[Hand surgery in the rheumatic hand-novel and established aspects].

Background: Hand surgery of the rheumatoid hand has undergone significant changes mostly as a result of biologicals and biosimilars.

Objective: The significance of established and innovative operative procedures in the modern treatment of the rheumatoid hand is elaborated and a subsumption of local interventional options in this context is carried out.

Methods: The analysis, evaluation and discussion of the literature and expert recommendations are presented.

[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.

[Primary repair of extensor tendon injuries of the hand].

Knowledge of the functional anatomy of the extensor tendons with the sliding mechanism is essential for better understanding the surgical therapy and the postoperative care in the different trauma zones of the extensor tendon. In addition the localization of the injury is very important for the clinical findings, therapy, after-care and long term prognosis. Anatomical facts, injury mechanisms and associated injuries have to be considered in the therapy concept.

[Hyperextension instability of the thumb metacarpophalangeal joint treated by sesamoid arthrodesis].

Summary. Inadequate treatment of hyperextension trauma of the metacarpophalangeal joint of the thumb can cause chronic instability with pain and weakness of pinch. Between January 1995 and December 1998, nine patients (seven posttraumatic and two associated with CMC joint arthrosis) were treated with an arthrodesis of the radial sesamoid.

[2 1/2 years experience with endoscopic carpal tunnel release].

We have been performing endoscopic carpaltunnel release using the two-portal technique since November 1992. Altogether, 139 hands were operated on until November 1993, among them 35 endoscopically. All patients were examined pre- and postoperatively.