Biomedical subjects
Publications and source records attributed to P Hippe.
In cases of congenital partial tibial aplasia or so-called diastases of the lower leg, very good results are to be expected from tibia/fibula fusion in association with a repositioning of the foot. Form and function of the limb are significantly improved, with ortho-prosthetic fitting being considerably facilitated.
In the course of the past nine years, 68 patients (42 boys, 26 girls) were surgically treated for syndactylism in 84 hands. In doing so, 135 syndactylies occurring mostly in the form of severe malformations of the hand were separated. In most cases the web spaces were made according to the surgical techniques developed by Blauth. With the exception of eight cases where secondary corrections had to be made due to shallow web spaces or to scarring, all results were highly satisfactory. The authors tend to evaluate any evidence of such disadvantageous scarring as a change which should be considered as "recurring syndactylism".
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The article reports on two cases of migrations of Kirschner wire following osteosyntheses at the hip joint. In one case of epiphyseodesis, the steel wire for skeletal transfixion was bent and eventually broken. Seven months later, a 6 cm piece of wire had to be removed from the omentum majus of the 14-year-old male patient concerned. In a child aged 4 years, coxa vara congenita was established intertrochanterally and osteotomy fixed by means of a shackle screw after Pohl. For greater safety, a Kirschner wire was additionally introduced. The wire migrated as far as the anterior abdominal wall. The article discusses guidelines which should be observed when employing Kirschner wires.
Polydactyl is a malformation which is usually associated with the radial or ulnar end of the forearm. The various anatomical malformations in relation to nerve supply and tendons are discussed. The importance of a careful functional assessment is essential in relation to the indication for surgery. 25 personal cases are reported and various techniques evaluated.
An isolated paralysis of the radial nerve in a newborn was reported. The displaced growth of the histologically proved angioleiomyoma caused a circumferential compression with subsequent atrophy of the nerve (Fig. 4). During operative treatment of the tumor, the damaged part of the nerve was resected, too. In a second stage the defect in the nerve was closed by suralis grafts. Possibly due to scar adhesions a good result was not obtained.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
The ankle joints of 109 extremities with fibula reductions wer examined. The authors' findings led them to conclude that the shape of the ankle joint must be regarded as the result of an adaptation to altered functions. Ball-shaped ankle joints are frequently found in cases of hypoplasia of the fibula; partial and subtotal aplasias of the fibula are more likely to be associated with a valgus deformity of the ankle joint (known as Volkmann's ankle joint deformity) or, if more severe, with kyphosis of the tibia. If there is no laterodorsal restraint by coarse fibrous strands in cases of fibular aplasia, it is also possible that ball-shaped ankle joints will develop.
A theory about formal aetiology of triphalangeal thumb is emphasized. All teratological grades of triphalangism of the thumb associated with preaxial polydactyly or reduction abnormality of the thumb are to be submitted to our diagram of thumb malformations.
In the operative therapy of slipped capital femoral epiphysis, a controversial discussion exists about the sense of a simultaneous stabilization of both epiphyseal plates and about the correct time of removing the implants. We show the epikrisis of two patients to demonstrate our therapy regimen: in the first case the implants were removed too early. The consequence was a further slipping of the femoral epiphysis consecutive on both sides and the necessity of further surgery. In the other case we observed an outgrowing of the implant out of the epiphyseal plate by use of unthreaded wires. The growth plate was not closed. The femoral epiphysis was stabilized again, because an outgrowing compares to an implant removal at a too early stage. These two cases show our point of view. We recommend to stabilize both sides simultaneously with threaded wires and not to remove the implants before closure of the epiphyseal plate. Furthermore, we hold it advisable to perform a restabilization, when the implants grow out of the unclosed epiphyseal plate during adolescence.