Peter Hahn

The purpose of this study was to evaluate the results of two-stage reconstruction of the flexor pollicis longus (FPL) tendon. Sixteen patients who underwent reconstructive surgery of the FPL tendon were assessed retrospectively. Eight weeks after implantation of a silastic spacer, a tendon graft was used for reconstruction (thirteen palmaris longus...

The aim of this follow-up study was to evaluate the functional and subjective results after thumb replantation. Twenty-four patients with replantation of the thumb, performed during the period 1992-1997, were reexamined after 6.5 years (range, 4.2-9.1 years post-injury). In 10 cases the amputations were isolated, 14 amputations were combined with o...

Background Currently, there are no tests that have been proven to be capable of rating an individual’s grip force measurement as sincere or insincere. However, different parameters have been found to vary in grip force testing for maximal versus submaximal effort. A novel data analysis and processing approach might be key to improving these measure...

For patients scheduled for surgery, long waiting times are unpleasant. However, scheduling that is too patient-oriented can lead to friction losses in the operating room and waiting times for the medical personnel. We have conducted an analysis of historical hand surgery data to improve forecasting of hand surgery durations, optimize operation room...

Introduction Data from clinical trials suggest that CT-confirmed nondisplaced scaphoid waist fractures heal with less than the conventional 8–12 weeks of immobilization. Barriers to adopting shorter immobilization times in clinical practice may include a strong influence of fracture tenderness and radiographic appearance on decision-making. This st...

Die Dupuytrensche Kontraktur neigt unabhängig von der Therapie zu Rezidiven. Nicht jeder neu aufgetretene Knoten oder Strang gilt als Rezidiv. Das Rezidiv ist definiert als eine passive Beugekontraktur von mindestens 20° in einem betroffenen Gelenk gegenüber dem Befund ca. 6–12 Wochen nach dem Ersteingriff.

Zusammenfassung Maschinelles Lernen (ML), ein Teilbereich der Künstlichen Intelligenz, ist die Fähigkeit von Computer-Algorithmen, Wissen aus Beispielen zu lernen, ohne dafür explizit programmiert zu sein und dieses Wissen dann auf unbekannte Fälle anzuwenden. Die Anwendung von ML in der Medizin wird in den nächsten Jahren exponentiell zunehmen. Är...

Background: Primary finger and thumb joint arthritis is common, with a markedly rising prevalence from age 50 onward. As the population as a whole ages, the need for effective, stage-appropriate treatment of this condition is increasing. Methods: This review is based on pertinent publications retrieved by a selective search in the PubMed and Coc...

Purpose: This study aims to investigate if the hands' load-distribution pattern differs during maximal and submaximal grip. Methods: Fifty-four healthy subjects used the 200-mm Manugraphy cylinder to assess the load-distribution pattern of both hands. On 2 testing days, the subjects performed grip-force testing: 1 hand with maximal effort and th...

Durch die Exposition der Hände im Alltag sind Defektverletzungen häufig. Die Verletzungsschwere reicht von kleinen Fingerkuppen- bis hin zu großen Hautweichteildefekten mit freiliegenden Sehnen, Nerven und Gefäßen. Meist ist das Ausmaß der Verletzung erst nach dem sorgfältigen Débridement einzuschätzen. Dem Chirurgen steht eine große Zahl an Verfah...

Background: Grip strength measurement is a widely used method for clinical as well as scientific purposes. In hand surgery, it is an essential component in the diagnosis of disease, treatment sequences and assessment. In epidemiological studies, it is a good predictor of healthy ageing or disease progression. Problem: Measurement results and the...

Objective: Arthrodesis of the distal interphalangeal joint of the fingers and interphalangeal joint of the thumb in order to gain reliable stability and function. Indications: Primary and secondary osteoarthritis, rheumatoid arthritis, defect lesions, septic joint destruction, posttraumatic joint deviation, fatal joint instability, fatal tendon...

