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Background: Evaluation of quality of life following surgical release of the first annular flexor tendon pulley in children suffering from pediatric trigger thumb in comparison to adult patients with trigger finger.Material and methods: All patients who underwent an A1 tendon pulley release between 2006 and 2010 at a hand surgery center were reviewed retrospectively. Chart review included operation type, length of hospital stay, and type of anesthesia. Patient satisfaction was assessed using two validated hand questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure and the German Michigan Hand Outcomes Questionnaire (MHQ).Results: A total of 13 children and 147 adults were included in the study. No postoperative complications or recurrence were observed in the pediatric patient population. Postoperative DASH score in children was 0±0 and in adults 14±2. Postoperative German MHQ score was 97±3 in children and 84±2 in adults. Patient satisfaction was rated positive in all children and in 87% of adults; all children and 93% of the adults would undergo this procedure again. Conclusions: The surgical release of the A1 pulley in children and adults is a safe and low-risk procedure. Postoperative quality of life, especially in children, is high; patients and parents were highly satisfied. Therefore, the surgical approach should be recommended as a first-line treatment of the trigger finger in all age groups.

Background: Evaluation of the quality of life following surgical release of the first extensor compartment in adult patients with de Quervain disease. Patients and methods: This retrospective study included hospital chart review and patient-reported outcome assessment using the German version of the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure and the validated German Michigan Hand Outcomes Questionnaire (MHQ). Results: A total of 46 patients underwent a surgical release of the first extensor compartment for de Quervain disease. Postoperative German MHQ was 78±4. Postoperative DASH score was 19±5. Satisfaction with surgery was rated positive in 85%, and 89% would undergo the procedure again. Patients with a transversal incision line had a DASH result of 11±6 and a German MHQ score of 83±7, patients with a longitudinal incision had a DASH score of 22±9 and a German MHQ score of 80±6. The patients pain level after transversal incision was markedly lower (resting pain=0.4±0.3; stress pain=1.0±0.6) than in patients operated with a longitudinal incision (resting pain=2.4±0.9; stress pain=3.1±1.1). Conclusion: The surgical approach for the treatment of de Quervain disease is associated with a high postoperative quality of life, a low postoperative morbidity and a low level of postoperative pain. A transversal incision is associated with better postoperative results than the longitudinal approach.

[english] Cheerleading is associated with substantial morbidity. As such, cheerleading fall-related injuries may cause serious to fatal outcomes especially falls from attempted pyramids. We report on a female adolescent cheerleader age 14 suffering a supracondylar humerus fracture related to a fall from a pyramid. Unfortunately, lateral pinning led to complete iatrogenic radial nerve palsy. However, given an intriguing compensatory athletic function of the wrist she was able to perform cheerleading artistic figures such as flic-flac within four months after the injury with a radial nerve palsy, which is highlighted in an attached video. 18 months after the radial palsy she was admitted to our hospital and underwent neuroma resection of the initially transsected radial nerve at the elbow and sural nerve grafting for radial nerve palsy.[german] Cheerleading kann zu verschiedensten Unfällen führen. Insbesondere bei dem Versuch Pyramiden zu bilden sind bereits Todesfälle aufgetreten. Wir berichten von einer 14-jährigen Cheerleaderin welche bei dem Versuch eine Pyramide zu bilden stürzte und sich eine suprakondyläre Humerusfraktur zuzog. Bei der osteosynthetischen Versorgung kam es leider zu einer kompletten Durchtrennung des N. radialis. Dennoch konnte sie bei der gegebenen erstaunlichen Kompensation ihrer Handgelenksgeweglichkeit weiterhin schwierige Cheerleading Übungen wie Flick-Flack durchführen, was im beigefügten Video verdeutlicht wird. 18 Monate nach Eintreten der Radialisparese wurde sie in unserer Klinik vorstellig und es wurde nach einer Neuromresektion eine Suralis Interposition zur Nervenrekonstruktion durchgeführt.

