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Biomedical subjects

F Gasperschitz

Publications and source records attributed to F Gasperschitz.

11 recordsLinked to original sources

[Technique, results and risks of endoscopic carpal tunnel release].

Endoscopic carpal tunnel release was performed in 168 cases of carpal tunnel syndrome using the two-portal technique described by Chow. There were 164 cases of idiopathic carpal tunnel syndrome and four cases following a wrist trauma. Sensory symptoms improved within few days in 113 patients (67%) and in 141 cases within eight weeks (84%). Nighttime pain relief was achieved immediately in 87% of the patients and in 94% within eight weeks. Grip strength increased to preoperative values within eight weeks and pinch strength reached preoperative levels within six weeks. In four cases an iatrogenic injury of the superficial palmar vascular arch occurred. In another four patients, open revisional surgery had to be performed. Three of these patients presented an incomplete release of the retinaculum flexorum and in one patient a remaining part of the palmar fascia led to further compression of the median nerve despite complete dissection of the carpal ligament.

Adult↗

[Donor site morbidity following radial forearm flap].

The results concerning morbidity of the fasciocutaneous radial forearm flap donor site of 20 patients are presented. The review was carried out with an average time of 4.4 years after raising the flaps, ranging from ten months to eleven years. Range of motion of the wrist joint was limited in extension in two patients with 15 degrees and in one patient with 30 degrees. Pinch and grip strength was found normal in 13 patients and was limited in five cases to 88% of the strength of the opposite limb. Dysesthetic areas were found in three patients on the radial border of the donor site and reduced sensation of the radial nerve was present in four patients.

Adolescent↗

[Epiphyseal growth after replantation in childhood].

Long-term results in 17 patients with 19 replanted parts of the upper extremity after replantation during childhood are presented. Regarding longitudinal epiphyseal growth, three patients had normal growth. In 15 cases, average length of the replanted digits attained 88.6% of normal and one patient gained overgrowth of 118% of normal. In every case, consolidation of the fracture was seen. Four patients developed a deviation of the replanted finger in the frontal plane. The cause of deviation in every case was incorrect primary reposition and not a disturbance of growth of the replanted epiphysis.

Adolescent↗

[Value of plate osteosynthesis in treatment of radius fractures at a typical site].

In the past, distal radius fractures tended to be treated conservatively. Recently, however, unsatisfactory anatomical and functional results have led to an increase in their surgical treatment. Our preferred method of treatment has been percutaneous pin fixation after closed reduction. In our opinion, open reduction and internal fixation with an A0-plate is indicated for Smith fractures (B3 A0-classification), and for any fractures which cannot be ideally reduced (usually C1 to C3 fractures). From 1972 until 1989, 84 patients with distal radius fractures underwent surgical treatment in the Unfallkrankenhaus Salzburg. The procedure was usually performed under brachial plexus or Bier block, and we preferred a palmarly positioned plate for internal fixation. Follow-up of 42 patients showed good results, the functional and subjective results earning higher marks than the X-ray findings.

Adult↗

[Decrease in disability pension following replantation].

Between 1977 and 1986, 201 patients underwent replantations at the Accident Hospital in Salzburg. Of these 201 cases, 112 (55.7%) were work-related accidents. The first 47 cases were evaluated by two independent experts, comparing the actual occupational disability, i.e. impairment of earning capacity after replantation with the probable occupational disability payment had the replantation not been performed. In thirty-nine out of forty-seven cases, replantation had led to lower disability benefits.

Accidents, Occupational↗

[Economic aspects of replantation surgery].

Between 1977 and 1986 201 patients were treated by a replantation. 89 (44.3%) had a work accident. In order to find out the change in renumeration payed by the insurance company, 47 were seen at an follow up. They all had had a working accident and were insured by the "Allgemeine Unfallversicherungsanstalt, Landesstelle Salzburg". We compared the lifetime difference of degree of disablement with and without replantation. An average diminuation of rentpayment between 5 to 25% per patient was found after successful replantations.

Adult↗

High-pressure injection injury: a hand-threatening emergency.

A variety of tools mounted with high-pressure nozzles cause a typical pattern of hand injuries. Often the relatively mild initial symptoms conceal the actual degree of tissue damage and the need for prompt treatment. As illustrated by a case of dye impression, early extensive surgical exploration and radical removal of the injected agent are mandatory to minimize sequelae and to avoid mutilating complications. Pathophysiology and surgical management of this hand-threatening emergency are outlined.

Accidents, Occupational↗

Greenstick fracture of the forearm with median nerve entrapment.

A case of bony median nerve entrapment is presented. Roentgenograms of a greenstick fracture without dislocation lured the examiner to ignore sensory deficit. Finally, delayed surgical exploration revealed complete nerve entrapment. A nerve graft was performed to reduce the functional loss.

Adolescent↗

[Therapy of lunate necrosis].

Out of the multiple methods for treating Lunatum-malacia the following were used in our hospital: shortening of the radius, pisiform-transposition, cancellous bone graft, tendon interposition arthroplasty, intercarpal arthrodesis, prothetic replacement, wrist arthrodesis and denervation of the wrist. Because of non satisfactory results the conservative treatment was abandoned. The indication for one of the different operative methods depended on the radiological Decoulx-Stage, the profession and the age of the patient and his willingness to cooperate. From 1972-1988 36 patients with Kienböck's disease were treated in the Unfallkrankenhaus Salzburg. 20 were seen with an average follow up of 8.7 years. In the early stages of lunate necrosis with a minus variant of the ulna the best results were obtained by shortening of the radius otherwise with the pisiform transposition. The same results could be achieved in intermediate stages although with reservation for the pisiform transposition. Although the other operative methods gave pain relief and an improvement of grip strengths, they showed radiologically a progression of the necrosis. Denervation and wrist arthrodesis are reserved for stage IV. Despite some good results, new operative methods like revascularisation operations of the lunate bone seem promising.

Adolescent↗