This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.

All physicians are involved in the management of pain at some level or the other, but of the various specialties and health professions, surgeons are at the frontline of delivering perioperative pain care. Perioperative Pain Management for General and Plastic Surgery offers a concise yet comprehensive overview of the surgical pain management field to help practitioners effectively plan and enhance perioperative pain control. Chapters provide guidance on solving common dilemmas facing surgeons who are managing patients with pain related problems and clinical decision-making, and explore essential topics required for the trainee and practitioner to quickly assess the patient with pain, to diagnose pain and painful conditions, determine the feasibility and safety of surgical procedure needed, and arrange for advanced pain management consults and care if needed. This text also explores the latest evolving techniques and appropriate utilization of modern equipment and technology to safely provide care. Highly accessible and written by experts in the field, Perioperative Pain Management for General and Plastic Surgery is an ideal resource for practicing surgeons, anesthesiologists, critical care personnel, residents, medical students.

Discover a revolutionary approach to reconstructive surgery Now in its Second Edition, "The Atlas of Regional and Free Flaps for Head and Neck Reconstruction" delivers clear, heavily illustrated coverage of regional skin, muscle, and musculocutaneous flaps as well as donor sites from distant regions of the body where vascularized skin, muscle, bone, and nerves can be harvested and transferred to the head and neck.The Atlas will prove invaluable information to otolaryngologists, plastic surgeons, and general surgeons, who use both regional and free flaps to reconstruct damage to the head and neck caused by cancer and trauma. This Atlas provides the surgeon with techniques for mastering different donor sites needed to find solutions to virtually every reconstruction problem. It provides detailed descriptions of the anatomy and harvesting techniques of the major regional and free-flap donor sites currently employed in head and neck reconstruction."The in-depth coverage that readers trust...
"- Clinically detailed full-color line drawings emphasize proper harvesting technique for all flaps.
- Full procedural discussions address relevant anatomy, flap design and utilization, anatomic variations, preoperative and postoperative care, tips for avoiding potential pitfalls, and harvesting techniques for each donor site.
- Use of fresh cadaver dissections provides the most realistic portrayal of step-by-step detail that gives the resident and attending surgeon a thorough understanding of each donor site."Plus a wealth of features NEW to the Second Edition...
"- New chapters address the submental flap, ulnar forearm flap, anterolateral thigh flap, paramedian forehead flap, cervicofacial advancement flap, and perforator flaps.
- New content on skin-flap harvesting includes: addition of the coronoid harvest process to the temporalis chapter; addition of the osteocutaneous radial forearm flap to the radial forearm flap chapter; addition of scalp harvest to the chapter on the temporoparietal fascial flap; addition of scapular tip harvest for use in palatomaxillary reconstruction; and addition of harvest of the IMA and IMV recipient vessels and harvest of the TAC system of vessels to the recipient vessel chapter.
- New demonstrations of flap insetting and design for a number of reconstructions

The incidence of developing infection in prosthetic joints remains low after primary arthroplasty, but owing to the growing success of joint replacement surgery as a procedure to alleviate pain and improve mobility, infection numbers are increasing. The impact on the patient is immense, and surgical options are challenging. Prevention and reducing the incidence is the key to addressing this problem. Pathways in Prosthetic Joint Infection covers the most common incidences where the risk of PJI is elevated (such as following revision arthroplasty), and indicates suitable approaches to aid the improvement of outcomes. Featuring clearly-illustrated clinical cases on the typical presentation of established and latent infections, the microbiology profiles, assessment, and definitive management are all highlighted. Taking a team-based approach that includes the ortho-plastic surgery team, physiotherapists, and microbiologists, this new book provides a concise summary of the current literature and an essential overview of the management options for those with PJI. Endorsed by the Royal College of Surgeons, BAPRAS, The Vascular Society, and BASK, Pathways in Prosthetic Joint Infection is an indispensable title for all those working with patients who may face PJI.

