[Treatment of instability of the metacarpophalangeal and trapeziometacarpal joints of the thumb]. / Behandlung der Instabilität des Daumengrund- und des Daumensattelgelenks.

Restoration of stability of the thumb represents an enormous gain of function for the patient and can be achieved by arthrodesis or ligament reconstruction. Ligament reconstruction should only be performed if good stability and mobility and a pain-free grip can also be achieved. In every case surgery must protect the delicate soft tissues and should be based on a profound knowledge of the anatomical and biomechanical circumstances. Instability of the trapeziometacarpal joint is rare but metacarpophalangeal joint instability (ulnar, palmar and radial) is relatively frequent. For both conditions arthrodesis is the most frequently used and easier surgical procedure. Ligament reconstruction is more difficult to perform but can maintain the mobility of these joints.

[Treatment of fingertips]. / Infektion der Fingerbeere.

OBJECTIVE: The goal of excision of a subcutaneous abscess in the distal pulp of the fingertip is the fast and complete removal of the infected and devitalized tissue. INDICATIONS: Every acute infection of the fingertip. CONTRAINDICATIONS: Atypical infections, e.g., Herpes, Orf's disease, mycobacterial infections. SURGICAL TECHNIQUE: Excision of the infected area in the fingertip without damaging the digital nerves and their branches. POSTOPERATIVE MANAGEMENT: The wound is left open and is covered with a moist dressing. RESULTS: Early targeted incision brings good functional and cosmetic results.

[Treatment of paronychia]. / Die Nageltascheninfektionen der Finger - Behandlung der Paronychien.

OBJECTIVE: The procedure is selected based on the stage of infection with careful removal of the focal infection in the area of the nail fold. INDICATIONS: All infections of the periungual area. CONTRAINDICATIONS: Herpes infections [1, 12]. All purulent infections of the periungual area should be eliminated. SURGICAL TECHNIQUE: Opening of the abscess, excision of the eponychium, mobilization of the nail barrier away from the nail plate, inzision of the nail barrier at a defined place, necrosectomy, irrigation, and drainage. POSTOPERATIVE MANAGEMENT: Moist dressings and fingerbaths in the first few days. RESULTS: In most cases, the infection heals completely without substantial scar formation.