J Brachial Plex Peripher Nerve Inj
January 2025
To date, there are no uniform guidelines for the treatment of obstetric plexus lesions in German-speaking countries. An end-to-end direct suture after resection of trunk neuroma is recommended for surgical treatment if tension-free coaptation is possible, whereas the use of autologous nerve grafts bridging the gap between the adaptation margins is advised by consensus if tension-free coaptation is impossible. The aim of the study was to investigate which reconstruction strategy may provide a better recovery of motor function for patients after obstetric brachial plexus lesion.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
November 2024
Peripheral nerve surgery, particularly in cases of nerve compression syndrome (NCS), necessitates a comprehensive evaluation of intraneural blood flow, as localized reductions in nerve perfusion are integral to the etiopathogenesis of such conditions. Although nerve perfusion is currently guided by morphologic characteristics, this assessment is subjective and prone to bias. Intraoperative fluorescence-assisted perfusion imaging with indocyanine green (ICG) is an established tool in flap and lymphatic surgery to objectively assess perfusion intraoperatively.
View Article and Find Full Text PDFThe technology of microsurgical robotic systems has shown potential benefit during the last decade for a variety of microsurgical procedures, such as vascular anastomoses, lymphatic anastomoses or nerve coaptation. At the same time, peripheral nerve surgery has produced ever more sophisticated nerve transfers in which the smallest nerve structures are connected to each other. Following obstetric brachial plexus injuries, nerve reconstruction surgery is often required in the first few years of life in order to improve the function of the affected arm, including nerve transfers to denervated muscles, which enable reinnervation of target muscles.
View Article and Find Full Text PDFFor half a century, the Mallet Scale (MS) has been utilized to assess upper limb function in patients with obstetric brachial plexus palsy (OBPP). However, the correct use of the MS requires trained personnel and the MS does not measure compensatory movements. For this reason, new methods are needed to compensate for these weaknesses.
View Article and Find Full Text PDFBackground: There is substantial literature supporting the use of cellular and/or tissue-based product (CTP) in managing Wagner grade 1 and 2 diabetic foot ulcers (DFUs) and, to a lesser extent, venous leg ulcers (VLUs). Several studies advocate CTP therapy as an effective method for promoting healing in chronic DFUs and VLUs.
Objective: To evaluate how the number of CTP applications affect healing and wound area reduction (WAR) rates of DFUs and VLUs.
Handchir Mikrochir Plast Chir
February 2024
Handchir Mikrochir Plast Chir
February 2024
Handchir Mikrochir Plast Chir
February 2024
We present the Nerve Club, a community of colleagues originating from german-speaking countries and dedicated to those working in or outside surgery with interest in the peripheral nerve. This article reviews the club´s history and specific characteristics and activities, and highlights the concept of a certificate in nerve surgery. We have annual club meetings and organize every two years a plexus symposium.
View Article and Find Full Text PDFComplex brachial plexus injuries with multiple or complete root avulsions make intraplexic reconstruction impossible in some cases. Such cases necessitate the use of extraplexic nerve donors such as the spinal accessory nerve or intercostal nerves. The contralateral C7 root represents a donor with a high axon count and can be used as an axon source in such cases.
View Article and Find Full Text PDFSteindler flexorplasty (SF) is aimed at restoring independent elbow flexion in the late stages of dysfunction of the primary elbow flexors. Selection criteria for successful SF have been defined. The purpose of this study was to redefine the inclusion criteria for successful SF based on functional outcomes.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
August 2023
Microsurgical demands in peripheral nerve surgery are increasing. Because of the development of multiple simultaneous selective nerve transfers, the transposition of very small nerves and even single fascicles has evolved. Coaptation of these increasingly smaller structures require high skills in microsurgical techniques.
View Article and Find Full Text PDFDupuytren's disease is a common condition in hand surgery. The fifth finger is frequently affected, pre- senting the highest recurrence rate after surgical treatment. The ulnar lateral-digital flap is used when a skin defect prevents direct closure after fasciectomy of the fifth finger at the level of the MP joint.
View Article and Find Full Text PDFDev Med Child Neurol
October 2022
Background And Aims: The purpose of this investigation was to test the hypothesis that a novel adhesive retention suture device (ARSD) can increase perfusion at elliptical wound closures by distributing stress away from the suture site.
Methods: Stress in the skin around a suture both with and without support from an ARSD was evaluated using a finite element model. A single-center, randomized split-scar comparison trial using laser speckle contrast analysis was used to quantify the perfusion at elliptical wound closures in human patients both with and without an ARSD.
Oper Orthop Traumatol
October 2021
This review article presents the history, indications and techniques for the usual nerve transpositions in the upper extremities. By means of nerve transposition paralyzed muscles are reinnervated using dispensable donor motor axons. Many standard operations on the upper extremities are attributable to concepts of German-speaking surgeons and orthopedists.
View Article and Find Full Text PDFBackground: Nerve compression syndromes are referred to as chronic irritation or pressure palsies of peripheral nerves in areas of preformed anatomical constriction. Carpal tunnel syndrome is the most common nerve compression syndrome, followed by cubital tunnel syndrome. In addition, less frequent nerve compression syndromes of the upper extremities that affect the median, ulnar or radial nerves have been described.
View Article and Find Full Text PDFCranio-spinal irradiation (CSI) treatment of embryonal tumors is associated with long-term endocrine and neuro-cognitive sequelae. As an example, the radiation regiment for standard risk medulloblastoma is 23.4 Grays (Gy) CSI followed by a boost of 30.
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