[Rehabilitation of amputees]. / Die Rehabilitation amputierter Patienten.

An optimal rehabilitation result following amputation in each individual case depends on the smooth cooperation of the surgery department and the rehabilitation clinic. Equally important ist the good cooperation between physicians, physical therapists and orthopedic technicians. A decisive influence on the outcome of rehabilitation is already exercised with the choice of height of the amputation site and the operative technique. A positive development can be intensified by an early prosthesis fit and practice. It is imperative that the amputation be seen as the beginning of the patient's rehabilitation and not as a failure and the end of efforts to preserve the extremity. The degree of mobility achievable depends very decisively on the patient's remaining ability and will to succeed.

Neuralgic amyotrophy of the lumbar area. Case report.

Two cases of a rare peripheral neurological disease (neuralgic amyotrophy of the lower extremity) are presented, with clinical symptoms (severe sciatic pain with motor paresis) that pose differential diagnostic difficulties against a hernia of a lumbar disk. Because of a tendency to heal by itself, the disease has a good prognosis. The diagnosis is based on a process of exclusion of herniated disks, lesions of the lumbar plexus in tumors or after radiation therapy, hematoma of the psoas after coagulation disturbances, birth, or trauma, and nutritive disruptions of the nervous system as in diabetes mellitus. Knowledge of the symptoms of this--in orthopedics--mostly unknown disease and critical interpretation of the clinical and medical-technical data are important to avoid wrong indications for surgery.

[Mobilization of the partially stiff shoulder under anesthesia (ankylosing humeroscapular periarthritis)]. / Narkosemobilisation der Schulterteilsteife (Periarthritis humeroscapularis ankylosans).

"Humeroscapular periarthritis" (HPA) was first described by Duplay in 1872 and is to be understood as a syndrome whose typical symptoms are pain and partial or total stiffness of the shoulder ("ankylosing" HPA). This term includes all regressive and reactive affections occurring in the region of the shoulder joint proper (Refish and van Laack, 1985), and has meanwhile become a synonym for painful shoulder stiffness, a term which covers many different processes which are not covered in detail here. Today, however, thanks to refined clinical and radiological examination methods, it is often possible to detect objectively at least some of the changes and to gain insights into the pathophysiological processes. The goal of treatment of HPA is to restore the function of the shoulder joint and eliminate the pain. To this end, various forms of treatment are fundamentally available: 1) conservative treatment, with medication and physiotherapy; 2) surgical treatment; and 3) mobilization under anesthetic, with which, comparatively speaking, results have been best.