Search PubMed⌕ Search

Biomedical subjects

U Lanz

Publications and source records attributed to U Lanz.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Infections of the hand].

Tendon sheath infections and septic arthritis require early irrigation therapy in order to avoid permanent loss of function. In the thumb, infection of the sheath often leads to an acute carpal tunnel syndrome, necessitating open median nerve decompression. Differential diagnoses have to be taken into consideration: tuberculous synovialitis of the tendon sheath or finger joint is not yet extinct. The severely painful herpetic whitlow of the finger tip requires virostatic therapy. Operative measures are also not indicated in the acute calcium deposit, which as a rule resolves spontaneously within several days. Only its chronic recurrent form with or without pressure symptoms requires surgical intervention.

Arthritis, Infectious↗
PubMed1996

Explosion injuries of the hand. Spatial relationship and injury pattern.

Twenty-six hands in 25 male patients were treated for peace-time explosion injuries of the palmar aspect. All patients were examined after a mean interval of 7 (1-17) years. In order to establish a regional pattern for each injury the palmar surface of the hand was divided in 21 fields. For each field a score depending on the extent of injury was calculated. Comparing this regional score with the spatial relation between hand and exploding object resulted in six typical patterns depending on the grip during explosion. With knowledge of the three-dimensional relation between the hand and exploding object, the hand surgeon is prepared for potential problems during operation.

Adolescent↗
PubMed1996

[Outcome of flexor tenolysis after injury in zone 2].

Tenolysis of flexor tendons was performed in 48 fingers of 36 patients. After a mean follow-up to ten months, the total active movement (TAM) was improved from 79 degrees preoperative to 189 degrees postoperative in 84% of the fingers with a minimal improvement of 40 degrees. Following the classification of Buck-Gramcko, 80% (38) of the fingers showed an excellent, good, or fair result. In addition, the influence of nine factors (associated injuries or procedures) on the outcome was investigated. These results showed that there is a decrease in improvement when severity of trauma increases. Arthrolysis of PIP-joint showed no negative influence on the results. We are not able to establish a predictive score for flexor tenolysis from our results.

Adolescent↗
PubMed1996

[Communication in hand surgery].

Computer-aided communication provides us with an easy way of exchanging different messages. Personal data (E-Mail) can be transferred as easy as pictures. News-groups would be intended to act as a forum where many people could interact and share information on issues related to the practice and the advancement of hand surgery. This paper explains the technique and the advantage of electronic communication. Using already existing computer-networks will enable us to start communication at once.

Computer Communication Networks↗
PubMed1996

[Flexor pulleys of the fingers. Anatomy, biomechanics, reconstruction].

Primary or secondary flexor tendon surgery occasionally leads to damaged flexor pulleys. Insufficient pulley reconstruction causes loss of finger function by bow stringing of the flexor tendon. This paper reviews the anatomy and biomechanics of the flexor pulley system. Different techniques of reconstruction are discussed.

Biomechanical Phenomena↗
PubMed1995

Quantitative analysis of the linkage between the interphalangeal joints of the index finger. An in vivo study.

We have established a simple method of measuring joint motion under physiological conditions. For this purpose we use an ultrasound measuring system employing marker points consisting of miniaturized ultrasound transmitters. This device was tested on a simple biomechanical model, the linkage of the proximal and distal interphalangeal joints. The angles of these joints were recorded during opening and closing of the fist in 34 index fingers of 17 healthy persons. The results of the measurements were plotted on a rectangular coordinate system. Analysis showed an approximately linear linkage between the IP joints of the index finger. The curve for extension was the same as that for flexion. The linkage varies greatly. On average 1 degree of PIP joint flexion is equivalent to 0.76 degree of DIP joint flexion. Our study showed no significant difference between the dominant and non-dominant hand. The results showed that there is a linear linkage between the proximal and distal interphalangeal joints, which is equal for flexion and extension.

Adult↗
PubMed1995

[Preoperative continuous extension treatment of very severe Dupuytren's contractures].

The continuous extension of Dupuytren's contracture prior to aponeurectomy in severe cases, introduced by Messina, is presented. This technique demonstrates the possibility of reversing contractures; it simplifies the surgical treatment thereafter and avoids difficulties in blood circulation and sensibility. First results in ten patients are presented.

Aged↗
PubMed1995

Free gracilis muscle transplantation for hand reconstruction.

Free muscle transplantation with motor innervation is the only way to add contractile elements to upper extremities with extensive loss of musculature due to direct trauma or untreated compartment syndrome (Volkmann's contracture). The functional cross-sectional area and the mean resting fiber length determine the maximum power and the contracting amplitude of the donor muscle, respectively. Although considerably weaker than the finger flexors to be replaced, the gracilis muscle was the preferred donor muscle because of the consistent anatomy of its neurovascular pedicle and the minimal donor site morbidity. In a series of 15 gracilis transplantations, all 13 muscles that survived regained function. Finger motion was dependent on the preoperative condition of tendons and joints. Even after complete loss of the flexor and extensor compartment after direct trauma or infection, a useful upper extremity could be restored, which was preferable to the only alternative--amputation.

Adolescent↗
PubMed1995

[Dupuytren contracture--current status in research and clinical practice].

