[Timing indications for plastic surgery interventions in burns in the area of the neck and across joints]. / Zeitliche Indikation zu plastisch-chirurgischen Eingriffen bei Verbrennungen im Bereich des Halses und über Gelenken.

From 1985 to 1988, 120 patients underwent opertations. 200 times because of deep dermal or total dermal thermal injury. On the basis on the pathophysiology of tissue repair and scar contracture after burns as well as our experience we conclude that the first aim of the surgeon should be to avoid granulation tissue, the precursor of contracting scars. Only the immediate transplantation of autologous skin onto the surgically created wound after excision of burned tissue can halt the repair process. Flaps are the treatment of choice for reconstruction of existing contracturs deep in the fascia.

[Long-term results following reconstruction of the tendon of the extensor pollicis longus muscle by transposition of the tendon of the extensor indicis muscle]. / Langzeitresultate nach Rekonstruktion der Sehne des M. extensor pollicis longus durch Transposition der Sehne des M. extensor indicis.

Twenty-six patients with injury of the tendon of the extensor pollicis longus have been studied and the long term results of the transfer of the tendon of the extensor indicis are reported. Using Geldmacher's evaluation scheme for assessment of the results of extensor tendon reconstruction we found thirteen excellent, ten good, and three fair results. The prognosis is dependent upon the kind of injury and the time after injury of the transfer of the tendon of the extensor indicis.

[A morphological study of the peri- and epineurium in the compression zone of the median nerve in carpal tunnel syndrome]. / Morphologische Untersuchungen am Peri- und Epineurium aus dem Kompressionsbereich des Nervus medianus bei Karpaltunnelsyndrom.

The structure of the peri- and epineurium of the median nerve in the carpal tunnel syndrome was studied by light and transmission electron microscopy. Electron microscopy confirms the flattened lamellar arrangement of the perineurial cells, but in contrast to the normal architecture the perineurial component of the median nerve in carpal tunnel syndrome consists of 20-25 layers of ramified squamous-type cells, each layer being separated from the adjacent one by a wide space containing thick bundles of collagen fibrils. The perineurial cells are bounded on both sides by a basement membrane which is of substantial thickness. A prominent feature is the occurrence of multiple pinocytotic vesicles and caveolae opening on both the internal and external aspects of the flattened cells. They also contain bundles of closely aggregated filaments. In the spaces between the perineurial cells we find, in some places, extremely disoriented and individually abnormal fibrils and fine filaments arranged in form of a spider web. Matrix vesicles can also be seen. The epineurium of the median nerve in the carpal tunnel syndrome is also considerably thickened, and the attachment is solid, so that the median nerve is relatively immobile constricted like an hourglass. The thick collagen fibers are orientated predominantly parallel to the axis of the nerve, but circular fibers can also be seen. Apart from fibroblasts, the outer layer of the epineurium contains mast cells and vasa nervorum as well as myelinated nervi nervorum. Variable quantities of fat are also present, particularly in the surrounding loose connective tissue.

[Results of comparative studies of Strömbeck and Skoog breast reduction-plasty]. / Ergebnisse vergleichender Untersuchungen bei der Mammareduktionsplastik nach Strömbeck und Skoog.

Long-term results in reduction mammaplasty can be evaluated at the earliest after one year. Criticism about the result induced us to apply more often the technique of Skoog beside the procedure of Strömbeck. A follow-up study of 110 patients could be done. Objective parameters were considered as well as subjective factors. Special attention was paid to diagnosis of cancer after mammaplasty.

[Differential diagnosis, operative procedure and prognosis in complicated syndactylies]. / Differentialdiagnose, operatives Vorgehen und Prognose bei komplizierten Syndaktylien.

Two cases of congenital syndactyly of all fingers are presented. Special anatomical abnormalities found during the operations are discussed. The correlation with an anatomically and ontogenetically well-founded classification provides knowledge for use in the individual case which may be helpful in selecting the proper surgical procedure, in establishing a schedule, and in providing the prognosis.

[Long-term experiences in plastic surgery treatment of radiation damage]. / Langzeiterfahrungen in der plastisch-chirurgischen Behandlung von Strahlenschäden.

Over a period of 22 years the authors reconstructed 49 patients with radiation injuries of varying severity. The retrospective study examined the indications for the radiation therapy, the interval between the treatment and the development of tissue damage, its site and severity. A few typical case reports are presented. Particular aspects emerging from this series, the reconstructive methods used and the results achieved with regard to partial or complete excision of radiation damaged skin are discussed.

[Plastic surgery reconstruction of late sequelae following burns of the hands]. / Plastisch-chirurgische Wiederherstellung von Spätfolgen nach Verbrennungen der Hände.

Late consequences of burns of the hands can be divided into four types depending on their extent and the involvement of the underlying tissue structures. Of 88 hands operated on, 43% were Type I, 28% were type II, 25% were type III, and only 4% belonged to the mutilating type IV. Clinical examples of types I and III are shown. Type I requires operation on the skin only to restore full function of the hand, whereas type III also needs repeated surgical treatment of the dorsal apparatus, tendons, ligaments and joints to improve hand movement.

[Mamma augmentation with homoeoplastic fatty tissue. Long term observations (author's transl)]. / Mammaaugmentation mit homoplastischem Fett. Langzeitverläufe und deren Interpretation.

The report covers three cases of mamma augmentation with homoeoplastic fatty tissue, performed elsewhere. The defence reaction takes a three-phase course: 1st Phase: Clinically asymptomatic, with autolysis and capsule formation (1 to 8 years), 2nd Phase: intermittant complaints, hardening of the mammae and enlargement of lymph nodes (after 4 to 91/4 years), 3rd Phase: Acute mastitis (after 5 to 91/4 years). The long-term developments show that mamma augmentation with homoeplastic fatty tissue is a method which is detrimental to health.

[Malformation syndrome with constriction rings, pseudoligaments, acral defects and syndactylism: diagnosis and treatment (author's transl)]. / Fehlbildungssyndrom mit Schnürfurchen, Pseudoligamenten, akralen Defekten und Syndaktylie: Diagnose und Therapie.

Congenital constricting bands of the extremities, pseudo-ligaments, distal defects of fingers and syndacatyly are all characteristic marks of this syndrome. At least two of the features must be present to make the diagnosis. The authors' results are reported and experience in paediatric hand surgery is essential. This should be performed as early as possible. Operative techniques are described.

[Late results of shape-improving and shape-preserving mammaplasties: indication and selection of procedure (author's transl)]. / Spätergebnisse nach formerhaltenden und formverbessernden Operationen an der weiblichen Brust. Indikation und Verfahrenswahl.

Results of shape-improving and shape-preserving operations to a woman's breast and the quality of the operation method cannot be assessed until a number of years later. Subsequent processes entailing alteration in the structure of the skin and subcutaneous tissue, gliding down of gland tissue to Mm. pectoralis, broadening of vertical scars, and complications to the remaining gland tissue may basically vary the results obtained. Late results and view points leading to the selection of procedure will be discussed and compared with those in the literature.

[Surgical treatment of malformations of the hand (author's transl)]. / Chirurgie der Fehlbildungen der Hand

The frequency of malformations of the hand is estimated at 0.5 percent of live births. The course of early developmental processes makes early correction advisable. Knowledge of the special anatomy and mastery of the microsurgical operation techniques makes this possible. The main indications and methods that hve been tested are discussed.