Heat recordings at tips of Kirschner wires during drilling through human phalanges.

The temperature was recorded during drilling through fresh human cadaveric fingers with thermocouples built in the tips of Kirschner wires. High temperatures up to 190 degrees C were measured. This may contribute to osteonecrosis around the wires and to loosening and infections.

Results of small-joint arthrodesis: comparison of Kirschner wire fixation with tension band wire technique.

In a retrospective study the results of 203 interphalangeal and metacarpophalangeal arthrodeses performed between 1977 and 1990 were reviewed. Eighty-three percent of the cases involved severe hand injuries. Two fixation techniques were used. During the early period, 143 arthrodeses were performed with percutaneous Kirschner wires, combined with either interosseous wiring or plaster of Paris. From 1987 to 1990, 60 arthrodeses were performed with the use of tension band fixation. In the Kirschner wire group 18% of the patients had pin-track infections, and in 15% rearthrodeses were necessary. In the tension band group 2% of the patients had an infection, and in 5% rearthrodeses were performed. Both the infection rate and the rearthrodeses rate were significantly lower in the tension band group than in the Kirschner wire group. Judging from this study, the tension band fixation technique is the method of choice for arthrodeses of the small finger joints.

The effects of negative regional lymph-node dissection on survival and disease-free interval of patients with stage-I malignant melanoma.

A group of 46 patients, with stage-1 malignant melanoma of intermediate thickness and histologically proven negative regional lymph nodes, was retrospectively reviewed. The aim of our study was to determine whether the prognosis of these patients had been worsened by the regional lymph-node dissections. There was no influence on the survival or disease-free interval.

Anatomical and functional results after treatment of dislocated supracondylar fractures of the humerus in children.

From 1972 to 1983 105 patients were admitted with a dislocated supracondylar fracture of the humerus. The average follow-up was five years. In general the functional results of treatment were good. The anatomical results were less satisfactory, and most times concerned varus deformities of the elbow, which did not influence the elbow function. Lesions of arteries and nerves only occurred in seriously dislocated fractures. The isolated nerve injuries were reversible. Two patients developed a Volkmann's ischemic contracture; their case history is discussed. In 24 cases a second reduction was performed and/or a new therapy instituted. Closed reduction with plaster necessitated alteration of the therapy in 10 out of 23 cases. Based on this experience and the long average duration of hospitalization of 14 days, closed reduction under general anaesthesia with percutaneous K-wire fixation seems to be the treatment of choice.