The quintessential guide to state-of-the-art cosmetic breast surgery from international masters Cosmetic Breast Surgery by internationally recognized plastic surgeons Sameer Patel, C. Bob Basu, and esteemed colleagues presents the latest augmentation, lift, reduction, and revision surgery techniques. From dedicated chapters focused on the management and correction of undesirable results to expert perspectives on male aesthetics, this remarkable book provides a one-stop resource on cosmetic breast procedures. Every chapter includes technical pearls and methodologies to help surgeons master approaches and achieve optimal patient outcomes. Organized by six sections, the book starts with a discussion of breast anatomy, followed by a breast augmentation section that serves as a primer on breast implants, from selection to fat grafting. Section three covers management of the ptotic breast, including topics such as mastopexy, a novel internal bra technique, and reduction mammoplasty. Section four details important revision issues, such as managing acute complications and anaplastic large cell lymphoma linked to breast implants. Section five is devoted to male breast procedures, while section six includes chapters on congenital breast deformities, transgender breast surgery, and practice management issues. Key Highlights A contemporary update on capsular contracture and biofilms with evidence-based insights on prevention and treatment Pearls on managing and mitigating risk and complications in aesthetic breast surgery How to market a cosmetic breast surgery practice in an ever-evolving digital ecosystem Nearly 300 illustrations enhance understanding of techniques Comprehensive and diverse, this is a must-have reference for plastic surgery residents, fellows, and early-career aesthetic plastic surgeons. It will also benefit senior surgeons who wish to expand their surgical repertoire. This book includes complimentary access to a digital copy on https://medone.thieme.com.

This book provides a practical, step-by-step guidance on modern workhorse flaps for plastic and reconstructive surgeons in training or in their early career. The 50 chapters cover everything from surgical fundamentals to preconditions of microsurgical techniques, but also covers pre-operative planning, steps of microsurgical dissection and management of complications in a straightforward, explanatory style, and are supplemented by over 600 clinical illustrations and cadaveric images. Further videos demonstrations with pertinent steps in flap dissection, anatomical nomenclature and long-term outcomes are also demonstrated. For each flap a detailed discussion of key papers concerning its origin, pitfalls, technical refinements and tips for success are also included. Thanks to specific notes on common reconstructive challenges and complications, this book offers a valuable reference tool and would be unquestionably an integral reference guide for every surgeon interested in reconstructive microsurgical techniques, especially during their early microsurgical career.

This book presents the principles of hand trauma and plastic reconstructive surgery in a clear and concise manner. Its aim is to instruct the reader on how to identify the priorities of treatment and, using the principles of therapy, select the appropriate treatment modalities. Part one presents the principles of burns and plastic surgery, followed by an explanation of the roles of the multidisciplinary team. Part two explores the role of the physiotherapist and includes the principles of hand therapy, assessment and treatment modalities.

Treatment rationales are referenced with the available evidence and aspects that lack evidence are highlighted, with the intention of stimulating further investigation. In order to clarify and reaffirm essential parts of the text, key point boxes are provided regularly throughout the book.

Gender confirming surgery represents one of many therapies for individuals with gender dysphoria and can be pivotal in allowing individuals to become their true selves. An emerging field, this text represents a continuing evolution of surgical techniques, as well as a framework around which surgical therapies are based. Providing a fundamental understanding of the surgical principles while also recognizing the fast-paced nature of the advances in technique, Gender Confirmation Surgery touches upon the challenges and complexities in the surgical care of transgender individuals, featuring detailed sections for transwomen and transmen surgeries, non-surgical options, and establishing educational programs. Written as a guide primarily for surgeons in plastics, urology, and gynecology, this book can also appeal to primary care practitioners, mental health professionals, and endocrinologists. By representing an evolution of technique and advances in the field, Gender Confirmation Surgery offers a framework around which practitioners can familiarize themselves with gender surgery.

