Seasonal Flight Patterns of Chrysodeixis includens (Lepidoptera: Noctuidae) in the Florida Panhandle and Inventory of Plusiine Species Cross-Attracted to Synthetic Pheromone.

Chysodeixis includens (Walker) is a polyphagous economic pest in agricultural landscapes. To detect the occurrence of this pest in the field, trapping using sex pheromone lures is often implemented. However, other plusiine species are cross-attracted to these lures and may be misidentified as C. includens due to their morphological similarities. The objectives of this study were to provide region-specific information on the abundance of C. includens throughout the year as well as document the occurrence of related plusiines cross-attracted to C. includens sex pheromone traps in the Florida Panhandle. Twelve commercial fields of peanut and twelve commercial fields of cotton located across Escambia, Santa Rosa, and Jackson counties were monitored with Trécé delta traps baited with C. includens sex pheromone lures (Alpha Scents, Inc.; West Linn, OR) from June 2017 to June 2019. There was no difference in C. includens flight across dryland or irrigated fields. Identifications revealed that in addition to C. includens, the following species of the subfamily Plusiinae were crossed-attracted: Argyrogramma verruca (Fabricius) (Lepidoptera: Noctuidae), Trichoplusia ni (Hübner) (Lepidoptera: Noctuidae), Ctenoplusia oxygramma (Geyer) (Lepidoptera: Noctuidae), and Rachiplusia ou (Guenée) (Lepidoptera: Noctuidae). The occurrence of each species in the region and their flight phenology are documented. Chysodeixis includens abundance was greatest in September and decreased through December. Due to the high abundance of C. oxygramma and similar flight phenology to C. includens, this is the likeliest species to skew estimations and influence management decisions of C. includens, especially early in the crop season, when C. includens abundance is low.

Full-endoscopic posterior foraminotomy surgery for cervical disc herniations.

OBJECTIVE: Surgery for cervical disc herniation with full-endoscopic posterior access. INDICATIONS: Cervical disc herniation and neuroforaminal pathology with radicular symptoms. CONTRAINDICATIONS: Neck pain alone, cervical myelopathy or pathologies with central nervous system symptoms, instabilities requiring correction/instabilities. SURGICAL TECHNIQUE: Introduction of a surgical tube to the facet joint at the level to be operated on. Resection of bony and ligamentous parts of the cervical spinal canal under endoscopic guidance. Visualisation of the disc herniation and decompression of the neural structures. POSTOPERATIVE MANAGEMENT: Immediate mobilisation, specific rehabilitative physiotherapy depending on pre-existing neurological deficits. RESULTS: A total of 87 patients underwent full-endoscopic posterior surgery and were followed over a period of 2 years. Significant improvement was observed. No serious complications occurred. In all, 5 patients underwent revision in the follow-up period. Of the patients, 93% would undergo the procedure again.

[Grip strength measurement : Significance and boundaries]. / Die Messung der Griffkraft : Wertigkeit und Grenzen.

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 their interpretation can be influenced by many factors. The historical development of dynamometry, measurement technology and the standard values in various population groups are presented. Comparisons with standard values should only be made using current tables because the grip strength has changed in recent decades. Assessment of the voluntarily submaximal grip strength remains problematic. Proposals are made for how to assess grip strength during the evaluation.

[(Partial) fusion of the wrist : Indications and surgical procedures]. / (Teil­)Arthrodesen am Handgelenk : Indikationen und chirurgische Therapien.

Carpal bone fusions for secondary reconstruction are still indispensable despite state of the art diagnostic tools and modern treatment techniques for wrist lesions. The former fusions stabilize the wrist and enable sufficient residual carpal mobility. Pain can be reduced significantly by arthrodesis of destroyed joints and the progress of osteoarthritis may be stopped or delayed. This review presents commonly used fusions with their inherent indications, contraindications and complications.

[Compression of the median nerve by chronic palmar dislocation of the lunate due to carpal collapse]. / Die Kompression des Nervus medianus durch ein luxiertes Mondbein aufgrund eines karpalen Kollapses.

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 median nerve compression. With sufficient preoperative evaluation, the causes can be accurately detected and treated. Therefore, precise and complete history-taking is mandatory. Conclusions on further diagnostics that can be drawn from the latter must be consistently implemented to enable adequate therapy.

[Epidemiology of Dupuytren's disease]. / Epidemiologie des Morbus Dupuytren.

Dupuytren's disease is a chronic disease of the elderly. Assuming that life expectancy will increase considerably in the coming decades, Dupuytren's disease will gain more medical and socioeconomic relevance. In addition to well-known familial and genetic causes, other environmental factors (nicotine, diabetes, alcohol, trauma, work) are discussed. Knowledge of all factors and their influence on the onset and severity of the disease is important for diagnosis, therapy, and prevention of the disease.

