[Modified collateral ligament reconstruction with the tendon of the abductor pollicis tendon in treatment of chronic radial instability of the basal thumb joint]. / Modifizierte Seitenbandplastik mit der Sehne des M. abductor pollicis brevis zur Behandlung der chronischen radialen Instabilität des Daumengrundgelenkes.

Injuries to the radial collateral ligament of the MP joint of the thumb occur much less frequently than injuries to the ulnar collateral ligament. Ligament injury is usually a result of direct trauma. The resultant instability to the thumb usually impairs hand function. In acute lesions to the radial collateral ligament, direct repair is often possible. In cases of chronic radial joint instability, secondary ligament reconstruction with a free tendon graft, most commonly the palmaris longus tendon, is usually recommended. We describe another technique using the tendon insertion of the abductor pollicis brevis muscle. The tendon inserting distally can be used as a stable ligament after dividing it at the border to the muscle and attaching it to the head of the metacarpal bone with a wire. The follow-up for six patients treated by this method showed good and painless stability and function of the thumb in a time span of one year.

[A three-year aid program for plastic surgery in Peshawar (Pakistan). Ongoing management of severely injured patients of the Afghanistan war: 1,528 large operations, 5,171 smaller interventions, 15,932 patients examined]. / Ein dreijähriges Hilfsprogramm für Plastische Chirurgie in Peshawar (Pakistan). Kontinuierliche Versorgung schwerverletzter Patienten des afghanischen Krieges: 1528 grosse Operationen, 5,171 kleinere Eingriffe, 15,932 untersuchte Patienten.

Since 1980 Interplast Germany has sent many plastic surgeons to developing countries. In 1989 a new Interplast Germany program for helping Afghan refugees in Pakistan's Peshawar was started. The Federal Republic of Germany financed the first two years; thereafter, the European Community and Help supported the project. Twenty-four teams with 123 nurses, surgeons and anesthesiologists operated on 1,528 patients in two hospitals. In the same period 5,171 smaller operations have been performed and 15,932 patients have been examined. Low expense for the teams, good support by officials, and professional administration have made this project highly effective for 3 years.

[Therapeutic consequences of contamination injuries by highly radioactive substances]. / Therapeutische Konsequenzen bei Verletzungen mit Kontamination mit hochradioaktiven Stoffen.

A case of plutonium injury of the left hand is used to explain the correct management. In addition to radical surgical excision under repeated monitoring of radioactivity, it is obligatory to commence parenteral chelation therapy with DTPA. Close cooperation with radiological technologists is necessary. Discharges and used bandages have to be analysed for their radioactive content before elimination as radioactive waste. Isolation of the patient is not required. The relevant government department has to be contacted. A health center for radiation victims with special measuring equipment is desirable.

[Conservative treatment of fractures of the scaphoid bone--indications]. / Konservative Behandlung von Kahnbeinfrakturen--Indikationen.

Healing-up of the bone is achieved by immobilization in 96 to 98% of all recent scaphoid fractures. The average immobilization period is eleven weeks. Different methods of immobilization are used. The majority of authors apply an upper arm plaster cast including the thumb for a period of six weeks and then a forearm plaster cast. Even fractures showing a delayed healingup of the bone can be cured in more than two thirds of the cases by prolonged immobilization. In case of dislocated and not reducible fractures as well as fractures with great fragment diastases, conservative treatment with a fist plaster cast should only be performed exceptionally, for example if there is an increased anesthesia risk. In case of negative X-ray findings (four planes) and only clinical suspicion of scaphoid fracture, an initial fracture therapy is recommended with repeated X-ray examination 14 days later. Most of the fractures which have not healed up are vertical oblique fractures within the proximal third, fractures with great diastases, or fractures which have not been immobilized long enough.

[Fibrin adhesive in the surgical treatment of pseudarthrosis of the scaphoid bone--method and results]. / Fibrinklebung bei der operativen Behandlung der Kahnbeinpseudarthrose--Methode und Ergebnisse.

In 50 cases of pseudarthrosis of the scaphoid bone the operative technique of Matti and Russe was applied using fibrin adhesive in addition to a cortico-cancellous bone graft from the iliac crest to secure the fixation of the graft. 48 patients were re-examined. 27% showed bone consolidation after 3 months, 60% after 6 months or more. The total consolidation rate was 87%. It is not quite sure whether the better results are due to fibrin adhesive or not, especially when the consolidation took place after 6 month or more.