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3. Resection arthroplasty versus dual mobility prosthesis in the treatment of trapeziometacarpal joint osteoarthritis: A 3 year non-randomized prospective study.

Author

Falkner, F, Tümkaya, AM, Thomas, B, Böcker, A, Aman, M, Bickert, B, Harhaus, L, Panzram, B, Falkner, F, Tümkaya, AM, Thomas, B, Böcker, A, Aman, M, Bickert, B, Harhaus, L, and Panzram, B

Abstract

PURPOSE: Resection arthroplasty (RA) is still the most common surgical intervention for the treatment of symptomatic trapeziometacarpal (TMC) joint osteoarthritis. The implantation of a dual mobility prosthesis may represent a joint function preserving alternative. The aim of the presented study is to prospectively compare the outcomes of RA with dual mobility prosthesis. METHODS: In this 2-center non-randomized prospective study, we compared results of RA (n = 22) with implantation of a dual mobility prosthesis (n = 49) (Touch®) at a minimum of 3-year follow-up. The patients underwent preoperative assessments and postoperative follow-up at 6 weeks, 3, 6, 12, 24, and 36 months. Comparisons were conducted, covering pain assessment via the visual analogue scale (VAS), thumb range of motion (ROM), pinch and grip strength, as well as functional scores and radiological examinations. RESULTS: The time intervals from surgery until absence of pain on the VAS (3 months: 3 vs 1, p = 0.0001), recovery of ROM in radial (3 months: 33° vs 42°, p = 0.0001), and palmar abduction (3 months: 33° vs 48°, p = 0.0001), were significantly longer for the RA group compared with the prosthesis group. At 3-year follow-up there was no significant difference in absence of pain, ROM and grip strength between both groups. Key pinch strength was significantly weaker in the RA group compared to prosthesis group at 3 months (2.6 kg vs 4.6 kg, p = 0.001), to 3-year follow-up (3.1 kg vs 5.7 kg, p = 0.0001). The final mean DASH (15.5 vs 13.2, p = 0.01) and MHQ scores (78 vs 82, p = 0.01) were significantly better in the prosthesis group. CONCLUSION: Both techniques show high patient satisfaction in mid-term follow-up. Dual mobility TMC joint arthroplasty seems to be associated with a superior pinch strength and shorter time of recovery as compared to patients after RA.

Published
2024

15. Ultraschall – ein nützliches Point-of-Care-Hilfsmittel für die klinische Entscheidungsfindung bei Handinfektionen: Überprüfung der Literatur und einer Fallserie

Author

Müller, CT, Aman, M, Grünfelder, F, Thomas, B, Haug, V, Bollmann, C, Harhaus, L, and Kneser, U

Subjects
Klinische Diagnose, Infektion der Hand, ddc: 610, Medicine and health, Ultraschall
Abstract

Fragestellung: Patienten mit Phlegmonen stellen sich häufig erst Tage nach Biss- oder Stichverletzung mit akuten Infektionszeichen vor. Die klinische Untersuchung ist für die Therapie richtungsweisend. Die Operationsindikation kann je nach Stadium der Infektion nicht eindeutig gestellt werden. [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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16. Ein-Jahres-Follow-up einer prospektiven Multicenterstudie zum Outcome-Monitoring von Stammnervenverletzungen der oberen Extremität

Author

Aman, M, Schwarz, D, Stolle, A, Böcker, A, Pindur, L, Bendszus, M, Kneser, U, and Harhaus, L

Subjects
MRT, ddc: 610, Medicine and health, Nervenrekonstruktion, Nerven
Abstract

Fragestellung: Stammnervenverletzungen der oberen Extremitäten sind oft schwere und langwierige Verletzungen. Eine frühzeitige und präzise Diagnostik ist daher zur Therapieplanung entscheidend. Zusätzlich erscheint die Anwendung von bildgebenden Methoden auch im Verlaufsmonitoring [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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17. Das Management der Hyperextension im Daumengrundgelenk bei Patienten mit symptomatischer Daumensattelgelenksarthrose: eine retrospektive Studie von 168 Fällen

Author

Falkner, F, Tümkaya, AM, Thomas, B, Kneser, U, Harhaus, L, and Bickert, B

Subjects
ddc: 610, Medicine and health, Hyperextension, Transfixation, Rhizarthrose, Trapezektomie
Abstract

