[Radical principles in cancer surgery].
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Biomedical subjects
Publications and source records attributed to M Greulich.
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Tendon sutures were carried out in the flexor digitorum longus tendon 54 rabbits within the osteofibrous canal at the level of the ankle joint. The suture technique of BUNNELL, LENGEMANN and KESSLER were compared. The adhesions and the vascular pattern in the suture are were observed by means of idian ink injection, microdissection and in thin sections cleared with methyl salicylate. Tendon healing with only minimal adhesions seems to be possible provided that the gap between the tendon stumps is rather small. It originates from the vascularised epitenon of the tendon stumps. In tendon sutures after KESSLER the gap averaged only 2,5 mm whereas the average after BUNNELL suture was 6,7 mm, after LENGEMANN suture 9,8 mm. Early mobilisation of the tendons without tension according to the technique of KLEINERT seems to be suitable to minimise adhesions in the suture area.
1. In the reconstruction of nerves suture and autogenous grafts are employed in a complementary way. 2. The action potential of sensory nerves does not seem to be an objective parameter to evaluate the results. 3. The Moberg-test detects deficits of the pinch. 4. Two-point-discrimination seems to be the most valid quantitative measurement for sensible reconstruction. The examination is simplified by the two-point-star. 5. The Millesi-test shows good correlation to two-point-discrimination.
The development of a device for determining two point discrimination is described. Prongs of metal set apart by distances ranging from 2 mm to 25 mm protrude from the periphery of a metal disc and permit speedier evaluation than that achieved by conventional methods. The instrument weighs a standard twenty grams and so a constant pressure is applied to whichever prongs are employed.