Distal insertions of abductor pollicis longus muscle and arthritis of the first carpometacarpal joint in 104 dissections.

The different types of distal insertions of the tendons of the abductor pollicis longus muscle (APL) were studied in 104 cadaveric hands, and the appearance of the rhizarthrosis in the level of the basal joint of the thumb, as well, in a try to detect possible anatomical relationships. From the anatomical point of view, it was evident that the insertions of the APL muscle are usually multiple (95%), that the insertion to the base of the first metacarpal is constantly present, accompanied in 70% of the cases with an insertion to the trapezium. Finally, the accessory tendon to the thenar eminence was proved to be extremely frequent (42%).

Mid-palm replantation. Long-term results.

16 patients with complete mid-palm amputations underwent replantation between 1987 and 1991. 14 were successful. Young patients with guillotine type mid-palm amputations who could be treated with end-to-end suturing of the tendons and nerves, presented with the highest degree of function when evaluated both objectively and subjectively.

Major amputation of the upper extremity. Functional results after replantation/revascularization in 47 cases.

Over a 7 year period, 47 patients underwent replantation of complete (19) and revascularization of incomplete nonviable (28) amputations of the upper extremity. Revascularization of incomplete nonviable amputations had a success rate of 100 percent, where as replantation of complete amputations had a success rate of 74 percent. 37 of the 42 patients with successful replantations had satisfactory functional use of the replanted extremity.

Clinical assessment of primary digital nerve repair.

We have carried out a retrospective study of 64 primary digital nerve repairs in 50 patients who presented to our department between 1988 and 1993. 45 of the patients were operated on within 6 hours of the injury using microscope (x 14). Normal two-point discrimination was regained in only 9 cases, while 6-10 mm two-point discrimination was achieved in 22, 11-15 mm in 15 and protective sensation in 18.

Microsurgical reconstruction of large nerve defects using autologous nerve grafts.

Between 1986 and 1993, 643 patients with peripheral nerve trauma were treated in our clinic. Primary neurorraphy was performed in 431 of these patients and nerve grafting in 212 patients. We present the functional results after nerve grafting in 93 patients with large nerve defects who were followed for more than 2 years.