Biomedical subjects

B D Partecke

Publications and source records attributed to B D Partecke.

At least 19 recordsLinked to original sources

PubMed2001

[Anatomy of the dorsal mid-hand arteries--anatomic study and review of the literature].

By dissections of 20 cold-preserved hands, we investigated the dorsal metacarpal arteries (DMA) with regard to reliability, origin and anastomoses. The first dorsal metacarpal artery showed a trifurcation with three vessels: Ramus ulnaris (A. metacarpalis dorsalis I), Ramus medialis and Ramus radialis (A. ulnodorsalis pollicis). The DMA II to IV were observed medially in their respective intermetacarpal spaces. The A. metacarpalis dorsalis V was unreliable in reaching the skin of dorsal proximal phalanges as in the DMA IV. Most reliable for reaching the skin of dorsal proximal phalanges were the radial arteries--first, second and third dorsal metacarpal arteries. The dorsal digital arteries originate close to one another at the level of the metacarpophalangeal joints. There was an increase of epifascial position, from radial to ulnar. Irregular palmar intermetacarpal anastomoses were found proximal to the ligamentum metacarpale transversum profundum but nearly consistently in the web space.

Arteries↗

PubMed2001

[Covering defects of the basal finger area by pedicled flaps anastomosed to the doral metacarpal arteries].

Between 1993 and 1998, 12 distally based dorsal metacarpal artery flaps were used to cover defects of the fingers and palm. All flaps were raised from the dorsum of the hand. Eleven flaps allowed direct closure of the donor site area; one case required a full-thickness skin graft. Nine flaps healed uneventfully. Distal marginal flap necrosis occurred in three cases. All of these were used to cover defects at the distal part of the middle phalanx.

Adolescent↗

PubMed2001

[Operative treatment of vulnerable scars and deep soft-tissue defects of the thumb with a free toe pulp neurovascular flap].

Because of the capability of opposition, the thumb is the most important digit of the hand. In case of deep soft-tissue defects of the pulp, it is necessary to reconstruct the palmar surface of the distal phalanx of the thumb using tissue with good sensibility. Between 1982 and 1998 at the Department of Hand Surgery, Plastic and Microsurgery of the Berufsgenossenschaftliche Unfallkrankenhaus Hamburg, we used a free toe pulp neurovascular flap for reconstruction of the pulp of the thumb in nine patients. All flaps healed without complications. Indications, operative techniques, and results of this procedure are described.

Adolescent↗

PubMed2000

Callus distraction in the hand skeleton.

From 1992 to 1996, 27 patients with traumatic amputations or malformations underwent lengthening of thumb and fingers. A total of 36 procedures were carried out. In several cases, deepening of the web space or bone transplantations proved to be necessary to improve general function or to compensate for missing bone structure. Complications included pin-track infections, necrosis of bone, non-union and scarring. Overall the results indicate that distraction of the thumb and fingers is a feasible operative technique leading to a promising improvement of function.

External Fixators↗

PubMed1999

[Not Available].

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Journal Article↗

PubMed1999

[Persistent scaphoid pseudarthrosis after surgical treatment: results of repeated bone transplantation].

From 1984 to 1993, 30 patients with persistent scaphoid non-union despite bone grafting procedures underwent additional reconstructive surgery. Twenty-five patients were followed-up between one and eleven years after revision with a mean follow-up time of 4.8 years. Fifteen patients had bone graft procedures alone, ten patients had additional internal fixation with the Herbert screw or Ender plate. At follow-up, scaphoid union was achieved in 16 patients (64%), 19 patients had arthritic changes of the radiocarpal joint. Only patients with scaphoid union showed satisfactory functional results. Five patients with failed revision surgery needed further operations for chronic wrist pain, including three wrist arthrodeses.

Adolescent↗

PubMed1999

[Comparison of various evaluation measures for assessment of treatment success after scaphoid injuries].

Different evaluation scores have been developed in order to assess treatment outcome of carpal injuries. The available scores are not comparable and differ in type and number of parameters. This is a retrospective study of 100 patients who presented with a fracture or a pseudarthrosis of the scaphoid from 1983 to 1997. The Cooney and the Meine scores were compared with our own score. While the Cooney score and the newly developed score show an equal distribution of results in all categories, the score of Meine led to an overall better outcome assessment. The comparative evaluation of the different scores shows that the combination of only a few well defined parameters is sufficient for assessing the treatment outcome of carpal injuries.

Activities of Daily Living↗

PubMed1998

[Management and after-care of extensor tendon injuries of the hand].

