E. Schaller

Medizinische Hochschule Hannover

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P. Mailänder

University Hospital Schleswig-Holstein

A. Berger

Universitätsklinik Balgrist

Franz Lassner

Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie

Michael Becker

American University

G. F. Walter

International Neuroscience Institute

A Berger

Island Institute

A. Berger

University of Zurich

Alfred Berger

Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie

K Ruhe

University of Basel

P. J. Flory

Klinikum Braunschweig

Cooperative Institutions

Medizinische Hochschule Hannover

Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie

Chirurgische Universitätsklinik Heidelberg

University of Lübeck

Essen University Hospital

Friedrich-Alexander-Universität Erlangen-Nürnberg

Heidelberg University

University Hospital Heidelberg

International Neuroscience Institute

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[A comparison of different treatment methods of pseudarthroses and recurrent pseudarthroses of the scaphoid].

PubMed (1993)

E. Schaller Franz Lassner Norbert Pallua W. Schneider Aaron J. Berger

From 1981 to 1990 110 scaphoid non-unions were operated on in our clinic. The period from 1986 to 1990 was followed up. During this time, 45 cases were surgically treated: 27 by Matti-Russe plasty, 11 by Herbert screw, and 7 by vascularized radial bone graft. The following criteria were compared: 1. Radiological signs of healing; 2. Period of immobilization; 3. Clinical results. The shortest period of immobilization and best wrist function was observed in patients treated by Herbert screw.

Scaphoid bone

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Citations (6)

[Return of static and moving 2-point discrimination following nerve reconstruction].

PubMed (1989)

P. Mailänder E. Schaller A Berger K Ruhe

After 138 nerve sutures in the upper extremity the static and moving two-point discrimination tests were performed in the normal and the injured hand. Moving two-point discrimination recovered to a better level in 61%, the same level in 38%, and a worse level in 1% than static two-point discrimination after nerve repair.

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[Nerve regeneration in autologous and allogeneic transplant of the sciatic nerve of the rat with and without immunosuppression by cyclosporin A].

PubMed (1988)

E. Schaller P. Mailänder Michael Becker G. F. Walter A Berger

The following experimental studies show different stages of regeneration and rejection in autologous and allogenic nerve grafts in 162 rats with and without immunosuppression with Cyclosporin A. Allografts were used in congenic rats differing only in major histocompatibility complex (MHC). Nerve regeneration was studied in autologous grafts with and without treatment with Cy A and with toxic doses of Cy A. No difference in nerve regeneration was seen in these groups. Allografts were transplanted between congenic rats type LEW 1 A and 1 U and vice versa with and without treatment with Cy A. Various degrees of rejection from slight to moderate were seen. Without Cy A-treatment, nerve grafts were totally destroyed after four weeks. With Cy A, nerve grafting resulted in complete regeneration.

Immunosuppression

Congenic

Histocompatibility

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Citations (6)

[The Dellon tube in injuries of peripheral nerves].

PubMed (1994)

A. Berger Franz Lassner E. Schaller

Experimental efforts are being undertaken to improve nerve transplantation as a method for peripheral nerve repair. Major disadvantages of nerve transplantation are the creation of neurologic deficits at the donor site and the limited availability of nerve grafts. Mackinnon and Dellon propose the interposition of synthetic, biodegradable tubes as a nerve conduit for clinical use. This method is described according to its theoretical background and the surgical technique. The interposition of synthetic tubes seems possible for short defects in finger nerves, but will render unfavourable results in long defects of peripheral mixed nerves.

