[Midterm results following denervation of the ankle]. / Mittelfristige Ergebnisse nach Sprunggelenkdenervation.

BACKGROUND: Complications related to arthrodesis of the ankle or total ankle replacement require a critical assessment of the indication. Using denervation of the ankle, we have the possibility to delay the above-named surgical treatment for a number of years. The aim of this follow-up study was to review the results of ankle denervation after several years. METHODS: Within a follow-up examination, we were able to evaluate the results of 45 patients an average of 102 months following ankle denervation. RESULTS: A total of 82.2% of patients indicated an improvement of pain for an average of 60.9 months; 71.1% of patients reported that the operation was worthwhile. The AOFAS score improved from an average 37.9 (range 26-68) preoperatively to 55.6 (range 24-84) at follow-up. CONCLUSIONS: Ankle denervation can achieve good ankle pain reduction in the treatment of ankle arthrosis. Denervation should be considered a long-term treatment concept.

[Distal phalangeal fractures of the finger. Results of conservative and surgical treatment]. / Der streckseitige Endgliedbasisbruch am Finger. Ergebnisse nach konservativer und operativer Behandlung.

BACKGROUND: In this study 56 dorsal phalangeal fractures of the distal segment were classified regarding morphological criteria. MATERIAL AND METHODS: Clinical and radiological results after 4 months were analyzed. Fractures including subluxation of the distal interphalangeal joint occurred rarely (n=3) and were treated by surgery. Fractures without subluxation had either a triangle-shaped fragment (n=40) or a fragment similar to a hunter's hat (n=9). Furthermore, there were two fractures with a tiny bony avulsion and two fractures with more radial or ulnar-oriented fragments. The triangle and hunter's hat type fractures were treated either by splinting (n=20) or by open reduction and stabilization with screws and wires (n=29). RESULTS: Clinical outcome was similar in both groups. In 12 out of the 20 fractures treated by splinting a stepping of the joint surface had to be tolerated. Initially only 8 out of 20 fractures showed a stepping of the joint surface. The fractures treated by surgery showed a better radiological outcome. CONCLUSIONS: Initially 27 fractures showed a stepping in the joint line but after surgical treatment only 9 fractures still presented a stepping. The remaining four fractures were successfully treated by splinting.

[Assessment of force patterns of different primary grips through dynamic force measurement using a sensor glove]. / Erfassung der Kraftprofile verschiedener primärer Griffe durch dynamische Kraftmessung mit einem Sensorhandschuh.

The present study analyses force distribution patterns during primary grips. 10 subjects were examined using the TUB-sensor glove, which was equipped with 10 pressure sensors. 5 proximal sensors at the MCP joints and 5 distal sensors at the DIP joints were attached palmarly. 9 different gripping motions were examined: the cylinder grip using 4 different objects, the pinch grip and 4 different kinds of precision grips. The force distribution patterns can be clearly divided into 2 groups. On the one hand there are the "power grips", in which the force is distributed over the proximal and distal sensors. On the other hand there are the "precision grips", which only show a force distribution at the distal sensors. Therefore Napier's concept of the existence of primarily 2 gripping patterns, which is based on visual analysis, can be verified objectively. For the "power grips" the force distribution is shifted further distally with increasing size of the objects. In conclusion, their distribution pattern shifts towards the pattern of the "precision grips". At the small finger the distal sensor is already dominant during the "power grips" of smaller objects. The thumb plays a subordinate role during the "power grip" of smaller objects, since these grips are similar to the "closing fist motion" and the objects can be held between the fingers and the palm of the hand. However, with increasing object sizes the thumb gains more importance, since its opposing movement is now required to accomplish the grip.

An insight into domain combinations.

Domains are the building blocks of all globular proteins, and are units of compact three-dimensional structure as well as evolutionary units. There is a limited repertoire of domain families, so that these domain families are duplicated and combined in different ways to form the set of proteins in a genome. Proteins are gene products. The processes that produce new genes are duplication and recombination as well as gene fusion and fission. We attempt to gain an overview of these processes by studying the structural domains in the proteins of seven genomes from the three kingdoms of life: Eubacteria, Archaea and Eukaryota. We use here the domain and superfamily definitions in Structural Classification of Proteins Database (SCOP) in order to map pairs of adjacent domains in genome sequences in terms of their superfamily combinations. We find 624 out of the 764 superfamilies in SCOP in these genomes, and the 624 families occur in 585 pairwise combinations. Most families are observed in combination with one or two other families, while a few families are very versatile in their combinatorial behaviour. This type of pattern can be described by a scale-free network. Finally, we study domain repeats and we compare the set of the domain combinations in the genomes to those in PDB, and discuss the implications for structural genomics.

Domain combinations in archaeal, eubacterial and eukaryotic proteomes.

There is a limited repertoire of domain families that are duplicated and combined in different ways to form the set of proteins in a genome. Proteins are gene products, and at the level of genes, duplication, recombination, fusion and fission are the processes that produce new genes. We attempt to gain an overview of these processes by studying the evolutionary units in proteins, domains, in the protein sequences of 40 genomes. The domain and superfamily definitions in the Structural Classification of Proteins Database are used, so that we can view all pairs of adjacent domains in genome sequences in terms of their superfamily combinations. We find 783 out of the 859 superfamilies in SCOP in these genomes, and the 783 families occur in 1307 pairwise combinations. Most families are observed in combination with one or two other families, while a few families are very versatile in their combinatorial behaviour; 209 families do not make combinations with other families. This type of pattern can be described as a scale-free network. We also study the N to C-terminal orientation of domain pairs and domain repeats. The phylogenetic distribution of domain combinations is surveyed, to establish the extent of common and kingdom-specific combinations. Of the kingdom-specific combinations, significantly more combinations consist of families present in all three kingdoms than of families present in one or two kingdoms. Hence, we are led to conclude that recombination between common families, as compared to the invention of new families and recombination among these, has also been a major contribution to the evolution of kingdom-specific and species-specific functions in organisms in all three kingdoms. Finally, we compare the set of the domain combinations in the genomes to those in the RCSB Protein Data Bank, and discuss the implications for structural genomics.