The stability of imine-containing dynamic [2]rotaxanes to hydrolysis.

Large amounts (>100 mol equivalents) of water are required to effect by hydrolysis the partial disassembly of the rings from the dumbbell components of two dynamic [2]rotaxanes. The two dynamic [2]rotaxanes are comprised of [24]crown-8 rings-each of which incorporate two imine bonds-encircling a dumbbell component composed of a dibenzylammonium ion in which each of the two benzyl substituents carries two methoxyl groups attached to their 3- and 5-positions. A mechanism for the partial disassembly of the two dynamic [2]rotaxanes, involving the cleavage of the kinetically labile imine bonds by water molecules, is proposed.

Synthesizing interlocked molecules dynamically.

As the complexity of mechanically interlocked molecular architectures increases, it is important to understand the underlying principles, such as molecular recognition and self-assembly processes, that govern the practice of template-directed synthesis necessary to create these particular compounds. In this review, we explain the importance of dynamic processes in the synthesis of mechanically interlocked compounds. We show how many different dynamic covalent bonds have been used in the synthesis of rotaxanes, catenanes, and other higher-order mechanically interlocked compounds, with the goal of revealing the state of the art in dynamic covalent chemistry.

[Diagnosis and therapy of carpal tunnel syndrome--guideline of the German Societies of Handsurgery, Neurosurgery, Neurology, Orthopaedics, Clinical Neurophysiology and Functional Imaging, Plastic, Reconstructive and Aesthetic Surgery, and Surgery for Traumatology].

Evidence-based supradisciplinary guideline that deals with the epidemiology, pathogenesis, symptoms, clinical and electrophysiological diagnosis, supplementary imaging investigations, differential diagnosis, conservative and surgical treatments, prognosis and course along with complications and revision surgery. The recommendations on investigation and treatment are based on a comprehensive literature search with critical evaluation and two consensus methods (expert group and Delphi technique) within the participating specialist societies. Besides this long version, a short version and a patient version can be viewed through the AWMF platform.

Equilibrating dynamic [2]rotaxanes.

Upon mixing and dehydration, 2,6-diformylpyridine and 2,2'-oxybis(ethylamine) form a dynamic combinatorial library of at least nine members. Through hydrogen bonding and other intermolecular interactions, templating dumbbell molecules select one macrocyclic member of the library, at the expense of all the others, to create [2]rotaxanes. These rotaxanes, however, retain the dynamic character of the library, since a diformylpyridine analogue can exchange with the macrocyclic component in solution.

[Partial midcarpal arthrodesis with excision of the scaphoid for the treatment of advanced carpal collapse].

Objective: To eliminate painful arthrosis between the radius and scaphoid and between the lunate and capitate. Stabilization of the carpus with preservation of useful range of motion between the radius and the lunate.

Indications: Painful arthrosis of radioscaphoid joint due to an old lesion of the scapholunate ligament or a long-standing scaphoid pseudarthrosis with loss of carpal height (advanced carpal collapse, stage II) and eventual additional midcarpal arthrosis (stage III).

[Synovialectomy of the metacarpophalangeal joints with reconstruction of the radial collateral ligaments -- long-term results in patients suffering from rheumatoid arthritis].

Rheumatoid arthritis may lead to destruction of MP joints and severe alteration of grip and other hand functions. Due to the improvement in medical treatment, synovialectomy of the MP joints is necessary only in late stages. Most centres prefer alloarthroplasties in late stages, as erosion of the cartilage and loosening of the ligaments have already led to destruction of the MP joints and destabilization of grip functions.

[Adaptive patterns of the rheumatoid wrist after radiolunate arthrodesis].

Objective: The aim of this study was the analysis of long-term carpal changes after radiolunate arthrodesis.

Methods: Pre- and postoperative X-rays of 91 wrists in 78 patients with rheumatoid arthritis, who were treated for carpal instability with a radiolunate arthrodesis, were examined concerning the midcarpal joint and the Larsen grade. The mean follow-up was 60 months.

[The caput-ulnae-syndrome. Pathogenesis, clinic and therapy].

The ulnar head has a central function in stabilizing the wrist. In the treatment of caput ulnae syndrome, the radiocarpal joint must, therefore, always be considered. The integrity of the ulnar head and TFCC are of major importance for the rheumatoid wrist.

A comparison of two indices for ulnar translation and carpal height in the rheumatoid wrist.

The indices for ulnar translation described by Chamay et al. (1983, Annales de Chirurgie de la Main, Vol. 2, pp.

[STT-arthrodesis versus radial shortening osteotomy for Kienböck's disease].

Thirteen patients treated by STT fusion for Kienböck's disease (five stage 3 a, seven stage 3 b, and one stage 4) and 36 patients treated by radial shortening osteotomy (20 stage 3 a, 16 stage 3 b) were checked after 26 and 83 months average. The active range of motion and grip strength were compared by means of the Cooney score, discomfort and pain by the DASH score. X-rays were compared for the bone structure of the lunate and development or progress of carpal collapse.

[Complications after midcarpal arthrodesis--attempt to analyse the pitfalls].

Background: Midcarpal arthrodesis (MCA) with excision of the scaphoid is in our opinion a reliable procedure. Pitfalls and unsatisfactory results can be attributed to technical shortcomings during the operation or to poor indication.

Patients And Methods: From 1993 to 2001, 64 MCA were performed in 62 patients.

Neurophysiological recovery after open carpal tunnel decompression: comparison of simple decompression and decompression with epineurotomy.