Das Buch ist ein Operationsatlas, der anhand instruktiver Bildserien, in denen die einzelnen operativen Schritte festgehalten werden, und eines kurzen Textes das gesamte Spektrum der Plastischen Mammachirurgie abhandelt. Die Beitrage reichen von der Probeexzision uber Augmentations- und Reduktionsplastiken, Brustanomalien, Behandlung des primaren Mammakarzinoms, Metastasenchirurgie bis zur plastischen Deckung nach Rippenresektion. Es werden nur diejenigen Operationsmethoden beschrieben, die sich fur die Autoren in den letzten 15 Jahren bewahrt haben. Der Operationsatlas ist keine Einfuhrung in die Mammachirurgie, sondern ein Nachschlagewerk, das dem interessierten Chirurgen eine direkte Antwort auf besondere Problemfalle gibt sowie auf bestimmte Details und Komplikationen hinweist."

Since its serendipitous discovery, surgeons and physicians have continued to study and refine the surgical treatment of chronic headaches. This innovation has been a "disruptive" treatment challenging the classical methods of management for patients living with migraines. This comprehensive reference provides the starting point for many surgeons who are entering this field and also describes intricate and variable technical details, providing the reader with a basic knowledge while delving deeper into techniques honed through years of treatment experience. Surgical Treatment of Chronic Headaches and Migraines is organized across 17 chapters and contributed to by a multidisciplinary wealth of practitioners in the fields of plastic surgery, neurology, pain medicine, and more. Topics examine the various types of headaches that may require surgical treatment and include postoperative care alongside minimally invasive interventions. The text is rounded out by a look towards the future in this field and further enhanced by high-quality videos, tables, and figures, making it a valuable reference for anyone looking to treat patients exhibiting the debilitating pain of chronic headaches and migraines.

Now in full color, Maxillofacial Surgery, 3rd Edition covers the entire specialty of maxillofacial surgery, including craniofacial deformity, oral surgery, trauma, and oncology. Unlike other OMFS texts where the contributors are singly boarded in oral surgery, this richly illustrated text boasts OMFS contributors who are all dual boarded in both oral surgery and medicine. Thoroughly updated with evidence-based content, it addresses the advances in technology and procedures providing oral and maxillofacial surgeons with new and exciting treatment options. And with print and digital formats, it is easy to use in any setting. Authoritative guidance on oral and maxillofacial surgery by internationally recognized experts in the field. 2,800 illustrations, including radiographs and full color artwork and clinical photos, provide clinicians and OMS residents with a clear visual guide to diagnoses, key concepts, and surgical techniques, as well as examples of preoperative and postoperative results. A multidisciplinary approach reflects the best practices in the disciplines of oral and maxillofacial surgery, head and neck surgery, plastic surgery, and otolaryngology. Covers contemporary techniques and technological advances at the forefront of maxillofacial surgery. Evidence-based content supports the newest, most up-to-date diagnostic and therapeutic options available for a wide variety of clinical problems. Key Points and Pitfalls boxes clearly identify the most important information, as well as potential problem areas that can arise when treating patients. Available in print and digital formats that can be easily accessed via mobile tablets and smart phones in any setting, making it perfect for the modern student of surgery. NEW! Full-color images clearly depict pathologies, concepts, and procedures. EXPANDED and UPDATED! Expanded from 82 to 111 chapters with thoroughly revised content that reflects current information and advances in OMS, so clinicians and students can depend on this text as their go-to resource on oral maxillofacial surgery. NEW! 29 new state-of-the-art chapters covering new topics, including the salivary glands, thyroid and parathyroid glands, tissue engineering, navigational surgery, 3D modeling, and lasers in OMFS. NEW! Two new editors, Professors Brennan and Schliephake, and new section editors and contributors have helped bring advances in the field of oral and maxillofacial surgery and offer a fresh perspective. UPDATED! Expanded chapter on cancer keeps you in the know.

