{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,6,11]],"date-time":"2022-06-11T15:41:19Z","timestamp":1654962079772},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Bei gleichem Krankheitsbild muss bei kongenitalen Fehlbildungen der Hand mit unterschiedlichen pathologischen Ver\u00e4nderungen gerechnet werden. Daher ist das Wissen um diese Pathologien f\u00fcr die Planung des operativen Zugangsweges entscheidend. Exemplarisch werden in diesem Beitrag die Zug\u00e4nge h\u00e4ufiger Fehlbildungen abgehandelt. Hierzu z\u00e4hlen der Doppeldaumen und die Syndaktylien.<\/jats:p><jats:p>Beim Doppeldaumen mit asymmetrischer Kontur wird durch Augmentation von Anteilen des wegfallenden Daumens das Ergebnis verbessert. In diesem Fall ist eine andere Schnittf\u00fchrung als bei der einfachen Resektion erforderlich.<\/jats:p><jats:p>Bei den h\u00e4ufig durchgef\u00fchrten Syndaktylietrennungen gibt es viele Techniken, die nachweislich ein gutes Ergebnis erreichen. Aber nur, wenn auch hier Prinzipien wie lokale Verschiebelappenplastiken f\u00fcr die Kommissurbildungen, ein spannungsfreier Wundverschluss, keine longitudinalen Inzisionen und keine bilaterale Pr\u00e4paration eines Fingers beachtet werden. Ist pr\u00e4operativ davon auszugehen, dass ein gutes Operationsergebnis mit der herk\u00f6mmlichen Technik der Syndaktylietrennung nicht erreicht werden kann, ist die Vorbehandlung mittels Fixateur externe zur queren Weichteildistraktion die Methode der Wahl.<\/jats:p><jats:p>Der Operationszeitpunkt ber\u00fccksichtigt, die motorische Entwicklung des Betroffenen nicht zu st\u00f6ren.<\/jats:p>","DOI":"10.1055\/a-1779-9029","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T23:35:18Z","timestamp":1654904118000},"page":"178-186","source":"Crossref","is-referenced-by-count":0,"title":["Differentialtherapeutische Zug\u00e4nge bei kongenitalen Fehlbildungen an der Hand"],"prefix":"10.1055","volume":"54","author":[{"given":"Darja","family":"Sippel","sequence":"additional","affiliation":[{"name":"Katholisches Kinderkrankenhaus Wilhelmstift gGmbH 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