Trotz der Fortschritte in Diagnostik und Primärbehandlung von Handgelenkverletzungen spielen (Teil‑)Arthrodesen zur sekundären Rekonstruktion weiterhin eine wichtige Rolle. Teilarthrodesen stabilisieren den Karpus und ermöglichen über die verbleibenden Handgelenkanteile eine zufriedenstellende Restbeweglichkeit. Durch die Ausschaltung der schmerzha...

Das Trichorhinophalangeal-Syndrom (TRPS) wurde 1966 von Andres Giedion, einem Schweizer Kinderradiologen, beschrieben 1 , jedoch publizierte Klingmuller bereits 1956 eine Beobachtung uber diese Anomalie 2 . Der Typ 1 ist gekennzeichnet durch kolbenformig aufgetriebene Epiphysen (Phalangeal), sparlich dunnes Haupthaar (Tricho), eine Ausdunnung der s...

Carpal tunnel syndrome is among the most frequently diagnosed forms of peripheral nerve compression. Carpal tunnel syndrome due to carpal collapse that had progressed over decades, with a?palmarly dislocated lunate, is rare. Hints of past trauma to the wrist going back decades should prompt further radiological examination in case of recurrent medi...

Die Dupuytren-Kontraktur ist eine Erkrankung des älteren Menschen. Mit der zunehmenden Alterung der Bevölkerung steigen die medizinische Relevanz und die sozioökonomische Bedeutung der Erkrankung. Neben den bewiesenen familiären und genetischen Ursachen wird eine Vielzahl von externen Faktoren diskutiert (Nikotin, Diabetes, Alkohol, Trauma, Arbeit)...

Die Dupuytren-Kontraktur ist eine gutartige, fibroproliferative Erkrankung der Hohlhandaponeurose, die teilweise mit erheblichen funktionellen Einschränkungen für die Betroffenen einhergeht. Die limitierte Aponeurektomie ist als Primäreingriff der Referenzstandard. Aufgrund der Minimalinvasivität, der kürzeren Rekonvaleszenz und der niedrigen Kompl...

Fractures of the distal radius are very common. The majority of patients are elderly females. High impact trauma are often responsible for fractures in young men. Clinical and radiological diagnostics, including computer-assisted tomography (CAT) scan, are generally sufficient. The indication for conservative treatment is still recommended for spec...

Joint infections of the hand may lead to irreversible lesions and impairment of hand function due to early cartilage damage. Furthermore, persistent infections which are not treated immediately can cause osteitis and/or spread systemically. Finger joints are prone to infection due to bite wounds or crush and sharp injuries. Whereas the wrist is oft...

Purpose: Scores are essential for comparing function after flexor tendon reconstructions. The Buck-Gramcko Score, the Strickland Score and the ASSH (American Society for Surgery of the Hand) Score are the most commonly applied rating systems. The purpose of this study is to evaluate these systems and their interchangeability. Method: Based on an un...

Background It was not possible to detect the common problem of insincere grip effort in grip strength evaluation until now. The usually used JAMAR dynamometer has low sensitivity and specificity in distinguishing between maximal and submaximal effort. The manugraphy system may give additional information to the dynamometer measurements used to asse...

Many congenital malformations of the hand and forearm, e. g. polydactyly, thumb duplication, syndactyly and radial aplasia, are already evident at birth and newborns are promptly referred to specialized departments. In contrast, orthopedic surgeons are often confronted with malformations of the hand and forearm, which gradually become clinically co...

Posttraumatische Kontrakturen der Hand können auf vielfältige Ursachen zurückgeführt werden. Einerseits kann die initiale Verletzung schwerwiegende Strukturveränderungen nach sich ziehen, andererseits kann eine fehlerhafte Nachbehandlung bzw. Ruhigstellung eine Kontraktur begünstigen bzw. verursachen. Entscheidend sind die richtige Therapieplanung,...

Introduction To evaluate the efficacy of open partial aponeurectomy for recurrent Dupuytren’s contracture. Methods Eighteen patients with recurrent Dupuytren’s contracture of 22 fingers were retrospectively assessed with a mean follow-up time of 94 months (range: 70–114 months). Examination parameters included the determination of range of motion (...

