[Outcome of total arthrodesis of the hand]. / Ergebnisse der Totalarthrodesen an der Hand.

In cases of degeneration combined with pain and instability of a wrist joint, fusion of the joint is clearly indicated. A retrospective review of 39 patients a mean of 7 years after operation suggested that radiocarpal arthrodesis had been successful. Fusion of the 39 wrist joints was accomplished by means of an AO plate and cancellous bone grafting. Most patients achieved good function and were completely free of symptoms even during heavy work. Especially for patients with rheumatoid wrist joints and those engaged in hard manual labour subtotal arthrodesis cannot be recommended since the functional results are only negligibly better than those obtained with total arthrodesis.

[Results of silastic prosthesis for the semilunar bone in semilunar malacia]. / Ergebnisse mit der Mondbeinsilastikprothese bei lunatummalazie.

In the hospital of Plastic surgery and Hand surgery in Eschweiler has been treated in the period from January 1980 to June 1983 23 patients with lunatomalacia. They were treated operatively by an interposition of a silastic prothesis by Swanson. A follow-up study was made on 21 out of 23 patients after a period of 6 to 46 months. The clinical and radiological examination has shown that 20 out of 21 patients were satisfied by the result.

[Late functional results following replantation of a hand with resection of the proximal carpal row]. / Funktionelles Spätergebnis nach Replantation einer Hand unter Resektion der proximalen Handwurzelreihe.

A total amputation through the proximal carpus is presented in a 10 year old boy. Replantation was performed following partial resection of the proximal carpal row with capsulorrhaphy, avoiding time-consuming osteosynthesis. The late result shows normal development of the hand and the preservation of wrist motion. For this reason conservation of the wrist joint especially in the growing skeleton should be preferred to a primary arthrodesis.

[Three different tumors in a case of synovial sarcoma of the hand]. / Dreifaches Tumor- geschehen bei einem Synovialsarkom der Hand.

Examining a 74 year old female patient with a nodular goiter, a tumor of the left thenar eminence with a concurrent radiolucent swelling in the adjoining second metacarpal was found. The diagnosis was a struma nodosa with regressive marginal changes, a hypervascularized monophasic synovial sarcoma of the wrist joint, and an enchondroma of the second metacarpal bone. Following the amputation of the forearm, no radiotherapy or cytotoxic therapy was performed. After a follow-up time of one year no metastases were detected.

[A new treatment method for hydrochloric acid burns of the hand]. / Eine neue Behandlungs-methode von Flusssäure-Verätzungen der hand.

The progression of hydrofluoric acid corrosion on the hands, which cannot be arrested by other means and leads to crippling or amputation, can be stopped by one single or several repeated intra-arterial perfusions of 10 ml 20% calcium-gluconate solution in 40 ml normal saline over 4 hours as close to the defect as possible via the brachial artery or one of the forearm arteries. In 4 patients, with corrosion of a severity judged to be between first and third degree, spontaneous healing resulted after this treatment. Based on our experience we advise the use of intra-arterial perfusion and show its advantages over subcutaneous injections or intravenous infusion of calcium.

[A new treatment method of hydrofluoric acid burns of the extremities]. / Eine neue Behandlungsmethode von Flusssäureverätzungen an den Extremitäten.

A new method to arrest the unremitting progression of hydrofluoric acid burns, which occurs in the absence of appropriate therapy, is described. The treatment consists of repeated perfusions of calcium gluconate into one of the arteries supplying the affected areas. To date 11 patients have been treated in the described manner, and the therapy brought about recovery in all cases, with little loss of tissue or function.

[Behavior of reactive shaft pseudarthroses of the canine radius in the electric and electromagnetic fields]. / Verhalten reaktiver Schaftpseudarthrosen des Hunderadius im elektrischen- und elektromagnetischen Wechselfeld.

In 27 beagles, 19 radius shaft pseudarthroses and 8 tibia were stimulated either by directly applied alternating current of low frequency and strength, delivered from an implanted battery source, or by a pulsing electromagnetic field inductively coupled to bone. Increase of periosteal callus was only found beneath parallel sling electrodes placed on pseudarthroses parallel to the radius shaft. Stimulation by transverse electrodes implanted into bone produced no significant increase of osteogenesis and bone healing, evaluated by x-rays, scintigrams, and morphometry when compared with contralateral leg controls.