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Biomedical subjects

G Freilinger

Publications and source records attributed to G Freilinger.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Percutaneous measurement of oxygen partial pressure as an evaluation method of free flaps].

Transcutaneous, polarographic pO2-measurement can be used to estimate and monitor the circulation in free tissue transfers. Our experience in this field using a modified Clark's electrode is reported by presenting some examples. Its value in intraoperative and postoperative monitoring and for the early diagnosis of a critical reduction of blood flow in free flaps with microvascular anastomoses is assessed in the light of our early experience with this technique.

Blood Gas Analysis↗
PubMed1982

An experimental comparison of the different kinds of muscle reinnervation: nerve suture, nerve implantation, and muscular neurotization.

In this experimental study, the changes in histologic pattern and functional recovery of the rectus femoris muscle of the rabbit were investigated 6 months after denervation and immediate microsurgical repair of the nerve supply of the muscle. Three different ways of reinnervation were used: nerve suture, nerve implantation directly into the muscle, and muscular neurotization by the underlying muscle. For evaluation, histochemical methods and tension measurements were used. In the results, nerve suture and nerve implantation were superior to muscular neurotization. Nevertheless, muscular neurotization was successful in all cases and led to positive EMG recordings. The functional recovery in the nerve suture and in the nerve implantation groups was astonishingly high and reached 70 to 80 percent of the tension of the control muscles. The results of this experimental study and their clinical relevance are discussed.

Animals↗
PubMed1982

Grip reconstruction by double-toe transplantation in cases of a fingerless hand and a handless arm.

In two cases, a grip reconstruction by double toe-to-hand transfer is demonstrated. In the first patient, all fingers of the left hand were amputated at the metacarpophalangeal joint level. The second and third fingers were reconstructed by transplantation of the second toe from the left foot and the third toe from the right foot. Although the distal and the middle phalanx of the transplanted third toe had to be amputated because of mummification 2 weeks after the transplantation and was covered with a groin flap, good function of the newly formed grip can be demonstrated. The second patient is a 21-year-old man with amputation of both hands at the wrist. A grip formation on the right lower arm was performed by transplantation of the second toe of each foot together with the metatarsal bone and a dorsalis pedis flap. Both metatarsal bones were fixed to the ulna and radius with metal plates, and tendons and nerves, together with a vascular supply, were reconstructed. One year after the operation, a follow-up study demonstrates good function of the newly formed "hand." The patient is able to use his two new "fingers" during daily life, mainly to hold small objects. A myoelectric prosthesis has been placed on the patient's left arm, and the patient uses this to hold bigger objects. Restoration of sensation and the range of movement of the newly formed right "hand" are demonstrated and discussed.

Adult↗
PubMed1981

[Plastic surgery after extensive tumor surgery of the scalp].

Extensive resections of tumors of the scalp penetrating into the bone and the brain often require the use of free flaps for coverage as the only possibility. Four cases are reported and the specific problems of these microsurgical operations in this region are discussed.

Adult↗
PubMed1981

[Surgical specialties in replantation surgery].

Special operative techniques developed by the advances in the replantation surgery are the subject of a review. The replantation of an amputated finger in a more important position is demonstrated by a clinical case. Defects can be replaced by parts of non-replanted fingers or with the aid of transplanted structures, such as skin, vessels, bone and local flaps. Clinical examples are given of the primary transplantation of bone from the iliac crest and of enhancement of circulation from the healthy, neighbouring finger.

Amputation, Traumatic↗
PubMed1980

[Functional reconstruction of the striated sphincter muscle in the incontinent anus (author's transl)].

Anal sphincter reconstruction with muscle transplantation according to Thompson and transposition of the denervated gracilis muscle onto the surface of the pelvic floor muscles are described. The transplanted and transposed muscles are reinnervated by a collateral nerve from the adjacent functioning muscles. The follow-up examination of 16 cases of anal incontinence two years after anal sphincter reconstruction demonstrates in all but one case ontinence for firm feces and in most of them, continence for fluid feces. Reflectoric contractions of the new reconstructed sphincter can be demonstrated by myographic and manometric investigations. The advantages of dynamic sphincter reconstruction with muscular neurotization compared to other more static techniques are discussed.

