{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:54Z","timestamp":1740126834043,"version":"3.37.3"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Kn\u00f6cherne Defekte bei Fingerverletzungen und -infekten stellen\n                    durch die engen anatomischen Beziehungen hohe Anforderungen an ihre Behandlung.\n                    Bedingt durch den Unfallmechanismus liegen vielfach kontaminierte und\n                    kompromittierte Weichgewebe vor und setzen einer einzeitigen operativen\n                    Behandlung Grenzen. Vorgestellt werden die langfristigen subjektiven und\n                    funktionellen Ergebnisse nach zweizeitiger Rekonstruktion von kn\u00f6chernen\n                    Defektverletzungen an Fingergelenken.<\/jats:p><jats:p>\n          Patienten und Methoden Im Zeitraum von 15 Jahren wurden insgesamt 40\n                    Patienten mit 43 Fingern aufgrund einer Defektverletzung an den Phalangen\n                    behandelt. Initial wurde der Finger nach Debridement mit Kirschnerdr\u00e4hten\n                    stabilisiert. Nach Konsolidierung oder Rekonstruktion des Weichgewebes wurde in\n                    einer weiteren Operation der Knochen durch Interposition eines Beckenkamspans\n                    unter Arthrodese von mindestens einem Fingergelenk rekonstruiert. Bei 9\n                    Patienten traten Komplikationen auf. 25 Patienten mit 27 Fingern konnten im\n                    Median 10,3 Jahre nachuntersucht werden. Erhoben wurde der Bewegungsumfang, die\n                    L\u00e4nge des betroffenen Fingers und die Kraftentwicklung jeweils im Verh\u00e4ltnis zur\n                    Gegenseite. Neben einer subjektiven Einsch\u00e4tzung des Gesamtergebnisses wurde die\n                    Alltagsfunktion mittels Disabilities of the Arm, Shoulder and Hand (DASH)\n                    Fragebogen ermittelt.<\/jats:p><jats:p>\n          Ergebnisse Signifikante Unterschiede zur Gegenseite (p&lt;0,05) fanden\n                    sich in der L\u00e4nge (70\u2009mm; 91,0%) und der Gesamtbeweglichkeit des betroffenen\n                    Fingers (95\u00b0; 46,0%), der Handspanne bei Beteiligung des Daumens (202,5\u2009mm;\n                    93,4%) und im Kraftgriff bei Verletzung von einem der dreigliedrigen Fingern\n                    (30\u2009kg; 84,1%). Der DASH-Wert lag bei 4,2 Punkten (0\u201355,8). Subjektiv waren die\n                    Patienten zu 88% mit dem Behandlungsergebnis zufrieden.<\/jats:p><jats:p>\n          Schlussfolgerung Ein zweizeitiges Vorgehen bei ausgedehnten kn\u00f6chernen\n                    Defektverletzungen im Fingergelenkbereich unter Arthrodese des Gelenkes ist eine\n                    verl\u00e4ssliche Versorgungsstrategie. Sie ergibt langfristig trotz messtechnisch\n                    signifikanter Unterschiede zur Gegenseite eine subjektiv sehr gute Funktion der\n                    Hand im Alltag.<\/jats:p>","DOI":"10.1055\/a-2204-7599","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T22:52:56Z","timestamp":1712271176000},"page":"227-234","source":"Crossref","is-referenced-by-count":0,"title":["Zweizeitige Arthrodese bei kn\u00f6chernen Fingergelenkdefekten \u2013\n                    Langfristige Ergebnisse"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-2164","authenticated-orcid":false,"given":"Richard-Tobias","family":"Moeller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall-, Hand-, Plastische und Wiederherstellungschirurgie,\n                    Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Mentzel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall-, Hand-, Plastische und Wiederherstellungschirurgie,\n                    Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Vergote","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall-, Hand-, Plastische und Wiederherstellungschirurgie,\n                    Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Bauknecht","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall-, Hand-, Plastische und Wiederherstellungschirurgie,\n                    Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/s0363-5023(88)80103-5","article-title":"Arthrodesis of the proximal interphalangeal joint by solid bone grafting and\n                    plate fixation in extensive injuries to the dorsal aspect of the finger","volume":"13","author":"U Buchler","year":"1988","journal-title":"J Hand Surg Am"},{"key":"ref2","first-page":"851","article-title":"Trauma of the hand from circular saw table: a series of a 130 cases","volume":"94","author":"Y Hadj Hassine","year":"2016","journal-title":"Tunis Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1097\/PRS.0000000000000854","article-title":"Current concepts in treatment of fracture-dislocations of the proximal\n                    interphalangeal joint","volume":"134","author":"S C 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