[Percutaneous needle aponeurotomy for Dupuytren's contracture]. / Perkutane Nadelaponeurotomie bei Dupuytren-Kontraktur.

Dupuytren disease is a benign fibroproliferative disease of the palmar aponeurosis, which can cause considerable functional deficiencies for the person concerned. Partial aponeurectomy is the gold standard in primary surgery. Because it is minimally invasive and has short recovery and low complication rates, the importance of needle aponeurotomy under specific indications has been increasing in the last years. Needle aponeurotomy is a cost-effective treatment with low complication rates. The revision rate compared to partial aponeurectomy is higher. Under consideration of specified indications, needle aponeurotomy is an alternative treatment option.

[How Congruent is the Rating of the Results of Flexor Tendon Injury Repairs Using the Scores by Buck-Gramcko, Strickland, and the American Society for Surgery of the Hand?]. / Inwieweit stimmt die Ergebnisbeurteilung nach Eingriffen bei Beugesehnenverletzungen bei Anwendung der Bewertungssysteme nach Buck-Gramcko, Strickland und der Amerikanischen Gesellschaft für Handchirurgie überein?

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 unrestricted metacarpophalangeal (MCP) joint of 0-0-90° or limited range of motion of the MCP joint of 0-30-90°, the scores of the 3 rating systems were assessed and graphically displayed for each possible finger position regarding proximal (PIP) and distal (DIP) interphalangeal joints. RESULTS: Based on an unrestricted MCP joint, the scores of the 3 rating systems differed in 24-33% of the obtained values, depending on the sum of joint flexion and extension deficits of the aforementioned PIP and DIP joints. If the range of motion was restricted to 0-30-90° in the MCP joint, differing values were only observed in 16-19% of the obtained values. In extreme cases, scores for the same clinical presentation may thus be "excellent", "fair" or "poor", depending on which system has been used. CONCLUSION: The different rating systems for the evaluation of flexor tendon reconstruction are neither identical nor adjustable. Therefore, consensus or at least a recommendation is needed regarding the system to be used. It may even be necessary to develop a generally accepted rating system to compare studies. In the meantime, the readings of the active and passive range of motion of all joints of the affected finger/thumb ought to be published in studies to compare and validate the results.

Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography.

Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon's capabilities.

[Malformations of hand and forearm : Conspicuous postpartum]. / Fehlbildungen an Hand und Unterarm : Postpartal auffallend.

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 conspicuous during growth. This review article focuses on these specific malformations, which regularly upset the patients in practice and in most cases the parents even more so. In addition to the diagnostics and differential diagnostics, the conservative and surgical treatment options are presented.

Rate of intraoperative complications during cataract surgery following intravitreal injections.

PurposeTo investigate the effect of prior intravitreal injections on intraoperative and postoperative complication rates associated with cataract surgery.MethodsA retrospective cohort analysis reviewed 10 105 cataract surgery procedures performed by experienced surgeons at the Duke Eye Center from 1 January 2005 to 10 December 2012. A group of 197 eyes with prior intravitreal injections was compared with an equal number of matched control eyes without prior injection using the Fisher's exact test of difference in proportions and the Wilcoxon rank-sum test of difference in means. Outcomes analyzed included baseline demographic information, preoperative clinical characteristics, prevalence of intraoperative complications, and postoperative intraocular pressure, glaucoma surgery, and glaucoma medication requirement through 1 year following cataract surgery.ResultsAn increased rate of intraoperative complications was identified during cataract surgery in eyes with prior intravitreal injections compared with control eyes (3 vs 0%, P=0.030). Injection eyes required more glaucoma medications at 1 year, but no difference was identified if steroid injections were excluded. No difference in postoperative IOP or glaucoma surgery was identified. No cases of endophthalmitis were reported.ConclusionsA history of intravitreal injections may be a risk factor for cataract surgery-related intraoperative complications. We hypothesize this may be due to unidentified iatrogenic lens trauma during intravitreal injections. Particular attention to the posterior capsule during preoperative assessment and intraoperatively is recommended in eyes undergoing cataract surgery with a prior history of intravitreal injections.

[Proximal carpal row carpectomy]. / Die Entfernung der proximalen Handwurzelreihe.