This book provides over 400 questions, answers and explanations covering the breadth of plastic and reconstructive surgery including burns. The expansive array of questions with detailed explanations and references will provide a solid foundation for those preparing for final specialty examinations such as the American Boards, the FRCS (Plast), EBOPRAS, MCh and others. The questions are drawn from international experts and are up-to-date with the latest concepts and techniques, including face transplantation, new trends in reconstructive and aesthetic surgery, and recent scientific advances. It will therefore appeal to those interested in plastic surgery education globally. In particular, it will help plastic surgeons to keep up-to-date in the specialty, and demonstrate this through continuing medical education (CME) and for processes of revalidation.

The go-to pocket, computer, tablet and smartphone reference on plastic surgery essentials Essentials of Plastic Surgery, Third Edition by renowned plastic surgeon Jeffrey E. Janis and an impressive group of esteemed colleagues, retains its reader-friendly formatting, while featuring extensive updates that reflect significant changes in the field. The book is organized by the same seven sections as the prior edition: Fundamentals and Basics; Skin and Soft Tissue; Head and Neck; Breast; Trunk and Lower Extremity; Hand, Wrist, and Upper Extremity; and Aesthetic Surgery. The new edition includes 127 chapters, as well as updated and expanded references that guide readers to classic and definitive articles and chapters. New chapters include Pain Management in Plastic Surgery, Decreasing Complications in Plastic Surgery, Basics of Plastic Surgery Wound Closure, Scars and Scar Management, Skin Grafting, Posterior Trunk Reconstruction, Perineal Reconstruction, Nerve Transfers, Targeted Muscle Reinnervation, Hand Rehabilitation, Basics of Skin Care, Aesthetic Facial Anatomy, Secondary Rhinoplasty, Buttock Augmentation, and Male and Female Aesthetic Genital Surgery. Breakout chapters covering breast reconstruction and nonsurgical facial rejuvenation reflect new procedures developed since publication of the second edition. Key Highlights Contributions from a cadre of global plastic surgeons including new and completely rewritten chapters reflect accurate, state-of-the-art, contemporary plastic surgery practice Key points at the end of each chapter provide a quick source of information and a refresher on essential content Meticulous graphics such as new tables, charts, diagrams, pictures, and prior edition images updated in four color provide visually-rich insights This unique pocket guide provides high-impact information across the breadth and depth of plastic surgery, making it a must-have resource for medical school, residency and fellowship training, preparation for maintenance of certification, and beyond. This print book includes complimentary access to a digital copy on https://medone.thieme.com.

Known for its superb, step-by-step photo sequences, Colour Atlas of Ophthalmic Plastic Surgery, 4th Edition, by Drs. A. G. Tyers and J. R. O. Collin, remains your first choice for gaining essential knowledge in oculoplastic surgery. Ideal for both novices and experienced surgeons, this award-winning title offers comprehensive coverage of ophthalmic plastic surgery including eyelids, brows, and mid-face - all highlighted by unsurpassed photographic sequences and explanatory text that depict key stages of each procedure. New photos and new operative series, as well as major updates throughout the book, make this an invaluable resource for your practice. Provides more than 1,000 high-quality photos of every key step of every procedure, with corresponding explanatory legends and detailed descriptive text, making the surgeries easy to understand and follow. Features discussion of indications, preferences and advice on the management of complications with each chapter. Presents the knowledge and expertise of two internationally acclaimed oculoplastic surgeons, both previous Presidents of the British Oculo-Plastic Surgery Society and the European Society of Ophthalmic Plastic and Reconstructive Surgery. Includes an expanded video collection, now with 25 narrated surgical clips with over 2 hours running time, including brand new recordings and improvements to existing video footage. Includes updated coverage of ptosis surgery, lid and periocular reconstruction, and blepharoplasty and forehead rejuvenation. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

