[Complex regional pain syndrome versus chronic regional pain syndrome (Hand-Finger Syndrome)].

Dystrophy is a main factor of CRPS. A large number of patients do not develop dystrophy but, instead, they suffer from pain with limitation in movement, possible paraesthesia and/or swelling. This is then a chronic regional pain syndrome or (shoulder-arm-) hand-finger syndrome.

[The Mantero technique for flexor tendon repair - an alternative?].

Purpose: Regaining free tendon gliding after reconstruction of flexor tendons is essential to restore full function to the affected finger. Mantero et al. described a pull-out suture technique for the repair of flexor digitorum profundus (FDP) lesions in zone 1, allowing early postoperative active mobilisation and thus minimizing the risk of tendon adhesions.

[Repeat interventions after decompression of the carpal tunnel].

If after carpal tunnel release, symptoms continue or progress, or if new ones appear, they must be examined thoroughly and differentiated. Such symptoms may hint at incomplete splitting of the retinaculum flexorum, a more proximally located nerve compression (faulty diagnosis or double-crush syndrome), a general or a new disease, a previously unrecognized or a new hypertrophic synovialitis, a hypertrophically contracted scar, or a neuroma. Iatrogenic lesions have frequently been reported.

The synovial flap as treatment of the recurrent carpal tunnel syndrome.

After an exact definition of the recurrent carpal tunnel syndrome, its treatment, as described in the literature, is presented. To cover the median nerve isolated from the extended scar tissue with a thin and well-circulated tissue, the author proposes and demonstrates the synovial flap. The follow-up of 27 cases operated since 1979 with a follow-up time between 1 month to 14 years shows 6 excellent, 16 good, 3 satisfactory and 2 bad results.

[Chronic entrapment syndromes of the tendons].

The chronic entrapment syndromes of the tendons of the hand are: stenosing tendovaginitis of the flexor and extensor tendons, the trigger wrist, and the intersection-syndrome. Pathogenesis, symptoms, diagnosis and differential diagnosis are presented. The focus is on the localization of the individual disease and its particularities.

[The accessory tendon of the flexor pollicis longus].

The slender accessory tendon of the flexor pollicis longus muscle is described. It is found in 10 to 54% of the cases of trigger thumb, but approximately in the same frequency in the normal thumb too. A literature review of the incidence and genesis is presented.

[Results of follow-up examinations of treatment of Mantero flexor tendon injury in zone 1 and distal zone 2].

We did follow-up examinations of flexor tendon sutures of 161 digits in 151 patients treated according to the Mantero-technique. They revealed that the urgence différée still has its merits today. The results of the sutures in zone 2 correspond to those of zone 1, if only one tendon is affected (zone 2.

[Abductor pollicis longus-repair in treating basal thumb joint arthrosis].

Between 1987 and 1990, we operated 32 hands of 30 patients for basal joint arthrosis. After extirpation of the trapezium, a part of the abductor pollicis longus is pulled through and wrapped around the flexor carpi radialis, similar to the Lundborg method. This creates a tendinous web, which supports the first metacarpal bone.

[Synovial flap repair in treating recurrent carpal tunnel syndrome].

In 1980, we presented the synovialis flap plasty for the treatment of carpal tunnel syndrome recurrence. Since May 1979, we performed 41 secondary procedures, and among them 14 synovialis flap plasties. The results were very good in three patients, good in eight, satisfactory in two, and poor in one, but this patient with the poor result reported subjective improvement.

[Intersection syndrome].

The causes, symptoms and therapy of intersection syndrome are discussed, cases presented and the literature reviewed. If intersection syndrome does not respond favorably to conservative treatment, we perform synovialectomy and incision of the thick fascia of the abductor pollicis longus muscle.

Flexor tendon suture in zone 1 and distal zone 2 by the Mantero technique.

A series of 161 digits with flexor tendon division in zones 1 and 2 have been reviewed after management by the method described by Mantero. The concept of "urgence différée" (delayed primary suture) is still valid. In zone 2, we distinguish between division of tendons, where only profundus is divided (zone 2.

[The "open palm" technique in Dupuytren's contracture].

The authores reports on the "open-palm-technique" used in those patients in whom after excision of the Dupuytren's tissue and passive maximal extension of the fingers the skin in the palm cannot be closed without undue tension. Postoperative complications such as hematoma accumulation and edema can be avoided by this method. Neither the length of treatment nor the duration of incapacity is prolonged by this technique.

On the treatment of enchondroma.

We recommend simply removing an enchondroma without filling the cavity with cancellous bone or plaster-of-Paris. This method can also be applied to other benign bone conditions, such as aseptic necrosis.

[Post-traumatic ulnar nerve irritation and paralysis as a compression syndrome under the palmar carpal ligament].

The palmar carpal ligament is defined as the distal border of the fascia antebrachii. It is proposed that this name is not used for the region of the fascia antebrachii proximally to this structure or for parts of the retinaculum distal to this structure, i.e.

[Peritendinitis calcarea of the hand, a case report].

The authors present three cases of peritendinitis calcarea in the extensor tendons of the wrist and the flexor tendons of the fingers. The symptoms were gout-like pain attacks and local inflammation. In the X-rays calcification was seen within the tendon sheath.

[Malignant soft tissue tumors of the hand: report of 2 malignant fibrous histiocytomas and 2 extraskeletal myxoid chondrosarcomas].

The authors discusses two malignant tumors of the soft tissue of the hand: the malignant fibrous histiocytoma and the extraskeletal myxoid chondrosarcoma. With each tumor two patients were involved. One patient with malignant fibrous histiocytoma required amputation at the fourth and fifth carpometacarpal joints, one patient with extraskeletal myxoid chondrosarcoma amputation in the proximal third of the forearm.

[Kaplan's anastomosis in the little finger].

The connection between the dorsal branch of the ulnar nerve and the proper digital nerve of the little finger--described by Camper 1760 and by Kaplan 1963 more proximally--is shown in the little finger of four patients.

[Congenital radial dysplasia (thumb ray and radial carpus)--an atavism].

A case of hypoplastic thumb with anomalies of the radial carpal bones is reported, believed to be atavistic in origin.

[M. abductor digiti minimi longus: anatomical rarity?].

Within a period of five months, in eleven of all the cases examined, the author found the M. abductor digiti minimi longus as was described by Frohse and Fränkel in 1908. It ran from the fascia antebrachii through the Canal de Guyon to the hypothenar muscle mass.

Treatment of recurrence of the carpal tunnel syndrome.

Exact definition of the recurrent carpal tunnel syndrome. Presentation of the methods of operation for the recurrent carpal tunnel syndrome corresponding to the indication basing on the causes of the recurrences.

[Dupuytren's contracture as an accident sequela. Can progression of Dupuytren's contracture be recognized as an accident sequela?].

A healthy nineteen year-old soldier suffered a contusion of the distal interphalangeal joint of the fifth finger. A flexion contracture ensued. Histologic examination of the excised tissue revealed Dupuytren's contracture.

[Distal ulnar nerve irritation].

The authors present a rare compression syndrome of the deep branch of the ulnar nerve distally to the adductor pollicis muscle at the third metacarpal. After neurolysis, regeneration was proved clinically and electroneurographically.