Zeitschrift fur Kinderchirurgie und Grenzgebiete
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Among 3 000 injuries of the hand in 65 children over 10 years, 95 injuries to tendons were found. About a quarter of these were to the extensor tendon. Results from the lengemann-suture are good. ⋯ They are inreasingly being treated conservatively. 20 sutured flexor tendons proximal to the wrist healed well. 32 injuries in "No Man's Land" were sutured primarily, 19 were treated by secondary tendon transplant. 2 primary sutures, 4 transplants were unsuccessful. The primary suture technique of Kleinert is preferred. The healing phase is suported by a hyaluronidase preparation.
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This is a comparison of the results of 14 primary sutures of the flexor tendon, 11 secondary (one-stage) and 14 seconary (two-stage) interposition grafts. Flexion and extension of the fingers treated were best after the primary tendon suture, worst after the secondary interposition graft at one sitting. ⋯ Where the primary treatment is unsuccessful, the secondary two-stage procedure should be preferred to the one-stage interposition graft. The comparison also shows that the two-stage secondary procedure gives better results when the proximal tendon anastomosis is sutured near the muscle, instead of in the palm of the hand.
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Z Kinderchir Grenzgeb · Jul 1980
[Kleinert's primary flexor tendon repair in children (author's transl)].
The essential points of the Kleinert technique of primary suture of the flexor tendons are briefly laid out. Even although the success of this method depends especially on the co-operation of the patient, we have been able to obtain very good results, particularly in children. Here, too, we used dynamic splinting in the form of a whole-arm splint, and in the case of very small children, the mother was instructed in the therapy.
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Z Kinderchir Grenzgeb · Jul 1980
[Primary treatment of electric burns in children (author's transl)].
Electric burns in children should be given early operative treatment, especially when the bone is involved. 14 cases of children with electric burns on 33 fingers are reported. They were constantly checked over more than eight years. 11 out of 17 primarily conservatively treated fingers had to be operated on secondarily. 12 of these showed good function at the end of treatment, 5 were deformed. ⋯ In all we found no essential changes in the bones, but one slowing of growth. The necessity for early fasciotomy, or even amputation, in the case of extensive muscle necroses, is mentioned.
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Z Kinderchir Grenzgeb · Jun 1980
Case Reports[Respiratory disturbances caused by vascular tracheal compression after repair of oesophageal atresia (author's transl)].
Interference with respiration, caused by stenosis of the trachea after an operation for oesophageal atresia, is described. The narrowing of the tracheal lumen through blood vessels is particularly mentioned. Tracheal stenoses through the truncus brachiocephalicus, which cause serious symptoms following operation on oesophageal atresia, have a particular part to play. ⋯ This was caused by displacement of the mediastinum, pushing the heart backwards and to the left. It was cured by fixing the aortic arch to the sternum at the level of origin of the truncus. More than 1 1/2 years after the operation, the child is still symptom-free.