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Biomedical subjects

D Goth

Publications and source records attributed to D Goth.

29 records · Page 2Linked to original sources

[Giant cell reaction of short tubular bones].

This paper deals with the case of a so-called giant-cell reaction of the short tubular bones of a 31 year-old patient. Histologically, this rare benign disease falls under the category of tumor-like lesions of the bone. Clinically, the disease becomes evident through pain and swelling, and radiologically, a lytic bone process can be observed which may well perforate the cortical substance. The therapy consists in the total removal and the filling of the defect with autologous bone graft from the iliac crest, in some cases also by means of some additional autologous cancellous bone chips. The prognosis after surgical therapy is excellent. In the few cases which have to date become known, no cases of recurrence have been observed. Although the pathogenesis has not been clarified, thus far trauma and local disturbances of growth and/or development must be considered. Concerning differential diagnosis, one should distinguish above all the reaction from aneurysmal and juvenile bone cyst, as well as osteoclastoma.

Adult↗

[Iatrogenic nerve injuries of the arm].

Lack of caution, insufficient knowledge of anatomy, overrating of one's own abilities and operations which are carried out without restricting blood circulation and without sufficient anaesthesia are the most frequent causes of iatrogenic nerve injuries. On the one hand, the faulty treatment of pre-existing nerve injuries will be discussed; on the other hand, nerve injuries resulting from surgery will be considered.

Arm↗

[Motor paralysis of the ulnar nerve in an ice-stab injury].

The isolated cut of the motor branch of a peripheral nerve is very rare. A case is reported of a motor paralysis of the ulnar nerve following an uncommon "ice-stab-injury". Operative revision showed soft hypothenar muscles without scars. Taking the muscles off the flexor retinaculum, one could see the cut of the deep branch of the ulnar nerve. The secondary suture of the nerve by microsurgical technique was very successful, even after 2 1/2 months.

Child↗

[Juxtacortical chondroma in the thenar region].

Juxtacortical chondromas represent a special type of chondroma which, when in a parosteal position, have a pedicle on the bone or periosteum. These benign tumours are not specific to any age group or sex. Typical radiological findings are the combination of calcification and adjacent soft tussue vesicles, as well as a rarefaction and sclerosis of the cortex of the adjacent bones. The only successful therapy is complete exstirpation. The case of a 56-year-old female patient with a juxta-cortical chondroma in the thenar region is discussed.

Bone Neoplasms↗

[Surgical treatment of the ruptured ulnar collateral ligament of the metacarpophlangeal joint of the thumb].

The diagnosis of ruptured ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb is made from characteristic findings and special radiograms. Without treatment, impairment of hand function will result. Only in a few cases will conservative treatment be successful; the reasons are explained. 26 cases of total rupture of the collateral ligament and their surgical treatment are reported. 16 fresh ligamentous injuries were treated by suturing directly (n = 2), by pull-out wire technique (n = 10), and by screw osteosynthesis (n = 4). The ligament was reconstructed with a free tendon graft in 8 cases of old ligamentous injuries, while the remaining 2 cases were repaired using a pull-out wire. After treatment, all metacarpo-phalangeal joints showed full stability and all patients without discomfort. Restriction of mobility results much more from secondary than from primary treatment. Therefore, we recommend primary surgical treatment of the ruptured ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb.

Adolescent↗

[Management of extensive avulsion injury of the hand].

The case of a 25 years old industrial worker is reported, who suffered an extensive avulsion of his left hand in a rubber roller injury. The middle and ring fingers hand to be amputated. The skin loss was covered simultaneously by an axillary pedicled flap for the thumb, two pedicle flaps from the upper arm for the index and small fingers and split thickness skin grafts for the dorsum of the hand. In a second stage, sensation of the tips of thumb and index finger was restored by two innervated full thickness skin grafts from the dorsum of the foot.

Accidents, Occupational↗

[Primary and secondary microsurgical suturing of nerve injuries of the upper extremities. Results of treatment (author's transl)].

In the course of two years, 53 traumatic nerve severances of the upper extremity were sutured microsurgically at the Freiburg University Surgical Hospital. Continuity was restored by primary suture in 29 cases, by secondary suture in 4 cases and by transplantation in 20 cases. The first reinnervation potentials showing in the EMG served as evidence of the motor regeneration. With primary sutures, incipient voluntary innervation was observed after 2 1/2 months, but only after 9 months with nerve transplantation. Favourable conditions given, the authors therefore prefer the microsurgical primary suture to transplantation.

Arm↗