[Midterm results following denervation of the ankle]. / Mittelfristige Ergebnisse nach Sprunggelenkdenervation.

BACKGROUND: Complications related to arthrodesis of the ankle or total ankle replacement require a critical assessment of the indication. Using denervation of the ankle, we have the possibility to delay the above-named surgical treatment for a number of years. The aim of this follow-up study was to review the results of ankle denervation after several years. METHODS: Within a follow-up examination, we were able to evaluate the results of 45 patients an average of 102 months following ankle denervation. RESULTS: A total of 82.2% of patients indicated an improvement of pain for an average of 60.9 months; 71.1% of patients reported that the operation was worthwhile. The AOFAS score improved from an average 37.9 (range 26-68) preoperatively to 55.6 (range 24-84) at follow-up. CONCLUSIONS: Ankle denervation can achieve good ankle pain reduction in the treatment of ankle arthrosis. Denervation should be considered a long-term treatment concept.

[Distal phalangeal fractures of the finger. Results of conservative and surgical treatment]. / Der streckseitige Endgliedbasisbruch am Finger. Ergebnisse nach konservativer und operativer Behandlung.

BACKGROUND: In this study 56 dorsal phalangeal fractures of the distal segment were classified regarding morphological criteria. MATERIAL AND METHODS: Clinical and radiological results after 4 months were analyzed. Fractures including subluxation of the distal interphalangeal joint occurred rarely (n=3) and were treated by surgery. Fractures without subluxation had either a triangle-shaped fragment (n=40) or a fragment similar to a hunter's hat (n=9). Furthermore, there were two fractures with a tiny bony avulsion and two fractures with more radial or ulnar-oriented fragments. The triangle and hunter's hat type fractures were treated either by splinting (n=20) or by open reduction and stabilization with screws and wires (n=29). RESULTS: Clinical outcome was similar in both groups. In 12 out of the 20 fractures treated by splinting a stepping of the joint surface had to be tolerated. Initially only 8 out of 20 fractures showed a stepping of the joint surface. The fractures treated by surgery showed a better radiological outcome. CONCLUSIONS: Initially 27 fractures showed a stepping in the joint line but after surgical treatment only 9 fractures still presented a stepping. The remaining four fractures were successfully treated by splinting.

[Pyogenic granuloma of the thumb following the bite of a sheep]. / Pyogenes Granulom des Daumens nach Bissverletzung durch ein Schaf.

In the case of a patient with a large pyogenic granuloma of the thumb about three months after the bite of a sheep, we covered the defect after resection with a split thickness skin graft. Although at first amputation was discussed, after a few months a very good functional and aesthetic result was achieved.