ABSTRACT
In a ten-year-old boy with an atypical partial post-partum paresis of the dextrolateral plexus brachialis the function of the shoulder was affected substantially and the flexion of the elbow completely. The musculature of the forearm and hand was preserved completely from the anatomical and functional aspect. In compliance with the parents wish, the possibility of replacement with a muscle from a remote site by microsurgical transfer was abandoned and the authors used the well known method of transposition of the insertion of the m. pectoralis major and new retrograde transposition of the tendon of the m. flexor carpi radialis into this muscle to restore the function of the m. biceps brachii. Through postoperative rehabilitation, 90 degrees flexion of the elbow in a supine position was achieved.
Subject(s)
Brachial Plexus/physiopathology , Elbow Joint/physiopathology , Paresis/surgery , Pectoralis Muscles/transplantation , Surgical Flaps , Child , Humans , Joint Diseases/etiology , Joint Diseases/surgery , Male , Microsurgery , Muscular Atrophy/etiology , Paresis/complications , Paresis/rehabilitation , Physical Therapy Modalities , Range of Motion, Articular/physiology , Supine Position , Tendons/transplantationABSTRACT
The author presents his long term experience with his own modification of opposition operation of the thumb in peripheral paresis of the trunk of n. medianus. He describes in short the operation procedure, which is very simple both for the surgeon and the physiotherapist. In a group of 110 operated patients he showed that the results of surgery are very good, but the cooperation of the surgeon and of the physiotherapist in the early rehabilitation of the operated hand is most important.
Subject(s)
Median Nerve/surgery , Paresis/surgery , Thumb/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Muscle, Skeletal/transplantation , Peripheral Nervous System Diseases/rehabilitation , Peripheral Nervous System Diseases/surgery , Physical Therapy Modalities , Tendons/transplantation , Thumb/physiologyABSTRACT
From 5-cyano-3-chloro-2-pyrazinecarboxamide) (II) hydrolysis in acid medium) yielded 3-chloro-2,5-pyrazinedicarboxamide (III), which in a reaction with sodium hydrogensulfide in dimethyl-formamide) yielded 3-mercapto-2,5-pyrazinedicarboxamide (IV). This compound through condensations with alkyl- and arylhalogenides in triethylamine) yielded 3-alkyl(or aryl) thio-2,5-pyrazinedicarboxamides of type I. The structure of compounds was confirmed by elemental analysis, IR and 1H NMR spectra. A microbiological evaluation was carried out; the antituberculous effect of these compounds is not higher than that of pyrazinamide.
Subject(s)
Pyrazines/chemistry , Mycobacterium tuberculosis/drug effects , Nontuberculous Mycobacteria/drug effects , Pyrazines/pharmacologyABSTRACT
The author presents a new technique of dynamic operation designed to restore the opposition of the thumb in cases of distal median nerve paralysis affecting muscles of the thenar. The technique makes use of the function of the long flexor of the thumb as the basic motor unit to make up for the lost opposition of the thumb by means of a tendon graft from the m. palmaris longus or m. flexor digiti IV superficialis. Referring to literary sources and to his own surgical results, the author shows the simplicity of the operation and the usefulness of early rehabilitation for the restoration of the grasping function of the human hand.