[Post-traumatic osteoid osteoma of the hand. A rare cause of chronic pain. Case report and review of the literature]. / Posttraumatisches Osteoidosteom an der Hand. Eine seltene Ursache chronischer Schmerzen Fallbericht und Literaturübersicht.

One year after a nonspecific trauma and with a history of pain of four weeks only, an osteoid osteoma of the first phalanx of the left thumb was diagnosed in a 31-year-old man. The radiologic appearance as well as a bone scan were suggestive for an osteoid osteoma. The diagnosis was confirmed histologically after resection of the tumor. As indicated in the literature, osteoid osteoma of the hand is relatively rare. The symptoms and radiologic features (osteolytic nidus and sclerosis) of osteoid osteomas are independent of the tumor location. Surgery with resection of the nidus is the only known curative therapy. The etiological role of trauma is discussed and a review of the literature is done with 15 other cases of posttraumatic osteoid osteoma having been reported.

Scar sarcoidosis in a patient with Crohn's disease.

A patient with scar sarcoidosis and Crohn's disease is described. The possibility of patients with Crohn's disease being more prone to develop sarcoidosis is discussed.

[Defect coverage with a bilobed flap with reference to special aspects regarding the nose]. / Defektdeckung mit einem zweizipfeligen Lappen unter Berücksichtigung spezieller Aspekte der Nase.

Defects at the dorsum or tip of the nose are a special challenge for plastic surgeons. Considering the tough skin, primary closure is normally not possible. As full-thickness skin grafts are not satisfactory, we strive for defect-coverage using adjacent skin. One possibility is the bilobed flap which can be used all over the body. Indications, special planning, and technique as well as several variations of the bilobed flap in the nasal region are discussed.

[Management of lateral type B malleolar fracture with penetrating wires, cerclage and hemicerclage]. / Versorgung der lateralen Malleolarfraktur Typ B mit Spickdrähten, Cerclagen und Hemicerclagen.

In this retrospective study 52 cases of malleolar fractures type B, that were treated with Kirschner wires, cerclages and hemicerclages, between 1981 and 1991 at the Männedorf Hospital, were compiled and completed with the corresponding synopsis. The results show that the osteosynthesis technique, in certain cases, is absolutely justifiable and represents a reliable alternative to tensile screw osteosynthesis. This procedure of osteosynthesis is a good method in comminuted fractures as well as osteoporotic bone, in which the screws grip badly. A minimum of osteosynthesis material is implanted in precarious soft tissue conditions. As in the tensile screw osteosynthesis, the removal of the material can be done ambulatory under local anaesthetic with stab incision. The functional after-treatment is not recommended. We suggested a postoperative plaster of Paris treatment for 6 weeks (2 weeks without and 4 weeks with strain). As the postoperative course shows comparable results, osteosynthesis of the lateral malleolar fracture type B with Kirschner wires, cerclages and hemicerclages represents a good variation to plate osteosynthesis and tensile screw osteosynthesis.

[Necrosis of the terminal ileum after drug poisoning. Case report]. / Nekrose des terminalen Ileum nach Tablettenintoxikation. Fallbericht.

In an attempt to commit suicide, a 32-year-old women swallowed a vast amount of psychiatric drugs, i.e. tranquilizers, amphetamines, hynotic and antidepressant agents. By intensive care, using high doses of catecholamines and appropriate antidota, satisfactory circulation and oxygenation could be maintained. 3 days after admission a peritonitis became apparent. A 50 cm long section of the distal ileum was found to be completely necrotic and had to be resected. However, circulation of the correspondent mesenterium was not disturbed at all. A drug-induced non-occlusive intestinal ischemia was postulated to be the pathophysiological mechanism of intestinal necrosis. Non-occlusive intestinal ischemia is rare; it has been reported in young adults intoxicated by cocaine or phenobarbital, in children with high overdosage of iron compounds, in elderly individuals suffering from low-output congestive heart disease and in patients treated with digitalis drugs, with or with or without overdosage.