[The Apert Foot: Anatomical Changes, Classification, Thoughts on surgical Treatment].

Diagnosis and therapy of the Apert foot are scarcely described in extant literature. This article describes anatomical changes observed in 30 Apert feet. By analysis of X-rays and computed scans 5 types of bony Apert foot malformations were identified.

[Developments in the Diagnosis and Therapeutic Strategy of the Apert Hand].

The necessity for early surgical correction of Apert hands for the overall child development has been highlighted repeatedly in older literature. Nevertheless, uncertainties regarding the time and the scale of the initial surgical treatment still remain. While in former times there were no regular follow-ups after the syndactyly release, we now know that during growth bony changes will develop in the Apert hand requiring regular check-ups and, in some cases, revision surgeries.

[Possible Compartment Syndrome of the Hand in Patients with chronic post-traumatic Pain - 2 Case Reports].

The authors present two young patients with atypical development of painful post-traumatic hand muscle compartment syndrome. The first patient showed congenital hyperplasia of the thenar and first dorsal interosseous muscle and developed chronic exertional pain that only occurred after trauma and is indicative of compartment syndrome. The second patient developed compression of the second palmar interosseous muscle due to post-traumatic haematoma in the third interdigital space.

[Three-year-old child with osteoid osteoma of the thumb: Diagnostic and therapeutic challenge].

A three-year-old girl experienced a fifteen-month odyssey before the surgical removal of an osteoid-osteoma at the distal phalanx of the thumb to relieve her pain. Osteoid-osteoma is a benign bone tumor rarely found in the hand and not yet described as occurring in a small child in extant literature. In one of the first x-ray examinations, a small foreign body was found in the soft tissues of the right thumb.

Three-dimensional CT angiography for surgical planning in congenital hand malformations: a case series presentation.

Between January 2000 and December 2019, three-dimensional computer tomographic (CT) angiography was used in a total of 140 hands (116 patients, mean age 6.8 years) with congenital hand malformation to assess the vascular and bony structures. Analysis showed overall satisfactory three-dimensional CT images for operative planning, including detailed abnormal vascular patterns and bony malformations.

[Neuroma prevention through a sensitive finger fillet flap and a central hand narrowing operation].

Two patients with functionless fingers as a result of an injury and various operations presented to obtain a second opinion. We offered a finger and partial middle-hand skeletal resection for the painful and disabled finger. As amputations often cause neuromas, we created a sensitive fillet flat and used it to fill the defect on the palmar aspect of the hand.

[Completeness and reproducibility of surgical reports: A retrospective analysis of documentation quality using the example of Dupuytren's disease].

 A surgical report is the surgeon's postoperative documentation of the procedure undertaken. The purpose of this study was to evaluate the completeness and accuracy of data extracted from surgical reports, using the example of Dupuytren's disease.  Between 1999 and 2007, surgical data were retrospectively collected from all primary Dupuytren's disease procedures performed at an academic department for plastic and reconstructive surgery and analysed for completeness.

Characterisation of the inflammatory response in Dupuytren's disease.

Background: Dupuytren's disease is characterised by fibrotic nodule and cord formation in the palmar aponeurosis. The pathophysiology of the disease is still unknown, although cell stress and subsequent activation of immune mechanisms seems to be crucial.

Materials And Methods: Surgically obtained tissue and blood samples of 100 Dupuytren patients were processed by immunohistochemistry, flow cytometry, as well as immunoscope analysis.

Effect of extracorporeal shock wave treatment on deep partial-thickness burn injury in rats: a pilot study.

Extracorporeal shock wave therapy (ESWT) enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance.

Molecular analysis of two novel missense mutations in the GDF5 proregion that reduce protein activity and are associated with brachydactyly type C.

Growth and differentiation factor 5 (GDF5) plays a central role in bone and cartilage development by regulating the proliferation and differentiation of chondrogenic tissue. GDF5 is synthesized as a preproprotein. The biological function of the proregion comprising 354 residues is undefined.

Inferior pole length and long-term aesthetic outcome after superior and inferior pedicled reduction mammaplasty.

Background: Long-term aesthetic results after reduction mammaplasty remain an important issue for evaluating the success of different techniques. Superior pedicled techniques are reported to maintain a better breast projection with less bottoming-out of the inferior mammary pole than inferior pedicled techniques.

Methods: The outcomes of 18 patients who had undergone the superior pedicled technique described by Pitanguy and 16 patients operated on using the inferior pedicled technique by Robbins were compared.

T regulatory cells and TH17 cells in peri-silicone implant capsular fibrosis.

Background: The authors investigated the immunological mechanisms underlying extensive peri-silicone implant capsule formation, one of the most frequent postoperative complications in patients receiving silicone mammary implants.

Methods: The authors studied immune response activation by phenotypic and functional characterization of lymphocytes accumulated within this tissue. Intracapsular lymphoid cells and autologous peripheral blood mononuclear cells were isolated and analyzed by flow cytometry.

World experience after more than a decade of clinical hand transplantation: update on the Innsbruck program.