Objective Resection of the proximal carpal row, termed proximal row carpectomy (PRC), is performed in order to treat pathologies of the proximal carpal row or radiocarpal joint between the scaphoid and scaphoid facet. It entails the articulation of the capitate and the lunate facet. Indications Lunate necrosis, carpal collapse, joint infection with...

Joint fractures of the fingers often entail operative interventions in contrast to extra-articular fractures. These types of fracture are inclined to dislocate in addition to the actual fracture. The proximal interphalangeal (PIP) joint in particular often shows comminuted fractures due to the long leverage of the finger and a relatively small diam...

Objective: Open decompression of the superficial radial nerve is performed at the distal forearm in cases of circumscript entrapment. Broad-based entrapments can be treated by endoscopically assisted decompression. Indications: Entrapment of the nerve along its course between the brachioradialis and extensor carpi radialis longus muscles or tend...

Sehnenverklebungen und Gelenkkontrakturen konnen nach operativer Versorgung von Sehnenverletzungen auftreten. Nach Ausreizen der Handtherapie kann bei persistierender Bewegungseinschrankung der Finger eine Tenoarthrolyse notwendig werden. Diese ist haufig nicht nur auf die reine „Tenoarthrolyse“ beschrankt, sondern kann verschiedene Eingriffserweit...

Beugesehnenverletzungen können, offen oder gedeckt, durch eine Vielzahl von Ursachen entstehen. Immer wieder wird der Funktionsverlust durch Beugesehnenverletzungen übersehen. Eine genaue Kenntnis der Anatomie der Hand, der Biomechanik der Beugesehnen, der Strecksehnen, sowie der intrinsischen Handmuskulatur erlaubt eine präzise klinische Diagnose...

The distal radioulnar joint (DRUJ) is crucial regarding the functionality of the upper extremity. DRUJ lesions can significantly limit functionality. Numerous clinical tests have been described to diagnose DRUJ instability. However, no consensus has been reached concerning standardization of the DRUJ instability evaluation. The application and inte...

Percutaneous transverse aponeurotomy of the cord by using a hypodermic needle as a scalpel blade in order to improve function of the hand. Symptomatic flexion contracture with positive table top test caused by a single, palpable cord within the palm (primarily Tubiana stages I and II). Multiple, infiltrating or broad-based cords within the palm; ir...

To establish normative values of tendon to bone distances (TBDs) to evaluate the A2 and A4 annular pulley integrity, we hypothesized that these values correlate with gender, athletic exercise, occupation, individual's age and body height. Ultrasonography of 200 healthy individuals was performed prospectively. TBDs for the A2 and A4 pulley sections...

Injuries of the triangular fibrocartilage complex (TFCC) may be fatal to the distal radioulnar joint (DRUJ). This structure is one of the crucial stabilizers and guarantees unrestricted pronosupination of the forearm. A systematic examination is mandatory to diagnose DRUJ instability reliably. A clinical examination in comparison to the contralater...

Background There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. Questions/purposes (1) Are surgeons more likely to recommend surgery when choosing for a patient than for t...

The feasibility of endoscopically assisted decompression of the superficial radial nerve at the midportion and distal forearm was assessed. After a 3 cm longitudinal skin incision at the Tinel's sign at the forearm, the subcutaneous tissue is dissected until forearm fascia is detected. The fascia is opened cautiously under direct visualization and...

To investigate functional and subjective outcome parameters after arthroscopic debridement of central articular disc lesions (Palmer type 2C) and to correlate these findings with ulna length. Fifty patients (15 men; 35 women; mean age, 47 y) with Palmer type 2C lesions underwent arthroscopic debridement. Nine of these patients (3 men; 6 women; mean...

Simultaneous flexion of thumb and fingers is described as the Linburg-Comstock phenomenon. Congenital and acquired coupling of the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) tendons is the reason for this clinical entity. Additionally, coupling of the FPL and the flexor digitorum superficialis II or III has been described. Th...

We present the case of a 54-year-old woman with symptomatic coalition of scaphoid, trapezium and trapezoid as well as a coexisting ipsilateral hypoplasia of the thumb. © Georg Thieme Verlag KG Stuttgart · New York.