Part of the best-selling Operative Techniques series, Operative Techniques in Plastic Surgery provides superbly illustrated, authoritative guidance on operative techniques along with a thorough understanding of how to select the best procedure, how to avoid complications and what outcomes to expect. This stand-alone book offers focused, easy-to-follow coverage of injuries and diseases afflicting the craniofacial region, all taken directly from the larger text. It covers nearly all plastic surgery operations for this area that are in current use, and is ideal for residents and physicians in daily practice. Comprehensively covers craniosynostosis, orbital dystopias, maxillary surgery, mandibular surgery, skull defects, frontal sinus surgery, trauma surgery, and much more. Succinct text, bulleted points, and quick-reference tables allow you to review information quickly and understand best practices and potential problems for each procedure. Hundreds of full-color intraoperative photographs and illustrations, as well as numerous high-quality videos, capture procedures step by step and help you immediately apply your knowledge. Each clinical problem is discussed in the same templated format: definition, anatomy, patient history and physical findings, imaging, differential diagnosis, nonoperative management where applicable, surgical management including preoperative planning and approach, step-by-step surgical techniques, pearls and pitfalls, postoperative care, outcomes, complications and references. Perfect for a quick preoperative review of the steps of a procedure. Editors and contributors are globally renowned authorities in their respective subspecialties and are known for their surgical expertise. Enrich Your eBook Reading Experience with Enhanced Video, Audio and Interactive Capabilities! Read directly on your preferred device(s), such as computer, tablet, or smartphone Easily convert to audiobook, powering your content with natural language text-to-speech

Part of the highly successful Mastering Orthopedic Techniques series, this book is a comprehensive guide to knee reconstruction. Beginning with an overview of diagnostic arthroscopy and MRI in sports injuries, each of the following sections discusses surgical procedures for different types of injury or disorder. Topics are presented in a step by step, "how to" approach, covering both basic and more complex issues. Edited by recognised authorities in the field, this practical manual is enhanced by nearly 600 images, diagrams and tables. Other titles in the series include: Intra-articular Fractures, Spine Surgery, Total Hip Arthroscopy, and Total Knee Arthroscopy. Key Points Comprehensive, step by step guide to knee reconstruction, covering basic and complex issues Provides overview of diagnostic arthroscopy and MRI in sports injuries Part of the highly successful Mastering Orthopedic Techniques series Highly illustrated with nearly 600 images, diagrams and tables

The definitive multimedia resource on wide awake hand surgery from renowned experts WALANT (Wide Awake Local Anesthesia No Tourniquet) eliminates the need for preoperative testing, sedation, intravenous insertion, and monitoring in upper and lower limb surgery. Coupled with minimal pain injection techniques using pure local anesthesia with lidocaine and epinephrine, this technique has significantly improved hand surgery for patients and surgeons in many ways. Wide Awake Hand Surgery and Therapy Tips, Second Edition, provides readers with the best and latest WALANT advances from Donald H. Lalonde and an impressive group of hand surgeons from 15 countries that have incorporated this groundbreaking technique into practice to benefit their patients. Each richly illustrated chapter encompasses evidence-based benefits, step-by-step guidance, patient education tips, detailed injection directions, surgery and therapy tips and tricks, postsurgical management, and related videos. WALANT produces better outcomes in flexor and extensor tendon repair, tendon transfer, tenolysis, tendon grafts, and finger fracture surgery because unsedated patients can easily move reconstructed parts during surgery. This allows surgeons to make required adjustments and teach patients uninterrupted while they are awake. Eliminating sedation also decreases risks, increases patient safety, and reduces pain associated with intravenous insertion. Simple surgeries such as trigger finger and carpal tunnel release no longer require costly main operating rooms. Instead, they can be performed in minor procedure rooms with evidence-based sterility, resulting in lower costs and reduced waste. New Features A three times larger video library with more than 500 videos, most of which are new New chapters on upper and lower limb fracture plating of the wrist, forearm, elbow, acromion, clavicle, tibia, fibula, ankle, and fo