The investigation and management of extensor tendons play a minor role compared to those of flexor tendons. The finger extension does not seem to be as important as the flexion. But the practical value of the hand is determined by both. Different managements are used depending on the level of extensor tendon injury. More distal located injuries require a longer restraint than those, which are located more proximal. On the one hand this depends on the blood supply of the extensor tendon, which is by far better in the lower arm and dorsal hand than peripheral. On the other hand the reason is the different amplitude of gliding of extensor tendons, which decreases from proximal to distal to lower than 1 mm. Therefore the tension on extensor tendon sutures increases from proximal to distal. The varies techniques of extensor tendon reconstruction will be described.

Aftercare↗

PubMed1998

Ilizarov distraction-lengthening in congenital anomalies of the upper limb.

Nine patients underwent Ilizarov distraction-lengthening for congenital anomalies. All were late cases and had undergone other procedures. In five radial club hand patients with very short forearms, we achieved an average 5.8 cm increase in length with each distraction cycle. In two patients with symbrachydactyly of the cleft hand type, we achieved pinch grip between a radial and an ulnar digit by lengthening the short ray. Another case of the monodactyly type in which we tried to lengthen three transplanted proximal toe phalanges ended in failure. A soft tissue distraction was attempted in a case of camptodactyly but failed. We report the problems we encountered and suggest some solutions.

Activities of Daily Living↗

PubMed1998

[Possibilities of preliminary treatment of infected soft tissue defects by vacuum sealing and PVA foam].

The vacuum sealing technique is a simple and cost-effective method in the treatment of traumatic and chronic soft-tissue defects. Wound cavities are filled with polyvinyl alcohol foam with embedded drainage tubes. The tubes are either drawn transcutaneously through the tissue, or placed epicutaneously, depending on the condition of the wound. The wound including the adjacent skin and the drainage tubes are covered by a transparent vapor transmitting polyurethane film. When the drainage tubes are connected with a vacuum bottle, negative pressure of 60 to 80 kPa is established. The advantages of this vacuum sealing procedure are: protection against wound contamination, complete evacuation of wound fluids independent of gravity and rapid stimulation of dense, well vascularized granulation tissue. Relief of pain and early mobilisation improve the patients comfort. Between November 1994 and July 1996, 25 patients with 28 soft tissue defects underwent this procedure. Wound closure was performed in two cases with a free flap, in five cases by a loco-regional flap, in sixteen cases with mesh-grafts, in three cases by secondary closure of the wound. Two cases were definitively treated with the vacuum sealing technique.

Adolescent↗

PubMed1998

[Surgical treatment of scaphoid pseudarthrosis--long term outcome with the Herbert screws].

Between 1984 and 1993, 131 scaphoid nonunions were treated with iliac crest bone grafting and the Herbert-screw. 105 patients were followed between one and ten years with an average followup period of 4.5 years. Bony union was achieved in 93 patients with improvement of range of motion and grip strength. In 14 patients with DISI-instability, the angulation deformity was incompletely corrected with an average reduction of the scapho-lunate angle of eleven degrees. Limited athritic changes at the radial styloid were noted in 58%, intercarpal in 25% of the patients. Most frequent reasons for persistent nonunion were technical problems with the Herbert-screw.

Adolescent↗

PubMed1998

[The supinator syndrome].

BACKGROUND: The posterior interosseous nerve syndrome is a rare compression neuropathy of the upper limb, which must be differentiated from tennis elbow. The aim of our study is to show etiology, symptoms, and diagnostic methods, and to illustrate the common operative techniques. PATIENTS AND METHODS: We examined retrospectively all patients of the Department for Hand Surgery, Plastic and Microsurgery of the Berufsgenossenschaftlichen Unfallkrankenhaus Hamburg, who underwent operative treatment because of posterior interosseous nerve syndrome between 1984 and 1992. Mobility of the elbow joint, postoperative complaints and patient's satisfaction were analysed. RESULTS: 23% of patients suffered a reduction of motion of the elbow joint, 87% had less pain, and 83% were satisfied with the result of treatment. CONCLUSIONS: The value of preoperative neurophysiological examination for diagnosis of posterior interosseous nerve syndrome is not clear. Clinical examination will allow to differentiate between posterior interosseous nerve syndrome and tennis elbow. To prevent incomplete decompression of the deep radial nerve, multiple locations of compression must be considered.

Elbow Joint↗

PubMed1997

[Reconstruction of thumb through continuous lengthening of the first metacarpus.].