The TFCC is a crucial stabilizer of the DRUJ. Based on its superficial and deep fibers, the TFCC guarantees unrestricted pronation and supination which is essential for performing sophisticated tasks. The ability to perform complex movements is of uppermost importance for hand function. Therefore, a functional intact TFCC is a prerequisite in this...

Introduction The triangular fibrocartilage complex is in conjunction with the interosseous membrane the most important stabilizer of the distal radioulnar joint. Lesions of the triangular fibrocartilage complex may cause instability of the distal radioulnar joint with serious consequences. Therefore, the goal is to reconstruct and provide stabilit...

Introduction: The dorsal capsular imbrication of the distal radioulnar joint (DRUJ) which was performed because of posttraumatic dorsal instability showed promising functional results after the first postoperative years. Therefore, we hypothesized that patients after capsular imbrication are characterized by good subjective and functional outcome...

Isolated fractures of the capitate in the frontal plane are both very rare and most of the time very discreet. There is a great risk to miss such fractures with potential longterm consequences. The following report of two independent patients highlights the importance of computed tomography in order to verify fractures and initiate adequate treatme...

Verletzungen des Kapsel-Band-Apparats der Fingermittelgelenke sind facettenreiche Läsionen, die einem strukturierten Behandlungsalgorithmus zugeführt werden müssen. Die Gefahr der Bewegungseinschränkung mit weitreichenden Konsequenzen ist bei falscher Therapie immanent. Eine suffiziente klinische Untersuchung und darauf basierte Bildgebung demaskie...

Congratulations to the authors for choosing this important topic (1). As shown in their review, regeneration after nerve reconstruction is by no means guaranteed (1), in particular not in older patients (2). The most common nerve injury – damage to the median nerve during carpal tunnel surgery (1) – often occurs in middle-aged/ older patients where...

Purpose: To address the null hypothesis that surgeons shown radiographs of little finger metacarpal neck fractures with measured fracture angulation would recommend surgery as often as surgeons shown unmarked radiographs. Methods: Members of the Science of Variation Group, an international collaboration of fully trained orthopedic and trauma sur...

Searching for relevant publications is becoming more difficult with the increasing number of scientific articles. Text mining as a specific form of computer-based data analysis may be helpful in this context. Highlighting relations between authors and finding relevant publications concerning a specific subject using text analysis programs are illus...

It was with great interest that we read the article by Kouwenhoven et al1 “Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna.” In this article, the authors describe a simple surgical technique to address the dorsal instability of the DRUJ. This technique, as a first-line treatment, does not block more invasive surgical options in case...

Trapeziometacarpal joint osteoarthritis is a very common degenerative joint disease which affects especially women between their fifth and sixth decade of life. To determine the final pinch, grip and functional outcome after trapeziometacarpal arthroplasty and to compare to non-arthritic controls, we hypothesized that patients after the former surg...

The palmaris profundus muscle is a rare entity which has been mentioned in association with nerve compressions. Madelung deformity is based both on an osteochondral lesion of the distal radial physis and often on the Vickers' ligament which originates around the lunate and inserts proximally in the radial physis. A 15-year-old right-handed female a...

The distal radioulnar joint (DRUJ) plays a tremendous role regarding the functionality of the upper extremity. Lesions of the DRUJ can limit the functionality of the upper extremity decisively. Many clinical and radiological procedures are used to diagnose instability of the DRUJ. Up to now, there has not been a general consensus concerning the sta...

Wiederherstellung der Stabilität des distalen Radioulnargelenks (DRUG) durch eine dorsale Kapseldoppelung bei dorsaler Instabilität mit dem Ziel der Schmerzreduktion und Vermeidung einer posttraumatischen Arthrose.Posttraumatische dorsale Instabilität des distalen Radioulnargelenks mit klinisch fehlendem Anschlag bei Translation im DRUG oder Sublux...