Dupuytren's contracture is a disease of the connective tissue, especially of the palmar side of the hand. Today, by means of electron microscopy and histochemistry, several alternations specific of pathology of the disease can be shown, providing a better understanding. However, a revolutionary change of treatment is far out of reach. Dupuytren's diathesis can be influenced by none of today's known methods, and therapy is still empirical. Operative therapy is only indicated in functional impairment. Treatment should be done by well-trained surgeons and in case of extensive diathesis by carefully planning and longtime follow-up to avoid complications and eruption of the disease.

Dupuytren Contracture↗
PubMed1995

[History of hand surgery].

Long before the term 'handsurgery' was coined, surgery in the hand was performed. The development towards a surgical speciality, however, is closely bound to the name Sterling Bunnell. By the end of World War II he instituted hand centers, in which tissue specific surgery was replaced by region specific surgery. Introduction of microvascular surgery made an immediate and global repair of all injured structures possible and desirable.

Europe↗
PubMed1994

Congenital unilateral muscle hyperplasia of the hand with ulnar deviation of the fingers.

Three cases of congenital unilateral muscular hyperplasia of the hand combined with ulnar deviation of the fingers are presented. In all three patients the deformity was confined to the right upper extremity, and there were no other associated congenital malformations. All patients displayed anomalous or hyperplastic musculature acting on the proximal phalanges of the fingers, contributing to the associated ulnar drift of the hand. This condition is previously unreported, and is a different entity from the previously described "windblown hand".

Adolescent↗
PubMed1994

[Monofascicular nerve rotation].

In case of the loss of one single muscle function in the hand, the possibility of a neurogenic cause should not be overlooked. The differential diagnosis includes: 1. Partial compression; 2. anatomical variation; 3. monofascicular rotational distorsion. Rotational distorsion of a nerve has previously been described by A. Wilhelm (1976). This type of compression syndrome occurs after repeated forceful muscle contractions and may involve for example either exclusively those fascicles in the main trunk of the median nerve, forming the anterior interosseous nerve or the deep branch of the radial nerve. We report a series of six patients in whom torsional nerve injury was found.

Adult↗
PubMed1992

[Advanced carpal collapse (SLAC-wrist) in scaphoid pseudarthrosis. Therapy concept: medio-carpal partial arthrodesis].

Longstanding unstable scaphoid nonunions inevitably lead to carpal collapse and symptomatic secondary arthrotic changes, ruling out reconstructive procedures to the scaphoid itself. Partial mediocarpal fusion, however, can preserve some wrist motion and markedly reduce or even eliminate wrist pain. By correcting the malalignment of the lunate and capitate, carpal height is restored. By excision of the scaphoid, its destroyed articular surfaces are removed. In 26 of 31 patients undergoing mediocarpal fusion, complete or at least significant reduction of wrist pain was observed. Average grip strength increased by 23%, whereas wrist mobility decreased by 33 to 40% with a relatively short follow-up of 14 months. Total wrist fusion remains the last line of defense.

Adult↗
PubMed1991

Four finger amputation injuries. Concept of treatment.

Fourteen patients with an amputation injury of four fingers are reported. Fifty-one of these 56 fingers were replanted with a survival rate of 88%. To achieve optimal results replantation of all fingers should be attempted. Dividing the operative procedure into a macrosurgical and a microsurgical part helps to economize both tourniquet time and total operative time. In case of arterial spasm or other difficulties to reestablish blood flow, a check list can be of great value. To achieve good results in such severe and difficult procedures a special organisation of replantation centers is needed.

Adult↗
PubMed1990

[Fresh nerve and vascular injuries of the forearm and hand (management, results and problems)].

Lacerations of arteries and nerves not only result in motor and sensory deficiencies. Trophic changes occur as well, more frequently after nerve injuries than after vascular injuries. The major progress in their treatment consists in primary repair of the injured structures in order to keep their loss of function as brief and as minimal as possible. Although the results after nerve laceration are still far from being ideal, there are strong indications that an improvement can be obtained with this treatment strategy. Alternatives to primary repair are discussed.

Female↗
PubMed1990

[Computed tomography of soft tissue tumors of the hand and the forearm].

Computed tomography was carried out in 32 patients with clinically equivocal soft-tissue lesions of the hand (24 times) and forearm (8 times). The CT scans were performed with the patients in standard positions; thin slices and zoom technique were used. All soft-tissue tumors were correctly diagnosed with regard to localization, size and infiltration of the surrounding tissue. The histological diagnosis was correct in tendon-sheath proliferations, deposits caused by metabolic disorders, epithelial and ganglion cysts, hemangiomas, lipomas and in one schwannoma. A malignancy was suspected and was proven to be correct in two cases. False-positive diagnoses of a malignant soft-tissue tumor were made in one case of an aggressive fibromatosis, in a rapidly progressive, ossifying myositis, and three times in the presence of postoperative scar tissue following the resection of a sarcoma. Finally, a case of proliferative myositis regarded as semimalignant was underrated by CT. The hand surgeon considered CT diagnostics to be very helpful in planning operations in an anatomically complex organ such as the hand.

Adolescent↗