Adolescent↗
PubMed1980

[Dynamic splinting in flexor tendon surgery].

Besides the special microsurgical operative technique, dynamic splinting is one of the basic fundamentals of KLEINERT's technique for primary repair of flexor tendons. The principle of this splinting is explained. Further applications are reported: 1. after secondary repair of flexor tendons (by tendon transfer or tendon transplantation), and 2. after tenolysis. According to our good results the application of dynamic splinting in the above mentioned cases seems to be advisable.

Fingers↗
PubMed1980

[A rare hand malformation, the Freeman-Sheldon syndrome].

A rare syndrome, first described in 1938 by FREEMAN and SHELDON, two English doctors, is discussed. The condition affects the face and both hands to a degree that no useful function is possible. The characteristic malformations are described in detail. They are caused by a soft tissue disorder and no bony involvement has been found so far. Therefore, the term "Cranio-carpo-tarsal dystrophy" is misleading. Conservative treatment by dynamic splints has brought very little improvement.

Abnormalities, Multiple↗
PubMed1980

[General aspects of hand surgery in childhood (author's transl)].

Good regeneration of tissue, easy adaptation and rapid nerve regeneration are all favourable factors of hand surgery in infants and children. On the other hand, unfavourable factors include diagnostic difficulties, especially following early trauma and the absence of co-operation, as well as late damage due to growth retardation. Indications for surgery include malformation, accident, burns, infections, and rarely tumours, and treatment should as far as possible, be delayed until preschool age. Accurate operative technique and careful planning of surgery are essential. Post-operative fixation and bandaging is equally important but even in the paediatric surgery group good results can be achieved.

Child↗
PubMed1979

[Mammography of non-palpable lesions (spot localisation) (author's transl)].

Modern methods of mammary investigation currently enable the detection of tiny-tumours which are not clinically palpable and referral of these patients to surgery at an early stage. This poses a challenge to the surgeon, who cannot rely on palpation as a guide to accurate extirpation of the tumour, but has to rely wholly on the radiological report. A method was, thus, worked out in this department to provide accurate evaluation of the position of the suspect area of the breast to facilitate operative measures and, furthermore, act as safety measure between the time of tumor biopsy and receipt of the histological report. Preparation radiography proves that the suspect area on mammography is identical with removed specimen. The advantages of this procedure are obvious. The surgeon can rely fully on the radiodiagnostic findings and enlist the radiologist as essential member of the therapeutic team. As a result the operative procedure can be finely gauged by the surgeon and the tumour removed with maximum sparing of healthy breast tissue. This procedure has produced excellent results in 35 patients and can be recommended for application to patients with tiny tumours.

Aged↗
PubMed1979

[Reconstruction of the breast after surgery for cancer (author's transl)].

The tendency towards less radical, stage-dependent procedures in the surgical management of breast cancer has opened the way to improvement in the reconstructive measures available. Reconstruction of the female breast can be undertaken with greater or lesser success and facility according to whether the initial procedure was subcutaneous mastectomy, modified radical mastectomy or the Rotter--Halstedt radical operation. The different plastic reconstructive methods developed over the past years are discussed and illustrated by cases treated under our care.

Breast↗
PubMed1979

[Functional outcome after reimplantations in the hand and finger region].

Successful replantation of total amputated parts of the hand having been performed during a period of five years were investigated as a homogenous group. Long-term function of replanted parts was evaluated by objective criteria, as signs of use, trophique, vascularisation, mobility, sensibility and the integration of replants into general function of the hand, and on the other side by subjective criteria as usefulness in professional and private life, retrospective personal attitude to replantation and subjective complaints.

Adolescent↗
PubMed1978

Replantation and revascularization of amputated parts of extremities: a three-year report from the Viennese replantation team.

A Replantation Team was instituted in Vienna 3 years ago. This team is the oldest in Europe. One hundred and eighty-one complete and incomplete amputated parts of 118 patients were replanted during this period. A survival rate of 86% and a useful functional result ("integrated parts") in 78% of the cases was obtained. Appropriate preparation of the amputated parts, the right timing, a 24 hour service and a clear indication with intensive postoperative physicotherapeutical treatment are the fundamental points for this result.

Amputation, Traumatic↗