Idiopathic thrombosis of palmar finger veins is rare and women suffer from it almost exclusively. Synovial cysts, epidermoid inclusion cysts, giant cell tumours and haemangiomatous lesions should be considered in the process of diagnosis. We present a 56-year-old woman with idiopathic and symptomatic thrombosis of palmar finger veins. Using the pal...

The article by Schuster et al. highlights an important problem in German hospitals. The economic effects of the lost time extrapolated to all hospitals in Germany are sure to be substantial. It would be interesting to know whether the intervals between surgeries also correlate with the beginning of the first operation, which might exacerbate the pr...

Untreated distal radioulnar joint (DRUJ) instability can lead to arthritis of the DRUJ. To date, however, the clinical determination of DRUJ instability still represents a challenge. We developed a new clinical test to determine its stability. This works by directly observing the ulnar head's dynamic behavior during active pro-supination or testing...

Spontaneous fixations of MP-joints of fingers and thumbs are rare and are often a challenging task for hand surgeons. We present a 25-year-old female office employee with a fixed painless MP-joint of the left index finger in 90° flexion with normal PIP- und DIP-joint range of motion. Using the palmar approach to the MP-joint the entrapped accessory...

OBJECTIVE To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis. INDICATIONS Posttraumatic dorsal instability of the DRUJ with missing block while performing translational activities...

Purpose: The purpose of this retrospective study was to examine the sensitivity and specificity of preoperatively performed MRI of the wrist in identifying tears of the scapholunate ligament. Additionally, these findings were then compared with findings from a subsequently performed -arthroscopy of the wrist. Patients and methods: The study was...

Purpose: The purpose of this study was to determine functional and subjective results of patients who received arthroscopic debridement for their TFCC Palmer 1B lesions and to compare their results with those of arthroscopic suture repair. Methods: Between March 2007 and August 2011, 36 patients were diagnosed with Palmer type 1B tears and under...

To compare short- and midterm functional and subjective outcomes of arthroscopically repaired Palmer 1B tears. At 2 time points, we evaluated 49 patients with Palmer 1B tears who underwent arthroscopic repair. We examined 46 patients (23 males and 23 females) in the short-term at an average of 11 months (range, 6-23 mo) postoperatively. In a second...

Background: MRI diagnostic is used for wrist pain diagnostic frequently. Clinical studies in specialized centers show high sensitivity and specificity concerning TFCC lesions. The aim of this study is a comparison of MRI and arthroscopy regarding TFCC lesions not in a specialized but in a common medical environment. Patients/material and methods:...

Purpose: The objective of this study was to examine the influence of anthropometric data, occupational manual strain, DASH (disability of arm, shoulder and hand) score and range of motion (ROM) on grip strength and key pinch. An additional goal was to develop models that enable the prediction of hand strength using the aforementioned parameters....

In clinical day-to-day life, grip strength, key pinch, and range of motion (ROM) serve to objectively evaluate treatment outcomes on wrist interventions. The goals of this study were to generate normative values of wrist function including the parameters of grip strength, key pinch, wrist ROM, and Disabilities of the Arm, Shoulder, and Hand (DASH)...

Hemihyperplasia of the upper extremity is a rare pathology that occurs in 1/86,000 births. Carpal tunnel syndrome may be associated with this disease. We describe the case of a 74-year-old male who has hemihyperplasia of both upper extremities since birth. At the age of 73, he started experiencing continuous, progressive and high intensity pain tha...

Oscar Vulpius dealt extensively with the problem of tendon transfer for motoric deficits. An analysis of his works shows that the knowledge of tendon healing, aftercare and operative techniques was already very widely advanced at the beginning of the last century.

The purpose of this retrospective study was to identify the postoperative complications and disorders associated with open trigger finger release. Factors that were investigated by this study included demographic details, the number of digits affected, BMI, level of manual strain, trauma, received systemic medication, hand dominance, pre-treatment...

Four-corner fusion is a proven treatment option for degenerative arthritis of the wrist (SLAC/SNAC); however, in some cases, non-union occurs. The purpose of this study was to evaluate the clinical outcome of rearthrodesis in cases of non-union following four-corner fusion. Furthermore, the goal was to identify the cause of non-union and the locati...