Fragestellung: Diese Studie untersucht das Outcome von Patienten, die bei primärer Rhizarthrose zusätzlich eine kompensatorische Hyperextension >30° im Daumengrundgelenk (MCP-1) zeigten und im Rahmen der Trapezektomie eine temporäre K-Draht-Transfixation des Daumengrundgelenks [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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25. The Therapeutic Role of Plastic and Reconstructive Surgery in the Interdisciplinary Treatment of Soft-Tissue Sarcomas in Germany-Cross-Sectional Results of a Prospective Nationwide Observational Study (PROSa)

Author

Thomas, B, Bigdeli, AK, Nolte, S, Gazyakan, E, Harhaus, L, Bischel, O, Lehner, B, Egerer, G, Mechtersheimer, G, Hohenberger, P, Horch, RE, Andreou, D, Schmitt, J, Schuler, MK, Eichler, M, Kneser, U, Thomas, B, Bigdeli, AK, Nolte, S, Gazyakan, E, Harhaus, L, Bischel, O, Lehner, B, Egerer, G, Mechtersheimer, G, Hohenberger, P, Horch, RE, Andreou, D, Schmitt, J, Schuler, MK, Eichler, M, and Kneser, U

Abstract

Although the involvement of plastic surgery has been deemed important in the treatment of sarcoma patients to avoid oncological compromises and ameliorate patient outcomes, it is not ubiquitously available. The accessibility of defect reconstruction and its therapeutic impact on sarcoma care is the subject of this analysis. Cross-sectional data from 1309 sarcoma patients were collected electronically at 39 German study centers from 2017 to 2019. A total of 621 patients with surgical treatment for non-visceral soft-tissue sarcomas were included. The associated factors were analyzed exploratively using multifactorial logistic regression to identify independent predictors of successful defect reconstruction, as well Chi-squared and Cochran-Mantel-Haenszel tests to evaluate subgroups, including limb-salvage rates in extremity cases. A total of 76 patients received reconstructive surgery, including 52 local/pedicled versus 24 free flaps. Sarcomas with positive margins upon first resection (OR = 2.3, 95%CI = 1.2-4.4) that were excised at centers with lower degrees of specialization (OR = 2.2, 95%CI = 1.2-4.2) were independently associated with the need for post-oncological defect coverage. In this context, the inhouse availability of plastic surgery (OR = 3.0, 95%CI = 1.6-5.5) was the strongest independent predictor for successful flap-based reconstruction, which in turn was associated with significantly higher limb-salvage rates (OR = 1.4, 95%CI = 1.0-2.1) in cases of extremity sarcomas (n = 366, 59%). In conclusion, consistent referral to specialized interdisciplinary sarcoma centers significantly ameliorates patient outcomes by achieving higher rates of complete resections and offering unrestricted access to plastic surgery. The latter in particular proved indispensable for limb salvage through flap-based defect reconstruction after sarcoma resection. In fact, although there remains a scarcity of readily available reconstructive surgery services within the current sarc

Published
2022

26. An Epidemiological and Etiological Analysis of 5026 Peripheral Nerve Lesions from a European Level I Trauma Center.

Author

Aman, M, Zimmermann, KS, Thielen, M, Thomas, B, Daeschler, S, Boecker, AH, Stolle, A, Bigdeli, AK, Kneser, U, Harhaus, L, Aman, M, Zimmermann, KS, Thielen, M, Thomas, B, Daeschler, S, Boecker, AH, Stolle, A, Bigdeli, AK, Kneser, U, and Harhaus, L

Abstract

BACKGROUND: Peripheral nerve lesions are associated with debilitating long-term consequences. Albeit being essential for evidence-based clinical decision making, epidemiological and etiological data are scarce. We therefore aimed to comprehensively analyze epidemiological and etiological factors of peripheral nerve lesions in one of the largest cohorts. METHODS: We screened a total of 110,667 patients treated at our level I trauma center between January 2012 and July 2020 for nerve lesions. Subsequently, demographics, etiologies, concomitant injuries, and lesion characteristics were analyzed. RESULTS: A total of 5026 patients, predominantly young males suffering from non-work-related nerve injuries, were treated. Proximal levels of injury were more likely to be accompanied by fractures, whereas more distal injuries with concomitant vessel or tendon injury. Main causes were 54.6% lacerations. Acute traumatic nerve injury was treated within 24 h in 55.9% of cases. CONCLUSIONS: Given the young age of affected patients, early diagnosis and treatment in specialized centers may facilitate their early return to work and improve long-term functional outcomes. The data show the importance of a special attention on nerve injuries, which may be masked by large accompanying injuries. New findings on lesion characteristics of selected subgroups and accompanying circumstances can support a change in treatment strategies.

