Der Unfallchirurg
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Clients with complex hand injuries are considerably restricted in their daily and occupational activities as well as participation in society. ⋯ By virtue of its unique perspective on human activity including the work context, occupational therapy plays a decisive role in the treatment process for clients with complex hand injuries. The aim of the rehabilitation is a successful performance of meaningful activities in the respective life context. This can only be successful through a close cooperation between all the specialist disciplines involved in the treatment. Such an interdisciplinary treatment approach enables activity and participation of the client.
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Osteopathy as a manual procedure is an important therapeutic tool in postoperative care. The essence of diagnostic and manual medical procedures in osteopathy is explained. ⋯ The functional significance of the fasciae and myofascial chains is examined in more detail. Finally, the range of applications and effects of osteopathy in postoperative care are presented.
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Successful treatment of complex regional pain syndrome (CRPS) depends mainly on an early diagnosis and an adequate treatment concept with active participation of the patient. ⋯ Good patient education regarding the clinical picture and course of the disease form the basis for the treatment of CRPS. The patient should always be considered holistically and treated correspondingly by a multiprofessional team. Active involvement of the patient in the treatment from the beginning is always essential.
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Extensor tendon injuries of the thumb include lesions of the tendons of the extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus muscles. The latter is practically only affected in open injuries. Open injuries require a tendon reconstruction by suture followed by immobilization in the distal and an adequate aftercare depending on the zone of injury. ⋯ This injury is often misdiagnosed as a rupture of the ulnar collateral ligament of the metacarpophalangeal joint. It should be treated by refixation of the ruptured structures. Closed chronic ruptures of the extensor pollicis longus tendon go along with a defect that requires a tendon transfer or a tendon autograft.