[english] Background: First quantitative evaluation of the requirements for the promotion as associate professor (AP) at German Medical Faculties Material and methods: Analysis of the AP-regulations of German Medical Faculties according to a validated scoring system, which has been adapted to this study.Results: The overall scoring for the AP-requirements at 35 German Medical Faculties was 13.5±0.6 of 20 possible scoring points (95% confidence interval 12.2-14.7). More than 88% of the AP-regulations demand sufficient performance in teaching and research with adequate scientific publication. Furthermore, 83% of the faculties expect an expert review of the candidate´s performance. Conference presentations required as an assistant professor as well as the reduction of the minimum time as an assistant professor do only play minor roles. Conclusion: The requirements for assistant professors to get nominated as an associate professor at German Medical Faculties are high with an only small range. In detail, however, it can be seen that there still exists large heterogeneity, which hinders equal opportunities and career possibilities. These data might be used for the ongoing objective discussion.[german] Hintergrund: Erste quantitative Evaluation der Anforderungen an eine außerplanmäßige Professur (APL) an Deutschen Medizinischen Hochschulen. Material und Methoden: Analyse der APL-Ordnungen auf sieben Zielparameter und Bewertung dieser mittels eines Scoring-Systems. Ergebnisse: Der Gesamtscore für die APL-Leistung von 35 deutschen Medizinischen Fakultäten beträgt 13,5±0,6 von 20 möglichen Punkten (95% Konfidenzintervall 12,2-14,7). Die überwiegende Anzahl (>88%) der APL-Ordnungen fordert hierbei hinreichende Leistungen in der Lehre und Forschung verbunden mit wissenschaftlichen Publikationen. Zudem erwarten 83% der Fakultäten eine Begutachtung der Leistungen. Kongressarbeit sowie die Verkürzung der Mindestzeit als Privatdozent spielen eher untergeordnete Rollen.Schlussfolgerung: Die APL-Anforderungen an Privatdozenten Medizinischer Fakultäten sind, den Gesamtscore betrachtet, hoch und mit nur geringer Streubreite. Bei genauerer Betrachtung der Einzelparameter zeigt sich jedoch ein uneinheitliches Bild, was im Hinblick auf die Chancengleichheit und Karrieremöglichkeiten der Kandidaten kritisch hinterfragt werden sollte. Für die objektive Diskussion sollten die Daten und Werte dieser Arbeit genutzt werden können.

This case report describes a novel and unique combination of both electromagnetic and electrohydraulic focused extracorporeal shockwave therapy (ESWT) and extracorporeal magnetotransduction therapy (EMTT) for accelerated healing in a calcaneus epiphyseal fracture with delayed healing in an adolescent Parkour athlete. After a 2.5m jump, the 14-year-old experienced significant heel pain, however avoided telling his parents. After eight weeks, the initial imaging using ultra low dose weight-bearing cone beam CT (WBCT) revealed a calcaneus non-union situation adjacent to the open calcaneal physis. To improve and accelerate bony healing substantially, we chose to apply both combined focused electromagnetic (Storz Ultra, Storz Medical AG, Tägerwillen, CH) and focused electrohydraulic (MTS, Konstanz, Germany) ESWT in a fractioned fashion plus EMTT (Storz Magnetolith, Tägerwillen, CH) in five consecutive weekly sessions while allowing the patient to fully weight bear. The follow-up WBCT after six weeks revealed a near to total healing of the delayed union and being pain-free. Notably, combination therapy with focused ESWT and EMTT did not result in early closure of the calcaneal epiphysis. We conclude that combined focused electromagnetic and electrohydraulic ESWT and EMTT facilitate bony healing in adolescent calcaneal apophyseal fractures without any adverse effects on the open physis. Evidence level IV (case report). [ABSTRACT FROM AUTHOR]

This paper presents a combined experimental and numerical investigation on a novel liner concept for enhanced low-frequency and broadband acoustic attenuation. In particular, two different realizations, derived from conventional Helmholtz resonators (HR) and plate resonators (PR) are investigated, which both deploy flexible materials with material inherent damping. In this context, a comprehensive experimental investigation was carried out focusing the identification and evaluation of various geometric parameters and material properties on the acoustics dissipation and related properties of various materials in a simplified setup of a single Helmholtz resonator with flexible walls (FHR concept). Furthermore, a parameter study based on analytical models was performed for both liner concepts, taking into account material as well as geometric parameters and their effects on transmission loss. In addition, design concepts that enable cylindrical or otherwise curved liner structures and the corresponding manufacturing technologies are presented, while considering essential structural features such as drainage. With respect to the potential application in jet engines, a structural–mechanical analysis considering the relevant load cases to compare and discuss the mechanical performance of a classical HR and the FHR concept liner is presented. Finally, both concepts are evaluated and possible challenges and potentials for further implementation are described. [ABSTRACT FROM AUTHOR]