Peripheral nerve injury

Nerve repair

Epineurial repair

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Citations (16)

Muscle Transfers in Brachial Plexus Lesions

Journal of Reconstructive Microsurgery (1990)

A Berger P. J. Flory E. Schaller

The concept of reconstruction to regain lost function after brachial plexus lesions has to be as broad and complex as possible. We have been exploring wider and more novel clinical concepts at the Clinic of Plastic, Hand, and Reconstructive Surgery at the Medical School of Hannover. Our ideas are supported by experience in 160 patients. We have attempted to combine the use of a vascularized nerve graft and a microvascularly-transferred autologous muscle. Patients undergoing the procedures have included those with late complete root avulsions and no functional return, as well as previously operated cases with poor recovery of biceps, wrist, and forearm function. The surgery is divided into two stages. In the first stage, the ulnar nerve is prepared as a vascularized nerve graft and is sutured to intercostal nerves 3 to 5 or 6. In stage 2, when the Tinel sign reaches the distal ends of the ulnar nerve graft (about six to eight months later), the latissimus dorsi muscle is harvested. The muscle is then placed as far distally as possible in the forearm and sutured to the deep finger flexors and flexor pollicis longus. Proximally, the insertion is performed similarly to Steindler's method. The vessels are connected to the brachial artery and vein and the thoracodorsal nerve is sutured to the graft. This method provides flexion of both the fingers and the elbow.

Latissimus dorsi muscle

Brachial artery

Musculocutaneous nerve

Intercostal nerves

Brachial plexus block

10.1055/s-2007-1006809

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Citations (47)

Enzymhistochemical evaluation of ulnar nerve grafts in brachial plexus lesions

Microsurgery (1993)

Michael Becker Franz Lassner E. Schaller Alfred Berger

Abstract Our concept for the reconstruction of brachial plexus injuries includes an intercostal nerve transfer to the vascularized ulnar nerve graft. A free neurovascular latissimus dorsi is then transferred in a second stage operation. For optimization of the regeneration result, the operative planning of the second step includes nerve biopsies and enzymhistochemical evaluation for the distribution of motor axons. The staining method according to Scabolcz et al. 13 is described and clinical cases are presented. © 1993 Wiley‐Liss Inc.

Neurovascular bundle

Intercostal nerves

Latissimus dorsi muscle

10.1002/micr.1920140704

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Citations (6)

Nerve Allografts: Survey of Present State

Journal of Hand Surgery (European Volume) (1994)

Franz Lassner A. Berger Michael Becker E. Schaller

10.1016/0266-7681(94)90302-6

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Brachial Plexus Injuries: An Integrated Treatment Concept

Annals of Plastic Surgery (1991)

A. Berger E. Schaller P. Mailänder

An integrated concept is presented for the treatment of lesions of the brachial plexus. In such patients, nerve repair is useless as a single method of therapy. Only the combination of nerve repair with both conventional and new methods of muscle and tendon transfer, including the free muscle transplant innervated by vascularized nerve grafts, can give the patient functional use of the paralyzed arm.

Nerve repair

Brachial plexus injury

Tendon transfer

10.1097/00000637-199101000-00011

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Citations (37)

[Adverse effects of cyclosporin A with special reference to the peripheral nervous system].

PubMed (1990)

Michael Becker E. Schaller G. F. Walter A. Berger

Since the introduction of Cyclosporine A (CsA) in 1972, several studies have focused on its effects on experimental autologous peripheral nerve transplants. Although several studies have reported neurotoxicity of CsA in the central nervous system, no such data exist regarding the peripheral nervous system. The present study focuses on the effects of CsA in the therapeutic and toxic doses on axon regeneration, particularly the rate and quality of axon regeneration. Autologous nerve transplantation was performed in Lewis rats and axon regeneration evaluated clinically (motor function, body weight), electroneurographically and histologically. In transplanted nerves, even high doses of CsA (30 mg/kg bodyweight) did not lead to delayed or impaired axon regeneration. Long-term application in normal peripheral nerves did however cause axon degeneration with edema and vacuolisation of myelin sheaths, retraction of myelin sheaths from the node of Ranvier, and marked enhancement of the Schmidt-Lantermann incisures. As neurological side effects such as tremor and paresthesia have been reported under application of CsA in man, the above data might be of clinical relevance.

Peripheral Nervous System

Neuroregeneration

Neurotoxicity

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Citations (1)

Progress in limb and digital replantation: Part B

World Journal of Surgery (1990)

Alfred Berger Peter Brenner P. J. Flory E. Schaller Wolfgang Schneider

Degloving

Interphalangeal Joint

Polytrauma

10.1007/bf01670528

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Citations (21)