GOAL OF SURGERY: Reconstruction of the amputated thumb through continuous distraction with an Ilizarov ring fixator. INDICATIONS: Traumatic loss of thumb at the level of the proximal half of the proximal phalanx. CONTRAINDICATIONS: Insufficient soft tissue coverage of stump. Stiff saddle joint. POSITIONING AND ANAESTHESIA: Tourniquet. Brachial plexus or general anaesthesia. SURGICAL TECHNIQUE: Installation of a ring fixator. Incomplete osteotomy at mid shaft of first metacarpus with chisel and completion through osteoclasia by twisting the chisel. Preserve palmar periosteum. Deepening of first web space if necessary after removal of external fixator. Use of Z-plasty and proximal transfer of adductor pollicis insertion. POSTOPERATIVE MANAGEMENT: After 1 week continuous lengthening 0.7 mm/day in 3 daily increments. After removal of fixator plaster cast for 2 weeks. POSSIBLE COMPLICATIONS: Improper installation of fixator. Incomplete osteotomy. Too rapid or too slow distraction. Pin tract infection. Deep infection. RESULTS: Over a 2 year period 10 lengthenings. Average follow-up 23 months (10 to 36 months). Average gain in length 38.1 mm. Average length of treatment 163 days. Deepening of web space in 7 patients. Force of grasp 64% of opposite side. Pin tract infection: 4, too early removal of fixator: 1, revision of scar: 1 and correction of stump: 1. All patients were satisfied with the result but for scar at web space.

English Abstract↗

PubMed1997

[Not Available].

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Journal Article↗

PubMed1997

[A rare case of metastasis of urinary bladder carcinoma in the pisiform bone. A case report].

Metastases to the hand are rare. The incidence of secondary tumors in the hand is about 0.15%. The lung, breast, and kidneys are the most common sites of primary lesions that metastasize to the hand. The authors report about a 66-year-old female who showed an osteolytic metastatic lesion in the os pisiforme which was ulcerated on the ulnopalmar aspect of the right wrist, 18 months after radical cystectomy because of a bladder carcinoma. In agreement with the patient, as well as with colleagues from the pathological, oncological, and radiotherapeutical field, the hand was not amputated as this was a solitary metastatic lesion.

Bone Neoplasms↗

PubMed1997

[Results of interphalangeal joint arthrolysis in patients with Dupuytren disease].

The results of 226 arthrolyses of the proximal interphalangeal joints of ring and small fingers in patients with Dupuytren's disease are presented in a retrospective study. 52% of cases involved first operations, 48% were operations of recurrent diseases. Proximal interphalangeal joints of small fingers were more frequently affected than those of the ring fingers. Arthrolysis was carried out stepwise in Buck-Gramcko's technique. In 13% of the cases an additional temporary transarticular Kirschner wire fixation was carried out. The results were graded according to extension deficits and the distance from fingertips to distal palmar crease. The average pre-operative extension deficit was 65 degrees. The average extension deficit three months after operation was 35 degrees. The post-operative distance from fingertips to distal palmar crease was 2.5 centimeters. Ring fingers yielded better results than small fingers. A temporary transarticular Kirschner wire fixation did not lead to better results. In unfavourable cases however, this fixation seems to be indicated. Complications occurred in 27% of the cases, mainly involving wound healing.

Dupuytren Contracture↗

PubMed1996

[Donor site defect after removal of free and pedicled forearm flaps: functional and cosmetic results].

The donor-site defect poses a special problem in free and pedicled forearm flaps. A multi-center-study of seven departments for Hand and Plastic Surgery in Germany and Switzerland studied the problem and showed the functional and cosmetic results. 342 questionnaires were checked. 267 patients came for a follow-up examination. 83.9% of them were satisfied with the result of the operation. Restrictions of movement in the wrist, forearm, and elbow appeared to be very rare. Half of the patients considered the donor-site defect to be ugly. Nearly the same number objected to preoperative information about the appearance of the donor-site defect. Based on the results of this study, we can still recommend the radial forearm flap for small and medium size soft-tissue defects, delicate technique of closure of the donor site defect provided.

Esthetics↗

PubMed1995

[Description of Dupuytren disease by the Basel physician and anatomist Felix Plater in 1614].

Plater's description of Dupuytren's disease in 1614 is explained with regard to his understanding of the anatomy. The current view that Plater believed the disease to be caused by dislocation and shortening of the flexor tendons is based upon misinterpretation of the original Latin text. With the help of his anatomical studies, Plater had proven that subcutaneous ligamentous extensions of the palmar aponeurosis and not the flexor tendons were responsible for Dupuytren's disease. Felix Plater realised more than one hundred and fifty years before Cline, Cooper, and Dupuytren the palmar aponeurosis as the anatomical substrate of the disease.

Dupuytren Contracture↗