. In order to choose the optimal anastomoses, the blood supply is discussed.
The aim of plastic surgery in children with down-syndrome is the improvement of speech (by correction of macroglossia) as well as improvement of cosmetic appearance (by correction of saddle nose deformity, epicanthic folds receding chin and deformity of ears). Altering the typical mongoloid physiognomy facilitates the integration of these children into the community.
The possibility of replantation is discussed for children's amputation injuries. The use of this technique is also indicated for multiple amputations and severe crush injuries. More than half of the replanted fingers healed successfully. Since the existence of the Replantation centre of the Klinikum Rechts der Isar, over 600 operations of separated limbs were performed. The healing rate of totally and subtotally separated limbs of adults was 87%. The attempt was made to replant separated digits of 14 children, aged from 1 to 8 years, with microvascular anastomoses. The grade of injuries and the minimal size of anatomic structures demand a particularly high standard of the operative standard. Replantation was also indicated for badly squashed and contaminated limbs.
878 breast hypertrophies were operated in the period 1.1.1971 and 31.12.1979. In 116 cases (13,2%) a visible difference in volume between the breasts were observed. These cases of asymmetry were divided into 4 categories. The various corrective approaches are discussed.
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