Published
2022

27. Combined versus Single Perforator Propeller Flaps for Reconstruction of Large Soft Tissue Defects: A Retrospective Clinical Study

Author

Bigdeli, AK, Didzun, O, Thomas, B, Harhaus, L, Gazyakan, E, Horch, RE, Kneser, U, Bigdeli, AK, Didzun, O, Thomas, B, Harhaus, L, Gazyakan, E, Horch, RE, and Kneser, U

Abstract

Sufficient wound closure of large soft tissue defects remains a challenge for reconstructive surgeons. We aimed to investigate whether combined perforator propeller flaps (PPFs) are suitable to expand reconstructive options. Patients undergoing PPF reconstruction surgery between 2008 and 2021 were screened and evaluated retrospectively. Of 86 identified patients, 69 patients received one perforator propeller flap, while 17 patients underwent combined PPF reconstruction with multiple flaps. We chose major complications as our primary outcome and defined those as complications that required additional surgery. Postoperatively, 27 patients (31.4%) suffered major complications. The propeller flap size, the type of intervention as well as the operation time were not associated with a higher risk of major complications. A defect size larger than 100 cm2, however, was identified as a significant risk factor for major complications among single PPFs but not among combined PPFs (OR: 2.82, 95% CI: 1.01-8.36; p = 0.05 vs. OR: 0.30, 95% CI: 0.02-3.37; p = 0.32). In conclusion, combined PPFs proved to be a reliable technique and should be preferred over single PPFs in the reconstruction of large soft tissue defects at the trunk and proximal lower extremity.

Published
2022

28. Die Implantation einer Dual-Mobility Touch Prothese als funktionelle Behandlungsalternative der Rhizarthrose: Eine prospektive Studie von bisher 26 Prothesen

Author

Falkner, F, Tümkaya, AM, Thomas, B, Kneser, U, Harhaus, L, and Bickert, B

Subjects
ddc: 610, Daumensattelgelenksarthrose, Daumensattelgelenksendoprothese, 610 Medical sciences, Medicine, Rhizarthrose, Endoprothese
Abstract

Fragestellung: Die Implantation einer Dual-Mobility Touch Endoprothese als eine modular aufgebaute, sphärische und zementfreie Prothese stellt eine Trapezium-erhaltende Methode zur Behandlung der Rhizarthrose im Stadium 2 oder 3 dar. Das Ziel dieser Studie ist es, die frühen funktionellen [zum vollständigen Text gelangen Sie über die oben angegebene URL], 60. Kongress der Deutschen Gesellschaft für Handchirurgie

Published
2020
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34. 1015 peripheral nerve injuries of the upper extremity – epidemiology and cost analysis

Author

Harhaus, L, Bergmeister, K, Rhodius, P, Große-Hartlage, L, Beyersdorff, M, Böcker, A, and Kneser, U

Subjects
ddc: 610, cost analysis, epidemiology, 610 Medical sciences, Medicine, peripheral nerve injuries
Abstract

Objectives/Interrogation: Nerve injuries are considered to be highly cost intensive due to the specialized therapy, rehabilitation and long healing processes. So far only few European cost analyses are available from small Swedish and Swiss collectives (, 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Published
2020
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35. Enzymatic Debridement for Hand Burns: Function and Quality of Life One Year After Trauma

Author

Cordts, T, Ziegler, B, Diehm, Y, Fischer, S, Harhaus, L, and Kneser, U

Subjects
ddc: 610, nexobrid, enzymatic debridement, hand burns, 610 Medical sciences, Medicine
Abstract