Anl{ lich eines Symposiums }ber mikrochirurgische Rekonstruktionen in der Unfallchirurgie wurde }ber die M-glichkeiten der Mikrochirurgie zur Rekonstuktion nach traumatischen Defekten kompetent referiert und diskutiert. Die }berarbeiteten Referate sowie erg{nzende Arbeiten zu diesem Thema sind in dem vorliegenden Band zusammengefa t, der Zugangund Einblick in die modernen M-glichkeiten der Mikrochirurgie zur Rekonstuktion nach Trauma vermittelt. Das Buch soll dem nicht mikrochirurgisch T{tigen eine Hilfe zur Indikationsstellung bei der Rekonstruktion nach Trauma bedeuten, dem Mikrochirurgen wird eine Synopsis }ber den gegenw{rtigen Stand der rekonstruktiven Mikrochirurgie geboten.

The book provides a framework for diagnosis and treatment of the complex facial deformities found in craniofacial microsomia and Treacher Collins syndrome. These conditions are difficult to treat due to their complexity and variable presentation. The deformities may be mild or severe and merely cosmetic to life-threatening in nature. These conditions often manifest as complex facial deformities that require multiple surgical interventions. Timing is critical when treating these patients and knowing and choosing the correct operation is key to successful outcomes. This work provides a comprehensive approach in treating these complex patient populations, seeking to answer the following questions: When to operate versus when to wait? If operating is required what operation should be performed? What is the best orthodontic approach to the associated dental deformities that develop with these conditions? How should sleep apnea be evaluated and treated in this population? What is the best management for feeding patients with these conditions? Written by experts in the field, Craniofacial Microsomia and Treacher Collins Syndrome: Comprehensive Treatment of Associated Facial Deformities aims to provide the reader with literature based best practices in treating these children from the NICU through childhood and into adulthood.

Die Mikrogefasschirurgie spielt bei Gewebetransplantationen eine immer groessere Rolle. Dieses Buch ist ein "Gewusst-wie"-Text uber die mikrovaskulare Rekonstruktionschirurgie, das vorwiegend von einem einzelnen Chirurgen geschrieben wurde. Es richtet sich sowohl an den erfahrenen als auch an den noch in der Ausbildung befindlichen Chirurgen. Das Buch ist in zwei Abschnitte gegliedert. Der erste beschreibt die operative Anatomie und Technik, die mit der Hebung jedes freien Gewebetransfers verbunden ist. Der zweite Teil behandelt die Anwendung dieser Transplantate fur die Rekonstruktion in drei anatomischen Regionen, in denen die rekonstruktive Mikrochirurgie bedeutende Ergebnisse geliefert hat: Kopf, Hals sowie obere und untere Extremitat. Das Buch ist ein aktuelles Nachschlagewerk fur jeden auf diesem Gebiet arbeitenden Chirurgen, Orthopaden und Traumatologen.

Die Tumeszenz Lokalanasthesie ist ein neues Verfahren, dessen Vorteile inbesondere bei ambulanten Eingriffen deutlich werden. Das Narkoserisiko fur den Patienten sinkt. Komplikationen wie Thrombosen sind nicht mehr zu befurchten. Das Verfahren kann vom Dermatologen oder Chirurgen selbst durchgefuhrt werden. Wie das im Einzelnen geschehen soll, beschreibt dieses anwendungsorientierte Buch. Fur alle in der operativen Medizin Tatigen.