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 concomitant intercarpal ligament lesions. CONTRAINDICATIONS: Severe cartilage lesions of the lunate facet and the capitate, wrist capsule laxity, rheumatoid arthritis, neuromuscular dysbalance of the wrist-covering soft tissue structures. SURGICAL TECHNIQUE: Dorsal approach to the wrist, incision of the third and fourth extensor compartments, resection and coagulation of the dorsal interosseous nerve, usage of a ligament-sparing capsule incision, identification of the proximal carpal row and inspection of cartilage of the lunate facet and capitate, mobilization and excision of the lunate, scaphoid and triquetrum, articulation of lunate facet and capitate is controlled clinically and fluoroscopically, wound closure, application of plaster slabs. POSTOPERATIVE MANAGEMENT: Immobilization of the wrist on plaster slabs for 2 weeks, removal of sutures after 14 days. RESULTS: PRC is a surgical procedure with few complications. Satisfactory range of motion and grip strength could be preserved without limiting function of the upper extremity. Postoperative osteoarthritis of capitate and lunate facet did not correlate with the good clinical outcome.

[Percutaneous needle aponeurotomy for Dupuytren's disease]. / Die perkutane Nadelaponeurotomie der Dupuytren-Kontraktur.

OBJECTIVE: Percutaneous transverse aponeurotomy of the cord by using a hypodermic needle as a scalpel blade in order to improve function of the hand. INDICATIONS: Symptomatic flexion contracture with positive table top test caused by a single, palpable cord within the palm (primarily Tubiana stages I and II). CONTRAINDICATIONS: Multiple, infiltrating or broad-based cords within the palm; irritated skin conditions; exclusive digital cord localization; recurrence after aponeurectomy; previous surgical intervention at the site of interest, digital nerve lesions; lack of patient compliance. SURGICAL TECHNIQUE: Pinpoint surface anesthesia is obtained by injecting each portal area subdermally with 0.1 ml of local anesthetic. These applications start from distally to proximally within the palm while the most distal injection site is located proximal to the distal palm crease. Then the needle tip is introduced perpendicular to the cord. Sawing movements through the cord are performed transversely. While passively extending the contracted finger, the cord is held under tension which guarantees safe cutting. Patients are encouraged to report immediate pain sensation or numbness in order to prevent injuries to neurovascular structures and active finger flexion excludes tendon lesions during the procedure. Introducing the needle tip may be performed at several sites along the cord, if necessary, from distal to proximal at least 5 mm apart with prior pinpoint surface anesthesia. Finally, cautious passive stretching may be done after each release. POSTOPERATIVE MANAGEMENT: Bandaging allowing immediate motion; application of a hand-based extension splint-glove during the night for 3-6 months. RESULTS: Recurrence rate was 53% in 15 retrospectively examined patients after a mean interval of 40 months postoperatively.

[Instability of the distal radioulnar joint: Treatment options for ulnar lesions of the triangular fibrocartilage complex]. / Instabilität des distalen Radioulnargelenks: Möglichkeiten der Behandlung ulnarer Läsionen des triangulären fibrokartilaginären Komplexes.

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 contralateral side is obligatory. Plain radiographs are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral, pronation and supination is necessary to verify DRUJ instability in ambiguous situations. Based on a systematic examination wrist and DRUJ arthroscopy identify lesions clearly. Injuries of the radioulnar ligaments which entail DRUJ instability, should be reconstructed preferably anatomically. Ulnar-sided TFCC lesions may often cause DRUJ instability. Osseous ligament avulsions are mostly treated osteosynthetically. Ligament tears may be refixated using anchor or transosseous sutures. Tendon transplants are necessary for an anatomical reconstruction in cases of irreparable ruptures.

[The Linburg-Comstock phenomenon: a review]. / Die Linburg-Comstock-Variante: Eine Übersicht.

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. The coupling can be between the muscles, the tendon sheaths or the tendons themselves. Asymptomatic and symptomatic coupling should be differentiated. In general symptomatic congenital or acquired coupling demands surgical intervention. We report about a 35-year-old patient with a congenital asymptomatic coupling of FPL and FDP-II who suffered a distorsion of the thumb. Afterwards she complained of pain and strength loss. An accessory tendon of 3 mm in diameter and 3.5 cm length between FPL and FDP-II was identified during surgery. The patient recovered completely after resection of this coupling.

[Symptomatic carpal coalition of scaphoid, trapezium and trapezoid with coexisting ipsilateral hypoplasia of the thumb]. / Symptomatische karpale Koalition zwischen Os scaphoideum, Os trapezium und Os trapezoideum mit ipsilateraler Daumenhypoplasie.

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.

[A 15-year-old adolescent presenting both Madelung deformity with Vickers' ligament and additional palmaris profundus muscle]. / 15-jährige Heranwachsende mit symptomatischer Madelung-Deformität, Vickers-Band und M. palmaris profundus.

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 adolescent suffered from symptomatic left-sided Madelung deformity with Vickers' ligament and additional palmaris profundus muscle.