Biomedical subjects
Publications and source records attributed to H Förstner.
In the differential diagnosis of cystic lesions in bones, the intraosseous ganglion must be included. These tumor-like lesion is rare in the carpus, but often the cause of therapy-resistant pain. Four patients with intraosseous ganglion in the carpus are presented. This bone disease is treated by curettage and bone grafting. Postoperative prognosis is good.
Morphologic and biomechanical changes are often the causes of osteoarthrosis in a joint. Complete integrity is necessary, if a joint will be intact the whole life. This integrity is very often disturbed in the distal radio-ulnar joint by trauma and also by surgical treatment. To avoid any incongruence in this joint, which seemed to be neglected by surgeons and orthopaedics, in 1985 about 700 wrists were examined by X-ray, to study the exact morphology with regard to the relation between ulna, radius, declinations and lengths. The aim was to avoid failures in future by all therapeutic procedures. 31 negative ulnar variances (4.4%) and 9 (1.4%) non-traumatic positive variances with a difference of more than 2 mm were revealed. The declination of the distal radio-ulnar joint in relation to the axis of the radius was measured by a special goniometer. To find out the three-dimensional structure of this joint, oblique X-ray photographs were also taken. The results were: in joints with negative ulnar variance declinations of 100 degrees and more were found, and the stereoscopic pictures were conical; in the presence of positive ulnar variance the declinations amounted to 80 degrees or less and the distal radio-ulnar joint surfaces were spherical; in neutral ulnar variances the angle was found to be about 90 degrees and the joints were cylindrical in form. Nearly all operative or traumatic changes were associated with incongruence of this joint. Therefore all therapeutic methods must be planned exactly with reference to this stereoscopic relations between radius and ulna. In traumatic cases the three-dimensional integrity must be reconstructed.(ABSTRACT TRUNCATED AT 250 WORDS)
The trigger wrist identified by an extraosseous "snap" is very rare. The clinical symptoms and the successful treatment of a patient with a trigger wrist are described. Histopathologically a tendon sheath fibroma was found. The clinical and the pathological symptoms of this patient were compared with those published in the literature.
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To satisfy the demands of tactile gnosis, it is necessary to have intact fingertips. For this purpose, the fingernail has an important function. With the help of an example of a nailbed transplantation after a complete amputation of a finger end, a possibility of reconstruction of injured fingertips, especially of the nailbed, is shown. Attention is called to the importance of an exact primary treatment of injured nailbeds.
The os lunato-triquetrum is a fusion of the lunate with the triquetral bone. It is the most frequent anomalie of the carpe and nearly always asymptomatic. The coalition is mostly an isolated event or part of a syndrome of multiple anomalies. A case report of four patients with an synostosis between the lunate and the triquetrum is represented, two of them were members of African people. The high incidence in Africa and the geographical distribution of the described anomalie in black people of African descent are seen - under anthropological points of view - as ethnogenetic and ethnohistorical events.