Two hundred and seventy-three patients with carpal tunnel syndrome without advanced neurophysiological changes (distal motor latency below 11 ms) were randomized to treatment by open carpal tunnel release with, or without, epineurotomy. Patients were examined clinically and by nerve conduction studies preoperatively and at 3, 6 and 12 months postoperatively. We found no statistically significant difference between simple decompression and decompression combined with epineurotomy with regard to either the clinical or the neurophysiological outcome.

[The rheumatoid wrist. Pathobiomechanics and therapy].

A stable and pain-free wrist is a prerequisite for normal hand function. Since the wrist joint is involved early in rheumatoid disease and progress is rapid, operative treatment is of major importance. It is indicated not only for treatment of established osseous changes with instability, deformation, and extensor tendon ruptures but for early treatment of drug-resistant synovitis and monarthritis of the wrist.

[Results of arthroscopic synovialectomy of the wrist].

In the course of inflammatory rheumatic diseases, isolated synovialitis of the wrist and distal radioulnar joint can be found without simultaneous affection of the extensor tendons. It may be the only manifestation of the disease in the sense of monarthritis or one of few affected sites as in oligoarthritis. With modern medical treatment of disease-modifying drugs, this constellation seems to be more frequent.

[Functional results of medio-carpal partial arthrodesis with excision of the scaphoid].

Midcarpal arthrodesis with excision of the scaphoid for the treatment of painful carpal collapse has been performed in our hospital since 1993. A clinical study was carried out to evaluate the results and determine special factors, which might influence the results. 26 out of 29 patients operated until 1999 were reexamined after an average follow-up of 27 months.

Radiolunate arthrodesis in the rheumatoid wrist: a retrospective clinical and radiological longterm follow-up.

A retrospective study was performed to investigate the clinical and radiological results of radiolunate arthrodesis in the rheumatoid wrist. Ninety-one wrists in 78 patients were assessed at a mean follow-up of 60 months. Most patients were pain-free and content with the overall result.

[What are the indications for arthroscopic repair of ulnar tears of the TFCC?].

A clinical study was performed to assess the outcome after arthroscopic repair of ulnar tears of the TFCC of the wrist, and to determine which factors are of importance for the results. From 1994 until 1998, in 23 patients an ulnar tear of the TFCC of the wrist was found and treated by arthroscopic repair (average age 32 years, range 16 to 56, 11 female, 12 male). The articular disc was sutured by inside-outside-technique with 2/0 PDS to the floor of the sixth extensor compartment.

[Treatment of a radio-ulnar synostosis by resection and interposition of a septofascial flap--a case report].

Posttraumatic bone formation between radius and ulna can limit forearm rotation considerably. Recurrence after resection of synostoses is likely to develop if the bony surfaces are not covered by gliding soft tissue that is well vascularised. The interposition of a fascial forearm flap pedicled on the septal vessels of the posterior interosseous artery is suitable for this particular purpose.

[Long-term outcome of partial alloplastic replacement of the scaphoid bone].

The operative treatment of scaphoid nonunion with a small, sclerotic, or avascular proximal fragment and with accompanying radioscaphoid arthrosis is difficult and often disappointing. Excision of the proximal fragment, styloidectomy, partial replacement of the scaphoid, and insertion of a silicone-rubber lunate prosthesis has been recommended in these cases. From 1980 to 1984, eleven patients (all male, average age 42 [25 to 59] years) with conditions described above were treated by partial replacement of the scaphoid.

[Results of Kapandji-Sauvé operation after distal radius fractures].

Incongruity of the distal radioulnar joint represents a major problem following malunited fractures of the distal radius. A useful solution is the arthrodesis of the distal radioulnar joint with distal ulnar pseudarthrosis as described by Kapandji-Sauvé. The results of this procedure are presented and the indication compared to alternative treatment options discussed.

Intraepineurial constriction of nerve fascicles in pronator syndrome and anterior interosseous nerve syndrome.

In PS or AINS, if obvious epineurial compression deformity of the median nerve or the AIN is not found at known sites of compression, IeCNF should be considered. IeCNF may occur in one or more nerve fascicles of the median nerve at one of multiple levels in the distal upper arm and proximal forearm. Decompression of the nerve fascicles is achieved by epineurotomy, microsurgical interfascicular dissection, and removal of the constricting outer layer of the perineurium above and below the elbow.

[Idiopathic arthritis of the finger joints].

Degenerative arthritis of the finger joints is a very common disease in middle-aged and elderly patients, in females more frequently than in males. Concerning differential diagnosis rheumatoid arthritis and related conditions, gout, calcinosis, tumors and tumor-like lesions must be considered. Therapy is not necessary in every case.

[Closure of rheumatic palmar perforations of the wrist capsule with a flap of retinaculum flexorum].

In 53 hands with rheumatoid arthritis, bony spurs of the scaphoid and trapezium were found perforating the capsule of the radial wall of the carpal tunnel. After removal of the spurs, the remaining capsular defect was covered by a flap of the flexor retinaculum. The flap is raised from the flexor retinaculum in a width of approximately 15 mm by parallel transverse incisions and is based radially.

[Malignant schwannoma of the median nerve].

The case of a 52-year old patient is described who was operated on for pronator-teres syndrome. Eight months postoperatively reoperation was necessary because of recurrent pain. The median nerve showed haemorrhagic necrosis in the region of the pronator teres muscle with an extensive intrafascicular swelling of the adjacent proximal and distal nerve segments.