[Diagnosis of arterial diseases of the upper extremity. Value of arteriography].
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Evaluation of 74 Arteriograms of the upper limb. At the shoulder-girdle arteriosclerotic obliteration is most common. Arteriography is essential for preoperative diagnosis. The same applies to post-traumatic changes in the upper arm. In fore-arm and hand inflammatory and systemic disease predominate. Here arteriograms may provide the diagnosis in part of the cases but almost always important data for the differential diagnosis.
Neurotrophic effects on tissues microcirculation in upper limbs traumas were revealed by 9-year investigations using electroneuromyography, capillaroscopy of the nail matrix, polarography, oxygen test, hydrogen clearance test. It is shown that oxygen polarography is most adequate for evaluation of nerve trophism. A total of 136 patients with neuropathies of 174 nerves have been examined. Of principal importance for the results interpretation is examination of the neurosecretory function of thin nonmyelinated fibers and vasoactive neuropeptides in neuromicrocirculatory interactions. The action potential of neurotrophic substances depends on their tissue levels.
Large soft tissue defects on the upper arm and the forearm of a 14-year-old boy caused by electrical trauma were repaired with a free latissimus dorsi flap on the left forearm and a neurovascular lat. dorsi island flap to the right upper arm. Both extremities were saved, the defects covered and good functional repair was achieved. The latissimus dorsi flap is a save and easy procedure with a high variability. It is especially suitable for primary repair of large soft tissue defects.
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