Biomedical subjects
Publications and source records attributed to C Wulle.
The connection between the dorsal branch of the ulnar nerve and the proper digital nerve of the little finger--described by Camper 1760 and by Kaplan 1963 more proximally--is shown in the little finger of four patients.
Exact definition of the recurrent carpal tunnel syndrome. Presentation of the methods of operation for the recurrent carpal tunnel syndrome corresponding to the indication basing on the causes of the recurrences.
Within a period of five months, in eleven of all the cases examined, the author found the M. abductor digiti minimi longus as was described by Frohse and Fränkel in 1908. It ran from the fascia antebrachii through the Canal de Guyon to the hypothenar muscle mass. Vascularization and innervation were by the ulnar artery and nerve. This muscle must be assigned to the hypothenar muscular system, while a variation of the palmaris longus muscle, which is found in the same region and frequently described in the literature is supplied by the median nerve. Further, the literature has held this muscle to be the cause of compression of the ulnar nerve. In the author's view, the compression of the nerve is caused by the distal transverse ligament of the fascia antebrachii. By severing this transverse ligament, regeneration of the nerve is made possible.
A case of hypoplastic thumb with anomalies of the radial carpal bones is reported, believed to be atavistic in origin.
The authors present a rare compression syndrome of the deep branch of the ulnar nerve distally to the adductor pollicis muscle at the third metacarpal. After neurolysis, regeneration was proved clinically and electroneurographically.
A healthy nineteen year-old soldier suffered a contusion of the distal interphalangeal joint of the fifth finger. A flexion contracture ensued. Histologic examination of the excised tissue revealed Dupuytren's contracture. Despite several more operations, progressive Dupuytren's contracture made it necessary to amputate the little finger at the level of the proximal phalanx. This was accepted for disability purposes as an injury acquired during military service.
In a case report the difficult histologic differential diagnosis between Myositis ossificans and extra-osseous osteosarcoma is illustrated. For the patient, one diagnosis means the preservation, the other the loss of an extremity with all possible complications of a malignant growth.
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By injecting an antibiotic in combination with an anesthetic agent through the healthy surrounding tissue into the focus of septic arthritis, one often can achieve a quick improvement clinically and roentgenologically. By this method resection or amputation can be avoided in many cases.
We report on an operating-method for the treatment of the recurrent carpal-tunnel-syndrome by using a synovial-flap-technique. In 4 patients a continuous regeneration of nerve-function could be observed.
In the typical claw hand deformity following a burn in childhood, the function of the MP-joints can be improved by resection of the metacarpal head and by covering the bone stump by cartilage, pedicled on the periosteum and lifted from the metacarpal head before resection. A "new" metacarpal head will be established, so that the proximal phalanx can glide towards the palm.
We amputated the ringfinger of a 75 years old patient under the diagnosis of a pathologic fracture of the proximal phalanx, based on the case-history and the X-ray-picture. Even knowing the X-ray-findings of the lung only the microscopic evidence confirmed the tuberculosis as the cause of the osteolysis.
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The proximal ulnar compression syndrome when it is not a result of trauma, tumors, inflammatory and degenerative processes, inborn deformations or external pressure, is caused by two mechansims, namely the pinching of the ulnar nerve between the proximal edge of the ligamentous and muscular coverings of the cubital tunnel and of the exit of the nerve from the tunnel under the tendinous arch of the flexor carpi ulnaris. The compression itself is dependent upon the possibility of subluxation of the ulnar nerve. Therapy should consists not only in "decompression", but also in a simultaneous anterior transposition of the ulnar nerve.
The operative treatment of six cases of paresis of the fibular nerve caused by external compression in five patients are reported. From the intraoperative findings and the postoperative results, decompression of the fibular nerve with simultaneous neurolysis can be recommended as the optimal method for cases, which have been treated conservatively without success.
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