Objectives/Interrogation: Over the last years, Enzymatic Debridement has become an accepted alternative for the treatment of severe burns. A topical burn eschar removal by the proteolytic enzyme mix NexoBrid® has certain important advantages when compared to Standard of Care. Most notably,[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Published
2020
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36. Implementation of a finger stump database after traumatic finger amputation – Concept evaluation and clinical consequences

Author

Böcker, A, Rasner, AS, Bickert, B, Harhaus, L, and Kneser, U

Subjects
ddc: 610, clinical treatment, neuroma, nerve, 610 Medical sciences, Medicine
Abstract

Objectives/Interrogation: Aim of the current study is to evaluate risk factors, treatment strategies and outcome evaluation after traumatic finger amputation. Replantation is still the gold standard for treatment of traumatic finder amputation. However, if replantation is not feasible or not[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Published
2020
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37. Die V-Reha-Studie: Analyse der Rehabilitationsziele bei Brandverletzten im Bezug auf die Komponenten der International Classification of Functioning, Disability and Health

Author

Neubauer, H, Harhaus, L, Ziegenthaler, H, Stolle, A, and Kneser, U

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: In der V-Reha-Studie wird an zwei Rehabilitationseinrichtungen (Moritz-Klinik Bad Klosterlausnitz, BG Klinik Ludwigshafen) die Brandverletztenrehabilitation evaluiert. Das Rehabilitationskonzept beider Kliniken ist ICF orientiert und patientenzentriert. Wichtiger Bestandteil einer patientenzentrierten[zum vollständigen Text gelangen Sie über die oben angegebene URL], 38. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2020)

Published
2020
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38. Objektives Assessment von Verbrennungsnarben – Entwicklung und Validierung eines standardisierten Messprotokolls für das Cutometer MPA 580

Author

Klimitz, F, Neubauer, H, Stolle, A, Ripper, S, Daeschler, S, Kneser, U, and Harhaus, L

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Verbrennungsnarben sind gleichzeitig ein zentrales Behandlungsobjekt und Evaluationskriterium in der Behandlung Brandverletzter. Ihre präzise Beurteilung stellt Untersucher allerdings vor eine Herausforderung, da selbst weit verbreitete Narben- Scores wie die Vancouver Scar Scale (VSS)[zum vollständigen Text gelangen Sie über die oben angegebene URL], 38. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2020)

Published
2020
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40. Physio- und ergotherapeutisches Assessment zur Evaluation eines ICF-orientierten 'Rehabilitationskonzepts Thermische Verletzungen'

Author

Strupat, M., Ripper, S., Stolle, A., Neubauer, H., Laux, S., Harhaus, L., and Kneser, U.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: In den vergangenen Jahren hat die BG Klinik Ludwigshafen das Behandlungsspektrum für Schwerbrandverletzte von der intensiv- und akutmedizinischen Versorgung um die Rehabilitation erweitert. Das „Rehabilitationskonzept Thermische Verletzungen“ der BG Klinik Ludwigshafen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 37. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2019)

Published
2019
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41. Apparative Messung von Verbrennungsnarben – Entwicklung und Evaluation eines standardisierten Messprotokolls

Author

Neubauer, H, Klimitz, F, Stolle, A, Ripper, S, Harhaus, L, and Kneser, U

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Nach Verbrennungen liegen häufig großflächige Narbenareale vor, deren Narbenbild und -eigenschaften durch die Nachbehandlung günstig beeinflusst werden soll. Zur Beurteilung der Narben stehen neben klinischen Beurteilungskriterien und Scores verschiedene Messgeräte[zum vollständigen Text gelangen Sie über die oben angegebene URL], 37. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2019)

Published
2019
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42. Ergebnisorientierung in der Rehabilitation Brandverletzter

Author

Ziegenthaler, H., Ripper, S., and Harhaus, L.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Ziel: Wie ist beim bisher erwerbstätigen schwer Brandverletzten eine ressourcensparende und zeitnahe Rückkehr ins Berufsleben praktikabel mit standardisierten Prozessen? Methode: Im Rahmen eines DGUV-geförderten prospektiven klinischen Evaluationsstudie werden nach Analyse der[zum vollständigen Text gelangen Sie über die oben angegebene URL], 37. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2019)

Published
2019
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43. Die V-Reha-Studie

Author

Harhaus, L, Ripper, S, Stolle, A, Ziegenthaler, H, and Kneser, U

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Mit der Etablierung der Verbrennungsrehabilitation an der BG Klinik Ludwigshafen im Jahre 2014 wurde erstmals in einer BG-lichen Einrichtung ein brandverletztenspezifisches Rehabilitationsprogramm geschaffen. In Deutschland existierten bis dahin nur wenige nicht BG-liche Einrichtungen, die sich auf [zum vollständigen Text gelangen Sie über die oben angegebene URL], 37. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2019)

Published
2019
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44. The Treatment of Peripheral Nerve Injuries.

