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Biomedical subjects

C Wulle

Publications and source records attributed to C Wulle.

At least 19 recordsLinked to original sources
PubMed1998

[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. A second follow-up operation is indicated only after all findings, including the neurophysiological assessment, have been taken into consideration: scar, neuroma resection, revision and neurolysis of the median nerve at all levels. The most difficult question is the coverage of the nerve in the scar tissue with thin and well-vascularised tissue. Various types of flaps using muscle or subcutaneous or synovial tissue have been suggested.

Carpal Tunnel Syndrome↗
PubMed1996

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.

Carpal Tunnel Syndrome↗
PubMed1995

[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.

Constriction, Pathologic↗
PubMed1995

[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. Therapy and possible complications are discussed subsequently.

Chronic Disease↗
PubMed1993

[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.

Adult↗
PubMed1993

[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. Patient assessment revealed good to very good results with only one dissatisfied patient; the objective evaluation showed two thirds good and one third poor results, comparable to those of alternative methods of creation of a tendon web with the flexor carpi radialis (Weilby) or the extensor carpi radialis longus (Necking and Eiken). The essential point is a permanent distance between the base of the first metacarpal bone and both the scaphoid and the base of the second metacarpal bone under normal conditions as well as under loading.

Adult↗
PubMed1993

[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 2.1), while they are clearly inferior, when two tendons are involved (zone 2.2).

Adolescent↗
PubMed1993

[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.

Adult↗
PubMed1992

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 2.1) and, where both profundus and superficialis are divided (zone 2.2). Results from zone 2.1 are comparable to results from zone 1. Overall, our results are of the order of those achieved by management according to Kleinert, but we would maintain that the Mantero technique is easier to perform and more confortable for the patient.

Adolescent↗
PubMed1991

[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.

Adult↗
PubMed1990

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.

Adult↗
PubMed1990

[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. The symptoms and the calcification disappeared spontaneously in a few months. In these rare cases there is no indication for surgery.

Adult↗
PubMed1990

[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. in the hypothenar region. The palmar carpal ligament has been found to be a cause of posttraumatic irritation of the ulnar and median nerve at the wrist proximal to the carpal tunnel or Guyon's canal.

Adolescent↗
PubMed1989

[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. Both remained free of metastases. Also the other two patients after surgical excision and amputation in the third metacarpal bone respectively, are free of recurrences or metastases till now.

Adult↗
PubMed1988

[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.

Dupuytren Contracture↗