Patients who have lost a hand or upper extremity face many challenges in everyday life. For some patients, reconstructive hand transplantation represents a reasonable option for anatomic reconstruction, restoring prehensile function with sensation and allowing them to regain daily living independence. The first clinical case of bilateral hand transplantation at University Hospital Innsbruck was realized on March 17th, 2000.

Reduced insulin-like growth factor-I serum levels in formerly obese women subjected to laparoscopic-adjustable gastric banding or diet-induced long-term caloric restriction.

Life-span extension in laboratory rodents induced by long-term caloric restriction correlates with decreased serum insulin-like growth factor-I (IGF-I) levels. Reduced activity of the growth hormone/IGF-I signaling system slows aging and increases longevity in mutant mouse models. In the present study, we show that long-term caloric restriction achieved by two different interventions for 4 years, either laparoscopic-adjustable gastric banding or reducing diet, leads to reduced IGF-I serum levels in formerly obese women relative to normal-weight women eating ad libitum.

The internal mammary artery perforator (IMAP) breast-flap harvested from an asymmetric hyperplastic breast for correction of a mild funnel chest deformity.

Pectus excavatum deformity is the most frequent congenital anomaly of the thoracic wall. If the invasive surgical procedures of thoracoplasty are not indicated or the patient refuses them, alternative treatment options should be considered. In such cases, local or distant transposition of autologous tissue could be appropriate.

Adipokine profile and insulin sensitivity in formerly obese women subjected to bariatric surgery or diet-induced long-term caloric restriction.

To better understand the contribution of the fat mass to the effects of long-term caloric restriction in humans, we compared adipokine profile and insulin sensitivity in long-term calorically restricted formerly obese women (CRW) subjected to different interventions, bariatric surgery, or reducing diet, with age- and BMI-matched obese (OW) and normal-weight women (NW) eating ad libitum. Our key findings are that despite a considerably stronger weight loss induced by bariatric surgery, both long-term caloric restriction interventions improved insulin sensitivity to the same degree and led to significantly lower retinol-binding protein-4 and interleukin-6 serum levels than in OW, suggesting that lowering of these two adipokines contributes to the improved insulin sensitivity. Moreover, serum leptin was considerably lower in CRW than in OW as well as in NW, suggesting that CRW develop hypoleptinemia.

Extracorporeal shock wave treatment in ischemic tissues: what is the appropriate number of shock wave impulses?

The dose-dependent effect of extracorporeal shock wave technology (ESWT) was evaluated using a murine skin flap model. Thirty-six Sprague-Dawley rats were divided into six groups (ESWT groups 1 through 5 and a control group). After surgery, shock wave impulses doses were administered: 200 (group 1), 500 (group 2), 1500 (group 3), 2500 (group 4), 5000 (group 5), and 0 (control group 6).

Familial congenital symmastia: ultrastructurally abnormal breast tissue.

Reports about congenital symmastia and its surgical treatment are few. We report two patients - a mother and daughter - with congenital symmastia in whom breast and fatty tissue was found to be mobile adhering poorly to the chest wall. Although histological examination showed no abnormality of the tissue bridge between the breasts, ultrastructural investigation of breast tissue (including Cooper's ligaments) showed an abnormal arrangement of collagen fibres.

[Ten years of hand transplantation experiment or routine?].

In the 20th century the legend of Cosmas and Damian - an extremity being transferred from one person to another - became reality. The first hand transplantation was carried out in 1964 in Ecuador but the hand had to be removed again within three weeks due to rejection. Although he was the first one to be treated with more modern immunosuppressants, the same fate overtook another patient who received a hand from a brain-dead donor in 1998 in Lyon.

Unilateral gigantomastia related to juvenile fibroadenoma with idiopathic thoracic scoliosis.

A 15-year-old girl was referred to our Department by the orthopedic surgeons, showing a massive unilateral gigantomastia of her right breast and a progressive idiopathic thoracic scoliosis. Ventral positioning of the patient for the planned scoliosis correction was impossible without prior treatment of the hypertrophic breast. In the first operation the fibroadenoma with a total weight of 3020 g was resected and histological examination revealed diagnosis of a juvenile giant fibroadenoma, which is a rare tumor of the stromal breast tissue.

Pollicization of the index finger in hypoplasia of the thumb. Experience with the method of Buck-Gramcko and retrospective analysis of the clinical outcome in a series of 19 pollicizations.

Background: In congenital malformation of the thumb index finger pollicization is a proven method for constructing a new thumb all over the world.

Methods: A series of 19 pollicizations in 15 patients is presented. In all cases of index finger pollicization the method of Buck-Gramcko is used and the functional outcome is evaluated after Percival's method.

[Anatomical considerations on treatment strategies for compression syndromes of the fibular nerve in the proximal leg].

Background: Posttraumatic or iatrogen compression syndromes of the common fibular nerve (CFN) are frequent. Based on previous anatomical investigations the aim of this study was to analyse the course of the CFN along the proximal portion of the leg with respect to its relationship to the anterior intermuscular septum (AIS). Further sites of constriction or fibrous fixation should be defined.