Biomedical subjects

P Pülzl

Publications and source records attributed to P Pülzl.

6 recordsLinked to original sources

PubMed2006

Free functional rectus femoris muscle transfer for restoration of knee extension and defect coverage after trauma.

In March of 2000 and May of 2002, two patients underwent restoration of knee extension with a free neurovascular rectus femoris flap. The female patient was 10 years and the male patient 19 years old. Both patients sustained a complex trauma of the thigh with fracture of the femur and posttraumatic loss of quadriceps femoris muscles. Follow up of the patients was 51 and 27 months. After 8 months reinnervation were detected by Electromyography (EMG) in both patients and contraction became visible 2 months later. The female patient obtained a good and the male patient a very good functional result. Both patients were able to walk unaided. The authors concluded that free functional rectus femoris transfer can obtain excellent results in treating knee extension and soft-tissue defect due to trauma and loss of the quadriceps femoris muscles.

Adult↗

PubMed2006

[Surgical treatment of persisting and recurrent carpal tunnel syndrome from 1999 to 2003].

The operative treatment of carpal tunnel syndrome is relatively simple and is carried out by doctors from various surgical specialities. In cases of persisting pain or postoperative worsening of the condition, the indication for the procedure could have been wrong or an iatrogenic complication may have to be taken into consideration. We have analysed 42 patients (48 hands) who underwent surgical treatment for carpal tunnel release from 1999 to 2003. We treated eight men and 34 women with an average age of 56 years in this way. Ten patients were initially operated upon by endoscopic release. We found an incompletely transected or even untouched retinaculum flexorum in 16 patients. In eight patients we found an iatrogenic nerve lesion and 24 patients developed serious scarring. Revision surgery should be undertaken only by a surgeon who is a specialist in hand surgery and has extensive experience in this field. In the same context, postoperative hand therapy is essential for a good result, which is performed by occupational therapists in our clinic.

Adult↗

PubMed2004

[Eyebrow injuries. Classification and therapy concept].

The aim of primary treatment for eyebrow injuries should be preservation of the original eyebrow under any circumstances. Debridement should be kept to a minimum even when the wound is severe. The treatment of total or partial loss of an eyebrow concerning the exact reconstruction of details and aesthetic aspects is a challenge for the surgeon. The therapy option depends on the type of eyebrow selected for reconstruction. We present a classification for eyebrow injuries, which considers type and size of defects. Based on this, different techniques and methods of reconstruction are recommended. Advantages and disadvantages are discussed and illustrated by several examples.

Eye Injuries↗

PubMed2003

[Free tissue transplantation for defect coverage of the dorsum of the hand: aesthetic and functional aspects].

BACKGROUND: Complex and large soft-tissue defects of the dorsum of the hand, which cannot be covered with skin grafts or local flaps have to be reconstructed by means of free tissue transplantation. The purpose of this study was to present our experience with free fasciocutaneous flaps and muscle flaps with split-thickness skin graft for defect coverage of the dorsum of the hand in eight patients. PATIENTS AND METHOD: Evaluation of eight patients who underwent coverage of the dorsum of the hand with free flaps during 1997 to 2001 is presented. Other treatment options are discussed. RESULTS: Average age of the patients was 57 years and average follow-up was 25 months. For defect coverage we used a later alarm flap in four cases, a gracilis muscle flap with split-thickness skin graft in three cases and a latissimus dorsi flap with split-thickness skin graft in one case. In five patients we performed an extensor tendon reconstruction. Three of those cases achieved a good, one a fair and one case had a bad functional result. In one patient we had a partial flap loss. Muscle flaps with skin graft revealed better esthetic results than fasciocutaneous flaps. CONCLUSION: Microvascular free-tissue transplantation has expanded our options, giving us the opportunity for more refinement in hand reconstruction and improving the standards for a successful outcome.

Adult↗

PubMed2003

[Reconstruction of the index metacarpophalangeal joint with an osteochondral metatarsal head graft].

We report on a 19-year-old male patient with partial destruction of the index metacarpophalangeal joint due to traumatic middle hand amputation. Six months after replantation the metacarpophalangeal joint defect was reconstructed with an osteochondral metatarsal head graft from the second metatarsophalangeal joint. At a follow-up period of four years the patient achieved full metacarpophalangeal extension, with 40 degrees of flexion and grip strength equal to 90 % of the contralateral index finger. Magnetic resonance imaging showed enhancement of contrast medium as a sign for vitality of the transplant.

Adult↗

PubMed2002

[Congenital arterio-venous malformations of the hand (type C)--the only therapeutic option].

We report on a 36-year-old male patient with a congenital arterio-venous malformation (type C) of the hand. Symptoms onset was three years ago with an ulcer on the tip of the left middle finger, with the fingers and the palm of the hand turning increasingly livid. The shunt-volume in the area of an arterio-venous fistula was 70 ml/min, there was also involvement of the third metacarpal bone. Increasing pain from the index to the ring fingers with no tendency of healing in the middle finger were indications for surgical intervention. In view of the diffuse expansion to all the tissue layers and the danger of peripheral circulatory disturbance and associated necrosis if embolisation was performed, the entire middle finger along with the third metacarpal bone was resected, and the index and the ring fingers were also amputated. Seven months postoperatively, the patient had no pain, had good grip function and was able to use his hand freely in his job as a labourer.

Adult↗