To analyze functional and subjective outcomes of patients with posttraumatic dorsal instability of the distal radioulnar joint (DRUJ) treated by a dorsal capsular imbrication. We reviewed 11 patients (7 men and 4 women) with posttraumatic instability of the DRUJ who were treated by a capsular imbrication. The patients ranged in age from 18 to 48 ye...

Sulcus ulnaris syndrome is the second most common neurocompression syndrome in the upper limb after carpal tunnel syndrome. Its severity can be appreciated by the Dellon Classification. We present our experience and results after endoscopic decompression. A retrospective chart review of 55 patients operated over a 3-year period was performed. The p...

Die Rekonstruktion der Handfunktion ist ein Abenteuer. Immer wieder jedoch führen operative Eingriffe aber auch konservative Behandlungen zu einer Verschlechterung der Ausgangssituation. Es sind nicht unbedingt schwerwiegende Fehler in der Planung oder Durchführung einer Therapie, sondern ein Überwiegen von vielen kleinen negativen Faktoren, die le...

Zusammenfassung Insbesondere Trendsportarten haben in den letzten Jahren zu einer Zunahme der Ringbandverletzungen geführt. Sorgfältige klinische Untersuchungen und Ultraschalldiagnostik bestimmen die Therapieoptionen.

In the treatment of the acute ligamental mallet finger the conservative therapy is well established. In contrast in the treatment of the chronic mallet finger (>4 weeks) a surgical therapy is often adviced. In a retrospective study 44 Patients with an acute and 33 patients with a chronic ligamental mallet finger after conservative therapy for at le...

The objective of this retrospective study was to determine functional and subjective outcomes of patients with Palmer type 1B tears repaired arthroscopically and to investigate whether clinical outcomes are related to ulna length. Forty-six patients with arthroscopic repair of Palmer type 1B tears were reviewed. There were 23 males and 23 females....

The objective of this study was to determine functional and subjective outcomes of an ulnar shortening procedure elected by patients who experienced persistent ulno-carpal symptoms following arthroscopic suture repair of a Palmer type 1B lesion. All patients had a dynamic ulna positive variance. Five patients (3 males and 2 females) with arthroscop...

Very little is known about the degeneration or healing process in traumatic triangular fibrocartilage complex (TFCC) lesions. Forty-two patients with symptomatic central traumatic tears in the TFCC (Palmer 1 A) were included in this study. The cartilage was debrided arthroscopically and used for histologic examination. Histologic sections were stai...

In spite of carpal tunnel release's prevalent good postoperative results, the number of revision surgeries needed should not be underestimated. In this study, subjective and functional results after carpal tunnel revision surgery were determined. Thirty-eight patients were examined approximately 2 years after their revision surgery of the carpal tu...

In this paper we introduce a novel approach for diagnosis and monitoring of ulnar nerve lesions, affecting the coordination of movement of the ring and little finger of the human hand. Based on data generated by ultrasound measurements, we developed suitable preprocessing methods for automatic extraction of relevant features from the movement patte...

Ziel: In dieser Übersichtsarbeit werden Indikationen zum motorischen Ersatz, Vorbereitung und Zeitpunkt des Eingriffs, OP‐Techniken für Radialis-, Medianus- und Ulnarisparese und deren Nachbehandlungen dargestellt. Methode: Im Zeitraum von 1992 bis 2005 wurden zirka 80 motorische Ersatzoperationen (50-mal N. radialis, je 15-mal N. medianus und N. u...

In this paper, we concentrate on the expressive power of hierarchical structures in data analysis. Recently, the so-called Split Net model was introduced. It develops a dynamic, growing network structure and belongs to the class of topology preserving networks. We briefly introduce the basics of this model and explain the different sources of infor...

The therapy for congenital hand malformations, especially in symbrachydactyly and constriction ring syndromes, is challenging. Between 1975 and 1995, 20 children with congenital hand deformities underwent reconstruction by 56 nonvascularized free toe phalanx transfers. The average age at initial surgery was 4.8 (range, 0.5 to 22) years. Retrospecti...