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J Hankiss

Publications and source records attributed to J Hankiss.

At least 19 recordsLinked to original sources
PubMed2005

[Dorsal capsulodesis versus triscaphe arthrodesis in patients with scapholunate dissociation. Do the results depend on the diagnosis or the operation?].

BACKGROUND: Dorsal capsulodesis and triscaphe arthrodesis are possible treatment modalities for patients with scapholunate dissociation. In light of overlapping indications for either operation for patients with carpal instability, it is important to compare the postoperative results. METHODS: From 1998 until 2002, we operated on 87 patients suffering from scapholunate dissociation. 52 patients were treated by dorsal capsulodesis after R. Berger and 35 patients were treated by triscaphe arthrodesis as published by Watson. Of these 87 patients, we managed to follow-up 77 patients (47 dorsal capsulodesis und 30 triscaphe arthrodesis) with a physical examination, X-ray of the wrists and Krimmer Score. RESULTS: In terms of grip-strength, range of motion, functional outcome (Krimmer Score), duration of the operation and hospitalisation, the dorsal capsulodesis group performed better (p < 0.05) than the triscaphe arthrodesis group at the time of follow-up. At follow-up, pain reduction was significant in both groups (p < 0.05). Krimmer Score (functional outcome) and the rate of complication was clearly better for the dorsal capsulodesis group as compared to the triscaphe arthrodesis group. CONCLUSION: In case of non-static scapholunate dissociation, dorsal capsulodesis should be the first choice treatment. In case of a young manually working man with static scapholunate dissociation, it should be a case-to-case decision whether performing a triscaphe arthrodesis or a dorsal capsulodesis. With this investigation we wanted to discuss and demonstrate the difficulties with the differential-indication for the two operations. Generally speaking the postoperative results did not depend on the type of scapholunate dissociation (dynamic versus static) but rather on the chosen surgical procedure.

Adolescent↗
PubMed2004

[Late results after nerve transplantation on the upper extremities].

PURPOSE: The purpose of this retrospective study was to determine the influence of the type of injury, the time elapsed after the injury, the blood supply to the operation area, the size of the graft, and the applied treatment method on the late results. METHOD AND MATERIAL: In the study period from 1985 through 2000, nerve transplantations had been performed in 281 patients. There were 204 men and 77 women. Reconstructions were applied on the median nerve in 59 patients, ulnar nerve in 48, median and ulnar nerves in 23, radial nerve in ten, and digital nerves in 141 patients. 188 patients presented for late follow-up (66.9%). RESULTS: Evaluation was made according to the Highet scheme. In patients with median nerve transplantation M(3) or better results were seen in 69%, with M(3) being 45.2%. S(3) or better was observed in 64.3%, with S(3) being 47.6%. In patients after ulnar nerve transplantation M(3) or better result was achieved in 56.8%, M(3) being 19%. S(3) or better result was seen in 32.4%, S(3) being 27%. In patients who underwent median and ulnar nerve transplantations M(3) or better result was seen in 36.8%, M(3) being 26.3%. S(3) was in 42.1%, while S(4) did not occur. In patients after radial nerve transplantation M(3) or better effect resulted in 87.5%, M(3) being 12.5%. In patients with digital nerve transplantation S(3) or better result occurred in 57.4 %, S(3) being 47.6%. CONCLUSION: The best result can be achieved with nerve suturing, performed as an optimum from all aspects. However, as far as the surgical technique is concerned, results of using interfascicular grafts are more advantageous than epineural nerve suture based on compromises. In ideal circumstances, transplantation of a nerve graft less than 2 cm is of the same value as a good primary suture. If a nerve graft is longer than 2 cm, and negative local factors are accumulating due to the type of injury, late results will gradually deteriorating. The final outcome definitely depends on the patient's age and the time elapsed from the injury to the operation.

Adolescent↗
PubMed1997

[Early diagnosis and management of femur head necrosis in young adult age].

There are a lot factors in the genesis of the ischemic femoral head necrosis. In the early stage the intraosseous pressure increases without any clinical or radiological sign. The disease is often bilateral. The early diagnosis (NMR) is essential in the treatment. In the case of a severe femoral head necrosis the radiological investigation of the other side is obligatory, in order to diagnose the early stage of the disease and to prevent the progression of the collapse with core decompression. The object of the adequate treatment of the collapsed femoral head is to release the pain and to avoid the total destruction of the femoral head. The untreated femoral head necrosis results in a painful, arthritic hip, where spontaneous regeneration is limited, and takes 8-10 years. With osteotomy and revascularisation the results are good, and the regeneration takes about 2-3 years. As a result of this treatment, the patients have a moderately limited function, and minimal limping. Rehabilitation is possible into the original profession, or into a somewhat easier job. Remodellation of the femoral head in younger patients following the revascularisation procedure has been observed in our experience in the last few years.

Adolescent↗
PubMed1997

[Microsurgical methods of bone replacement].

Vascularized bone grafting techniques are ideal for long bone defects in the extremities. The authors report on their experience in this field. From January 1991 to 2nd November 1995, 17 patients were treated by vascularized bone grafts. In ten cases iliac crest, in six cases fibula, and in one case a radial forearm composite flap was used. All patients have shown optimal healing and good bony consolidation, except for one case of circulatory disorder of the fibula graft.

Adult↗
PubMed1994

[Is remodeling still possible after collapse in femur head necrosis?].

A case of a femoral head necrosis, with collapsed joint surface after fracture of the femoral neck will be presented. Following varisation osteotomy, the necrotic parts of the bone was removed and filled with cancellous bone. A standardized bone block of the iliac crest was implanted into the hole. After the operation the patient was painfree. The X-rays showed the improvement of the bony structure and later a spherical remodeling of the femoral head. This result is in opposition with the earlier opinion of the disability of femoral head remodeling in adults. It is technically very important to pack tight the hole in the femoral head with cancellous bone chips after necrectomy, and to ensure the revascularisation with vascularised bone block.

Adult↗
PubMed1994

[Substitution of soft tissue defects on the lower leg and foot in septic cases].

After the spontaneous epithelialisation of the defects of soft parts so called unstable scars remain which, because of ulceration, are sources of infection, endangering both soft parts and bones. Substitution with soft tissues of adequate blood supply enables the complete sanation of the septic foci and by this the rapid healing of the patient with full function. Beside this a better cosmetic result can be achieved. In septic environment, if possible, local muscle flaps and free flaps are used, depending on the extent and localization of the defect. Experiences, gained in these operations are described.

Adult↗
PubMed1994

[Hand injury caused by a funnel-producing machine].

Authors describe a case of severe hand injury, caused by a funnel producing equipment. In the region between the metacarpals II and III a high pressure, penetrating, mechanical and thermal injury has arisen. The secondary necrosis expanded and this made a covering with soft tissue of full value necessary. Because of the local relations and allergic complications the local and distant possibilities were narrowed. It was possible to find a final solution by the transfer of flaps from the index and III finger and supplementary plastics, using split thickness skin grafts. The result was functionally perfect, esthetically adequate.

Accidents, Occupational↗
PubMed1993

[Management of malacia of the os lunatum by implantation of a dorsal metacarpal vascular bundle].

In the treatment of malacia of the lunate bone, beside the prosthesis and procedures aiming the decrease of load, the revascularization of the bone is the third basic therapeutic principle. One possibility of the later, not yet current in this country, is the implantation of the metacarpal vascular bundle in the lunate bone. As far as we know we were the first to perform this operation in Hungary. In this paper our first cases are described together with a detailed description of the operative technique and we would call at the same time to further common examinations.

Adult↗