Biomedical subjects
Publications and source records attributed to P Gebuhr.
Thirty-two patients with amputated thumbs were admitted to hospital. In none was replantation considered to be feasible because of the serious damage to the soft tissues and the bone damage. The social and economic consequences are discussed.
Leg amputation levels were decided in 24 patients suffering from atherosclerosis, using the conventional techniques of segmental blood pressure and radioisotope skin clearance. The skin microcirculation was measured and recorded before operation with a laser doppler flowmeter. A high correlation was found between the successful amputation levels and the maximal blood perfusion of the skin measured in this way.
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The results of a modified Wilson shaft osteotomy for hallux valgus in 77 feet of 51 patients were excellent or good in 62 feet after 2 to 4 years. The correction of the hallux valgus angle and intermetatarsal angle was excellent or good in 69 feet. The operation is technically simple provided dorsal angulation of the distal fragment is avoided in the early postoperative period.
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A 45-year-old man presented with swelling on the dorsum of both hands, discomfort and pain, all of which became aggravated with activity. An anomalous muscle, the extensor digitorum brevis was found bilaterally. Division of the extensor retinaculum was performed in one hand, excision of the anomalous muscle in the other. One year after surgery, the patient was asymptomatic in both hands.
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Two cases of injection of compressed air into the hand are reported. The air was injected under a pressure of 5-15 Atm. Both cases had a benign course. This is in contrast to high pressure injection (40-400 Atm) with foreign material. Both patients had minor skin lesions before the accident.
Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11 years after operation, a reduction in the hallux valgus angles, the intermetatarsal angles and the width of the forefeet was found. In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite the age. In 37 of 46 feet the overall result was found satisfactory by the patients. The authors find that McBride's operation can be used for hallux valgus, also in patients above 30 years, in spite of the generally accepted restriction to younger individuals.