Beschreibung
In the past 10-15 years marked progress has been made in the surgical treatment of congenital anomalies of the hand. More and more, the reluctance to operate on these deformities has been abandoned. One reason for this - at least in the German-speaking countries - was the thalidomide catastrophe (1959-1962), which involved the birth of many children with deformed upper limbs. These previously rare severe abnormalities resulted in many problems and required new ways of thinking in terms of their treatment by all persons concerned with their care. At the same time hand surgery was beginning to come of age and the combination of these two events increased the interest in the field of hand anomalies, particularly by orthopaedic surgeons who had always been involved in it. The idea and preparation for this book go back to 1964. Since that time nearly all operations on anomalous hands were systematically charted by us. They were photographically recorded from skin incision to wound closure. Regular follow-up examinations were performed. This atlas represents our experience gained in over a thousand operations. The book has been written by practitioners. We hope that a hand surgeon looking for additional advice will find answers in regard to therapy and surgical suggestions. This intent influenced the book's compilation and structure: - Only those operations that have given us good long-term results will be discussed.
Autorenportrait
Inhaltsangabe1 Introduction.- 1.1 General Directives.- 1.2 General Surgical Suggestions.- 1.2.1 Skin Preparation.- 1.2.2 Positioning.- 1.2.3 Anesthesia.- 1.2.4 Exsanguination.- 1.2.5 Instrumentarium.- 1.2.6 Operative Technique.- 1.2.7 Postoperative (Wound) Care.- 1.2.8 Postoperative Exercises.- 1.3 Review of Frequent Errors of Therapy and Their Consequences.- 2 Syndactylies.- 2.1 Cutaneous Syndactylies.- 2.1.1 Introduction.- 2.1.1.1 General Remarks.- 2.1.1.2 Timing of Surgery.- 2.1.1.3 General Surgical Directives.- 2.1.1.4 Postoperative Care.- 2.1.2 Total Syndactyly of Fingers of Equal Length (III/IV).- 2.1.3 Subtotal Syndactyly of Fingers of Unequal Length (IV/V).- 2.1.4 Total Syndactyly of Several Long Fingers.- 2.1.5 Partial Syndactyly ("Short Type").- 2.1.6 Partial Syndactyly ("Long Type").- 2.2 Osseous Syndactylies.- 2.2.1 Introduction: "Apert Hand".- 2.2.1.1 General Remarks.- 2.2.1.2 Timing of Surgery.- 2.2.1.3 General Surgical Directives.- 2.2.1.4 Postoperative Care.- 2.2.2 Total Syndactyly Between Thumb and Long Fingers.- 2.2.3 Partial Syndactyly Between Thumb and Index Finger.- 2.2.4 Total Syndactyly of the Long Fingers with Acrosynostosis.- 2.2.5 Radial Clinodactyly of the Thumb.- 2.3 Recurrent Syndactylies.- 2.3.1 Introduction.- 2.3.1.1 General Remarks.- 2.3.1.2 Timing of Surgery.- 2.3.1.3 General Surgical Directives.- 2.3.1.4 Postoperative Care.- 2.3.2 Recurrent Syndactyly of the Long Fingers (Narrow "Short" Type).- 2.3.3 Recurrent Syndactyly of the Long Fingers (Wide "Short" Type).- 2.3.4 Recurrent Syndactyly of the Long Fingers ("Short" Type) with Scars Extending to the Distal Phalanges.- 2.3.5 Recurrent Syndactyly of the Long Fingers ("Long" Type).- 2.3.6 Recurrent Syndactyly of the Long Fingers ("Long" Type) with Scars Extending to the Distal Phalanges.- 2.3.7 Recurrent Syndactyly Between Thumb and Index Finger.- 3 Peripheral Hypoplasias.- 3.1 Introduction.- 3.1.1 General Remarks.- 3.1.2 Indications for Surgery.- 3.1.3 Timing of Surgery.- 3.1.4 General Surgical Directives.- 3.1.5 Postoperative Care.- 3.2 Syndactyly with Digiti Superducti.- 3.3 Interdigital Cutaneous Bridge ("Bridge Syndactyly").- 3.4 Partial Syndactyly Between Thumb and Index Finger.- 3.5 Total Syndactyly of Rudimentary Fingers of Unequal Length.- 3.6 Total Syndactyly of Rudimentary Fingers of Equal Length.- 3.7 Anular Grooves with Excessive Dorsal Soft Tissue Finger Pads.- 3.8 Conical Rudimentary Finger; Excessive Dorsal Soft Tissue Finger Pad.- 3.9 Rudimentary Thumb with Excessive Soft Tissue.- 3.10 Anular Groove and Defect Pseudarthrosis of the Thumb.- 3.11 Rudimentary Index Finger with Excessive Soft Tissue and Anular Groove.- 3.12 Anular Groove of the Forearm.- 4 Numerical Variations.- 4.1 Introduction.- 4.1.1 General Remarks.- 4.1.1.1 Polydactylies.- 4.1.1.2 Oligodactylies.- 4.1.2 Timing of Surgery.- 4.1.3 General Surgical Directives.- 4.1.4 Postoperative Care.- 4.2 Thumb Hypo- and Aplasias.- 4.2.1 Partial Syndactyly Combined with Second-Degree Thumb Hypoplasia.- 4.2.2 Partial Syndactyly Combined with Second-Degree Thumb Hypoplasia and a Tight Web Space.- 4.2.3 Second-Degree Thumb Hypoplasia with Dysplasia of the First Metacarpophalangeal Joint and Hypo- or Aplasia of M. Opponens.- 4.2.4 Second/Third-Degree Thumb Hypoplasia (Index Finger Pollicization; Incision According to Blauth).- 4.2.5 Thumb Aplasia (and Fourth-Degree Thumb Hypoplasia) (Index Finger Pollicization; Incision According to Blauth).- 4.2.6 Thumb Aplasia (Index Finger Pollicization; Incision According to Buck-Gramcko).- 4.3 Long Finger Oligodactylies.- 4.3.1 Oligosyndactyly with Acrosynostosis.- 4.3.2 Oligodactyly with Total Syndactyly ("Spoon Hand").- 4.3.3 Oligodactyly with Total Syndactyly of the Long Fingers and Acrosynostosis.- 4.3.4 Oligodactyly with "Duplication" of a Middle and Distal Phalanx (and Acrosynostosis).- 4.3.5 Oligodactyly with Synostosis of the Proximal Phalanges.- 4.4 Thumb Duplication.- 4.4.1 Incomplete Duplication of the Distal Phalanx of the Thumb.- 4.4.2 Mirrorl