Author

Harhaus, L., Dengler, N. F., Schwerdtfeger, K., and Stolle, A.

Abstract

Background: Nerve lesions often heal incompletely, leading to lifelong functional impairment and high costs for the health care system. The updated German clinical practice guideline is intended to promote the early recognition of nerve lesions and the timely initiation of proper treatment for optimal restoration of function. Methods: The recommendations are based on an assessment of all the evidence revealed by a systematic search of the literature, as well as on the expertise of the multiprofessional guideline group. Results: Only a few publications contain high-quality evidence. This version of the guideline contains a more detailed discussion of war injuries, iatrogenic injuries, MR neurography, and specific treatments than the previous version. As for the different methods of nerve replacement, a comparison of autologous transplantation versus the use of conduits and tubes revealed no significant difference between these two methods on the mBMRC scale, and minimal superiority of autologous transplantation with respect to two-point discrimination. As for the use of nerve transfers when nerve reconstruction is not feasible or unlikely to succeed, nerve transfer yielded slightly better results than proximal reconstruction for elbow flexion, but the difference did not reach statistical significance (mBMRC ≥ 3: RR 1.16, 95% confidence interval [1.02; 1.32]). The treatment of neuromas with targeted muscle reinnervation was superior to the classic approach in decreasing both stump pain (MD 2.0 +/- 2.8) and phantom limb pain (MD 3.4 +/- 4.03). Conclusion: The delayed or improper treatment of peripheral nerve lesions can lead to severe impairment. Timely diagnosis, the use of appropriate treatments in conformity with the guidelines, and interdisciplinary collaboration among specialists are all essential for optimizing the outcome. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Verbesserung der zeitlichen Indikationsstellung bei peripheren Nervenverletzungen durch das Neuro-MRT in der klinischen Praxis

Author

Böcker, A, Lukhaup, L, Bergmeister, K, Bendszus, M, Schwarz, D, Harhaus, L, Bickert, B, and Kneser, U

Subjects
Diagnostik, ddc: 610, periphere Nerven, Nervenrekonstruktion, 610 Medical sciences, Medicine
Abstract

Fragestellung: Kann die Etablierung des Neuro-MRT als Diagnostikum im klinischen Alltag die zeitliche Indikationsstellung bei peripheren Nervenverletzungen verbessern? Methodik: In dieser retrospektiven Studie wurden 29 Patienten aus dem Zeitraum zwischen 2015 – 2017 eingeschlossen, welche[zum vollständigen Text gelangen Sie über die oben angegebene URL], 59. Kongress der Deutschen Gesellschaft für Handchirurgie

Published
2018
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46. Der freie funktionelle Pronator quadratus Lappen zur Rekonstruktion der Thenarfunktion

Author

Harhaus, L, Böcker, A, Struckmann, V, Bergmeister, K, and Kneser, U

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Schnittverletzungen der radialen Hohlhand sind häufige Verletzungsmuster und gehen nicht selten mit einer Läsion des motorischen Thenarastes und/oder der Thenarmuskulatur selbst einher. Bei ausgefallener Thenarfunktion sind bisher die unterschiedlichen Opponensplastiken als Standardverfahren[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2018
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47. Ultraschalltherapie zur Verbesserung der axonalen Regeneration nach Nervenverletzungen: Eine systematische Metaanalyse präklinischer Studien

Author

Bergmeister, K, Böcker, A, Harhaus, L, Kneser, U, Däschler, S, and Schönle, P

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Die limitierte Regeneration von Axonen nach traumatischen Nervenverletzungen führt häufig zur inkompletten Reinnervation der Zielorgane und entsprechenden Defiziten in Motorik und Sensibilität. Die adjuvante Applikation von niederenergetischem Ultraschall könnte diesen Regenerationsprozess[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2018
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