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[Non-invasive determination of oxygen saturation with the oxygenmet pulse wave oximeter on fingers, metacarpus and wrist of infants. Comparison with the oxygen saturation calculated from the pH and pO2 of the blood gas analysis (author's transl)].

Oxygen saturation was determined non-invasively with the oxygenmet pulse wave oximeter 1471 and mathematically from the pH and pO2 of the blood gas analysis. The determination of the oxygen saturation by the aid of the oximetric method was carried out on fingers, metacarpus and wrist of 80 infants (male = 44, female = 36 - ages: 1 day - 1 year and 8 months). Blood gas analysis was done just behind the oximetric analysis and oxygen saturation was calculated from the pH and pO2. The comparison of the oxygen saturations determined non-invasively on fingers, metacarpus and wrist among themselves, showed no statistical significant differences. Also no statistical significant differences were observed between the results obtained with the pulse wave oximeter and the results calculated from the blood gas analysis. The comparison of the oxygen saturations determined with the oxygenmet oximeter (mean of fingers, metacarpus, wrist) with the oxygen saturations calculated from the blood gas analysis showed a very close correlation. The correlation coefficient was 0.930.

Blood Gas Analysis

Effects of treadmill exercise on cortical bone in the third metacarpus of young horses.

The effects of exercise and relative inactivity on cortical bone were compared in young horses. Two groups were used; one was given a 14-week programme of exercise (n = 6) and the other kept as unexercised controls (n = 6). The first nine weeks of exercise involved trotting and cantering (2 to 4 km d-1 at speeds up to 12 m s-1) on a treadmill set at an incline of 3 degrees. Over the next five weeks the horses were trained at near maximal speeds (that is, up to 14.5 m s-1) with no incline of the treadmill. At the end of the programme marked differences in cortical porosity and distribution of subperiosteal osteogenesis at the mid-shaft of the third metacarpal bone were found between the groups. Histomorphometrical examination of the dorsal cortex showed minimal bone remodelling in the exercised horses, but extensive modelling as evidenced by the large amount of subperiosteal bone formation. In contrast, the unexercised horses had significantly more bone remodelling and less formation of subperiosteal bone. The histomorphometric and microradiographic findings provided an explanation for changes in the non-invasive bone measurements that occurred during training. Bone mineral content of the mid-metacarpus was found to increase more in the exercised than the unexercised horses despite a lower overall growth in bodyweight. In those horses that completed the full training programme, ultrasound speed increased significantly by the end of the training programme. It remained unchanged in the horse that did not complete the full exercise programme and decreased slightly in the unexercised horses. The difference in ultrasound speed between the groups was considered to reflect differences in intracortical bone porosity, endosteal bone formation and alterations in skin thickness. The stiffness of cortical bone increased significantly in the exercised horses but remained unaltered in the unexercised horses.

Alkaline Phosphatase

Gunshot and fragment wounds of the metacarpus.

Based on a study of 120 gunshot and fragment wounds of the metacarpus, we conclude that these wounds should be debrided and subjected to delayed closure technics. Even relatively low-velocity missiles may cause serious damage. Metacarpal stabilization with Kirschner wires may be done with impunity to obtain proper alignment, rotation, apposition, and length, in that order of priority. Immediate muscular activity is beneficial. Reconstructive procedures must be individualized to each case and should be considered technically difficult to perform.

Adult

[Therapeutic possibilities malformations of the metacarpus].

The most common deformities of the metacarpus occur in conjunction with poly- and oligodactyly. The authors first refer to the most important operations in treating these deformities and emphasize that in certain cases solitary resection of surplus fingers is not enough: in addition, outgrown articular process must be removed, bent metacarpals osteotomised and capsular defects closed. The treatment of oligodactylic hands is made difficult by cutaneous and osseous syndactyly. The operating surgeon should have sufficient experience in plastic surgery to be able to take care of severe adduction contractures of the thumb with constriction of thumb commissure. For aplasia and hypoplasia in the thumb ray the already proven index finger pollizisation is thetherapy of choice. Triphalangeal thumbs are operated according to the same principles. On the other hand in brachyphalangeal thumbs commissure increase and correction of the clinodactylia are of prime importance. Phalangisation is very rewarding in certain forms of synbrachydactyly. In some deformities only the thumb is present. In these cases we recommend an opposition post built out of a tubed flap and autogenous bone graft. Some examples of defective hands surgically treated are shown.

Congenital Abnormalities

Telemetric measurements of strain in the metacarpus of the horse: a pilot study.

The advances made by the use of a telemetric system in the study of bone strain in a free-moving horse are reported. A rosette strain gauge was bonded to the craniomedial aspect of the metacarpus of the horse. Attachment of a miniature FM transmitter to lead wires facilitated telemetric transmission of of resistance changes which corresponded to limb movement. During 3 different gaits, the trace pattern remained similar, although frequency and amplitude varied. The tracings were similar to those reported in other species in which nontelemetric transmission was used.

Animals

Nerve distribution in the metacarpus and front digit of the horse.

The nerve distribution to the digit of the horse was studied with the compound microscope in serial transverse sections of fetal limbs and plotted on life-size outlines of the horse's foot. It was learned that there is much variation in the topography of the branches of the principal nerves. There is no mirror-image nerve distribution on the 2 sides of the foot. The dorsal branch of the ulnar nerve does not extend below the fetlock. The communication between the palmar metacarpal nerves and branches of the dorsal branch of the digital nerves is only a crossing of nerves without exchange of fibers. The palmar metacarpal nerves usually do not innervate structures distal to the pastern joint. The innervation of the deep structures of the equine foot was tabulated.

Animals

[Treatment of severe callus of the metacarpus and phalanges. Indications and results apropos of a series of 38 patients].

Severe deformities of metacarpals and phalanges, whether isolated or associated with soft tissues lesions impair the hand function and are to be corrected. The authors initial proposal was the fixation after corrective osteotomy by wiring which have been proved to be suitable in the treatment of recent fractures. This technique was used in 25 cases out of 38 treated malunions with 21 satisfactory results. 4 poor results were related to associated lesions of the soft tissues more than to the osteotomy itself. The other 13 malunions were treated by several techniques arthrodeses, callus resections, dynamic splintage, osteotomies with satisfactory results.

Bony Callus

[Cancellous bone grafting for fingers and metacarpus].

Bone grafting using cancellous bone is a reliable method treating fresh and old fractures. In the period 1974-1977 the Department of Plastic Surgery of the University Hospital "Bergmannsheil Bochum" treated 39 cases of finger- and metacarpal-bone injuries and bone diseases successfully by cancellous bone grafting. Indications, technique and results of our methods are described.

Adult

[Successful re-implantation of the metacarpus (author's transl)].

Two cases of subtotal traumatic metacarpal amputation in young people are described. Re-implantation with the help of microvascular surgical techniques was successful. In one case in which vascular connections to two long fingers were still present, the advantages of reconstruction of important vessels are pointed out, not only for re-implantation itself, but also as prophylaxis against circulatory disorders.

Adult

Angiography of equine metacarpus and phalanges: alterations with medial palmar artery and medial palmar digital artery ligation.

Vascular supply of the equine forelimb was partially disrupted by ligation of the medial palmar and medial palmar digital arteries. Vascular architecture was evaluated before and after ligation by angiography. It was apparent from the present study that existing collaterals or newly formed collaterals, or both, were sufficient to maintain limb viability.

Angiography