Implantation of a denaturated cellulose adhesion barrier after plate osteosynthesis of finger proximal phalangeal fractures: results of a randomized controlled trial.

Adhesions after osteosynthesis of finger proximal phalangeal fractures often cause stiffness. To minimize adhesions, the use of an adhesion barrier has been proposed. The results until now have not been convincing. The aim of this prospective randomized trial was to evaluate the use of an adhesion barrier. The trial included any isolated, closed proximal phalangeal fracture needing plate osteosynthesis. The patients were randomized into two groups: with or without application of the adhesion barrier. The outcomes we measured were finger ranges of motion and DASH score at 6 weeks and 6 months post-operatively. A total of 42 patients (42 fingers) entered the study; 37 completed the study. The key baseline characteristics were comparable. At 6 weeks there was a trend favouring the adhesion barrier that disappeared at 6 months. Overall the results do not support the use of this device.

[Ten Cases of Cryptotia Corrected using Ono's Technique]. / Zehn Fälle von Kryptotie, korrigiert mit der Ono Technik.

Cryptotia is a very rare condition of ear deformity found in Europe which is more common in Asian populations. The upper ear portion is hidden and fixed in a pocket of skin of the mastoid. Conservatively, this deformity can be treated by molding of the posterior sulcus starting early after birth. Various surgical procedures are described in the literature. We successfully operated on a total of 10 ears of 9 patients with the technique described by Ichiro Ono in 1995. Here, a triangular flap is raised above the ear to reconstruct the posterior sulcus together with a rhomboid-shaped flap in the anterior part of the ear in order to elongate the helix. Among all patients, regular contours and a stable and successful outcome was observed.

Semi-occlusive dressing for the treatment of fingertip amputations with exposed bone: quantity and quality of soft-tissue regeneration.

Nineteen fingertip amputations with exposed bone were treated with a semi-occlusive dressing. The quantity and quality of the regenerated soft tissue was examined. In all 19 fingers there was sufficient uncomplicated healing such that secondary surgical procedures were not needed. At follow-up 6-18 months after the injury, soft tissue thickness around the bone of the distal phalanx measured 6.0 mm (SD 1.6) on the palmar aspect (opposite side 7.0 mm (SD 0.8)) and 4.2 mm (SD 1.7) distally (opposite side 4.5 mm (SD 0.8)). The two-point discrimination was 4 mm (SD 2) (opposite side 3 mm (SD 1)). The skin healed almost without scarring and the dermal ridges reformed. The regeneration of the soft tissue thickness to almost 90% of its former extent is higher than we expected.