Biomedical subjects
Publications and source records attributed to E Scharizer.
Two successive injuries to the same wrist of a patient led first to a scaphoid non-union and second to a capitate fracture. The case history, treatment and medicolegal implications are discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The number of hand injuries in overall occupational injuries has remained constant over the last fifteen years. Injuries to the dominant hand and the non-dominant hand are assessed differently. Because of changes in the work environment with increase in mechanization, key-boards, and demands on fine motor skills, the question arises whether this differential evaluation is still proper.
The authors report a lethal course of Ehlers-Danlos syndrome type IV. In this patient hypermobility of the finger joints had been seen. The patho-biochemical structure of fibrous tissue is discussed.
The author reports the case history of a female patient with a special form of progressive scleroderma, the Thibièrge-Weissenbach-syndrome. The removal of the recurring calcifications in the fingers made ten operations within eleven years necessary. After description of the pathology possible differential diagnoses are discussed.
This presentation concerns the findings in 105 tumors or tumor-like lesions in the bones of the carpus. These tumors generally produce complaints which are uncharacteristic and they are quite difficult to recognize on X-ray. Due to this difficulty, there may be many different therapies before the correct final diagnosis is confirmed. These tumors are usually found in the scaphoid, capitate, lunate, or hamate. Of the 105 tumors, 45.7% were osteoid osteoma, which has an incidence of only 11.33% of all bone tumors in the body as a whole. Of the remaining tumors, 15.24% were diagnoses to be intraosseous ganglia (= tumorlike lesions). Lesser percentages were giant-cell tumors, osteochondromas, chondromas. One intraosseous lipoma was found and this had never before been reported. The majority of the patients were between twenty and thirty years of age. With surgical removal, complaints are generally reduced. Dramatic relief from pain is reported by patients when an osteoid osteoma is removed. The most important deduction from these findings is that tumors in the carpus are not as rare as once assumed. The possibility of bone tumors should be considered in patients with intractable pain in the carpus.
Following primary repair of both flexor tendons of the middle finger and suture of a wound of the index finger, the distal interphalangeal joints of the second, third and fourth finger could not be flexed actively. Therefore, tenodeses of the DIP-joints were done six months later. The possibility that an injury of the deep flexor tendon in three fingers had been overlooked is considered together with the alternative explanation that a quadriga syndrome had resulted from adhesions of the repaired profundus of the middle finger.
The article discusses, first of all, the reasons for a failure to detect a fresh fracture of the scaphoid bone which may be ascribed to the patient himself or of an iatrogenic nature. This is followed by guidelines for early detection of scaphoid fracture on the basis of the course taken normally by a fresh but untreated fracture of the scaphoid bone, thus providing pointers towards clarifying whether the fracture has a causal connection with a claimed accident. Signs of strengthening of the treated fresh scaphoid fracture are explained. Hints for the possible need for surgical treatment are derived from a differentiation between the traumatic cavity of the scaphoid bone and covered pseudarthrosis.
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About two years after a questionable accident which did not lead to disability, the lunate bone was excised. It was found to be in two parts and the question was raised whether or not this was the result of an accident or secondary to Kienböck's disease. The radiologist describes the possible etiologies in his differential diagnoses and concludes that there had been a constitutional Os lunatum partitum.
The article describes, first of all, the structure and mechanism of working of the tendon sheath, as well as its wall structure, pertaining to the triple-jointed fingers. This is followed by a description of the architecture of the superficial and deep flexor tendon. The next section of the article deals with the tendon sheath of the thumb and with the architecture of the long flexor tendon of the thumb. A clinically important tendon variant between flexor pollicis longus and flexor digitorum superficialis of the index finger is described. After the division into zones, the article goes into details of the mm. lumbricales, their anatomy and function, as well as with the phenomenon of the lumbricalis-plus finger.
The article proves on the basis of 40 cases that surgery following spray pistol injuries yields good results if it is initiated as early as possible, it is also shown that the prognosis worsens markedly with every hour that is wasted subsequent to the injury.
Knowledge of the blood vessel supply of the flexor sinews has been considerably enlarged by micro-angiograms. Arrangement of the vessels in the non-tendinous area of the hollow hand is different from that of the osteofibrous channels. The digitalis propriae form arcades, of which the vincula longa and brevia are responsible for segmental supply of the two flexor sinews at the triphalangeal fingers. Tendinous areas without vessels and poor blood supply are most probably supplied by means of diffusion. The intratendinous arrangement of the vessels has led to a change in suturing technique. The long flexor sinew of the thumb is supplied by blood vessels in the thenar region and at the base of the end phalanx.
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