Das Gro8e Netz wurde lange vernachUissigt. Nur die Embryologen und Anatomen interessierten sich dafiir. Es wurde miBachtet, und in den meisten Biichern wurde sogar empfohlen, es generell bei Laparoto- mien zu entfernen, urn postoperative Verwachsungen zu verhindern. Heute weiB man, daB es zum Schutz und zur Verteidigung der Perito- nealhohle dient. Es war von groBer Wichtigkeit, in einem einzigen Buch alles zu sam- meln, was dieses peritoneale Gebilde betrifft und ihm damit eine eigene IdentiHitverleiht. Sein Studiumruft physiopathologische Problemeher- vor, die vie! komplexer sind als vermutet wurde. Seine Pathologie ist vieWiltig, sei es, daB es sich urn eine Einklemmung des Netzes in einen Leistenbruch oder urn entziindliche und tumorbedingte Uisionen han- delt. Sein Anteil an vielen bewahrten und erfolgreichen Wiederherstel- lungstechniken wird immer groBer - bei der Visierlappenplastik, bei Transplantationen, bei der Revaskularistion - die durch die Mikro- chirurgie so sehr den Bereich der Wiederherstellungschirurgie erweitert haben. Urn all diese verschiedenen Probleme zu erortern, sind die beiden Autoren an jedes Kapitel kritisch und prazise herangegangen, was der Leser selbst entdecken wird. Dieses ausgewogene Buch ist keine reine Zusammenstellung. Es ist das Ergebnis einer groBen Erfahrung, die die Autoren dazu gefiihrt hat, samtliche Techniken, die das groBe Netz betreffen, mit einer per- fekten Bildausstattung zu beschreiben.

Das Essential gibt eine systematische UEbersicht zur Diagnostik und Therapie des Karpaltunnelsyndroms (KTS), des mit Abstand haufigsten Kompressionssyndroms eines peripheren Nervs. Fuhrendes Symptom ist das "Einschlafen" der Hande. Wenn die konservative Behandlung, vorzugsweise mit nachtlicher Ruhigstellung des Handgelenks auf einer Schiene, nicht zu anhaltender Beschwerdefreiheit fuhrt, ergibt sich die Indikation fur eine offene oder endoskopische Retinakulumspaltung. Die diagnostischen Techniken und die Behandlungsmoeglichkeiten werden kritisch und leitlinienkonform diskutiert und eingehend beschrieben. Auf moegliche Risiken und Komplikationen sowie das Vorgehen bei Schwangeren, bei Dialysepatienten u.a. sowie die Tendovaginosis stenosans als wichtigste Begleiterkrankung wird gesondert eingegangen.

In nur wenigen Jahren hat sich die rekonstruktive Chirurgie am Handskelett grundlegend gewandelt. Die Vorteile einer stabi- len Osteosynthese werden weltweit in zunehmendem Masse auch in der Handchirurgie genutzt, vor allem in der Versorgung der an der Hand typischen multistrukturellen Verletzung und bei revitalisierenden Eingriffen. In bezug auf die Biomechanik des radiokarpalen Gelenkkom- plexes verlauft die Entwicklung dagegen zoegernd. Dies triff- etwa im Vergleich mit der unteren Extremitat - ganz besonders auch fur den alloplastischen Gelenkersatz zu. Dabei ist unver- kennbar, dass die Problemfalle mit posttraumatischen Handge- lenkbeschwerden standig zunehmen und vor allem junge Patien- ten betreffen, und immer deutlicher wird der Zwang zu therapeu- tischen Loesungen. Das "Handgelenk" in seiner Komplexitat ist lange schon Gegenstand wissenschaftlichen Interesses; eine neue klinische Dimension erhielt dieses Gelenk aber wahrscheinlich erst durch Gilford, Bolton und Lambrinudi im Jahre 1943, als sie das Langskettenkonzept mit einzelnen Gliedern darstellten und im seitlichen Roentgenbild die Achsen der einzelnen Glieder erkannten. Einen Stabilitatsverlust konnten sie so aufgrund der abweichenden Achsen im seitlichen Roentgenbild definieren. Seit- her haben sich innovative Anatomen und Kliniker mit wachsen- dem Erfolg um das Verstandnis von Bewegung und Stabilitat am Handgelenk bemuht. Auf diesen grundlegenden Arbeiten baut die anspruchsvolle Monographie von G. Sennwald auf. Dem Autor gelingt es in hoechstem Masse, Anatomie, Funktion und Pathologie dieses Ge- lenkkomplexes als Einheit darzustellen. G. Sennwald analysiert kritisch das internationale Schrifttum, analysiert aber mit ebenso grosser Akribie das eigene handchirurgische Krankengut mehre- rer Jahre.