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Biomedical subjects

A Apoil

Publications and source records attributed to A Apoil.

At least 19 recordsLinked to original sources
PubMed1992

Case report 728: Desmoplastic fibroma.

A 69-year-old woman with a 25-year history of recurrent sciatica presented with an expanding lytic lesion of the right side of the first sacral vertebra. Histological examination proved the lesion to be a DF. DF is usually diagnosed in young patients and is very rarely located in the spine and sacrum. The growth rate of the tumor was presumed to be very low because it had not progressed from radiological studies performed 9 years previously. The clinical, radiological, and pathological features of DF are described, and the differential diagnoses are discussed. The most difficult problem is to distinguish DF from a low-grade fibrosarcoma or chordoma.

Aged↗
PubMed1992

[Antero-internal impingement of the shoulder].

Anteromedial conflicts of the shoulder are situated in the subcoracoid or coracohumeral space, in the anterior part of the acromio-coracoid vault. The authors describe a first fibrous band connecting the anterolateral border of the acromio-coracoid ligament to the coraco-biceps tendon (Apoil) and a second deeper band between the superior border of the subscapularis and the insertion of the long head of biceps onto the labrum (Patte). The role of the vault varies according to constitution (length and direction of the coracoid process) and acquired factors (iatrogenic or traumatic); the role of the floor depends on numerous elements: traumatic sequelae (malunion), eccentricity of the humeral pivot, lesion of the rotator interval, variant of insertion of the anterior capsule, floating glenoid labra, anomalies of insertion of pectoralis minor. There are no pathognomonic signs, but Gerber's, Hawkin's and Yocum's signs are generally observed. Computed tomography and CT arthrography are currently the most reliable complementary investigations to demonstrate this type of conflict. This regional pathology is situated at the crossroads between pure conflictual mechanisms and hyperlaxity phenomena associated with subluxations.

Arthrography↗
PubMed1992

[Bipolar prosthesis in femoral neck fractures. Results and long-term acetabular tolerance of 36 bipolar arthroplasties].

The authors present the long-term results of 36 SEM cemented bipolar hip prostheses for femoral neck fractures with a mean observation time of 7.4 years. The objective was to study the acetabular tolerance of these prostheses comparing with Moore's and Thompson's conventional hemiarthroplasties. The average age of the patients was of 69 years. According to the Merle d'Aubigné's classification, clinical results were better than those results reported in the literature with conventional hemiarthroplasties. At long term, acetabular deteriorations were nevertheless frequent (41.6 per cent pinchings and 25 per cent protrusions), but with no clinical significative correlation. They seem to be favoured by technical errors (drilling, size of the cups) and acetabular morphology. The part of the intermediary joint's mobility is difficult to demonstrate and is far being univocal. The authors conclude, to the superiority of the bipolar hip prosthesis actually totalizable (long term clinical results and middle term acetabular tolerance) in comparison with the conventional hemiarthroplasties, and recommend the use of those implants in sub-capital displaced femoral neck fractures for elderly patients with no arthrosis.

Acetabulum↗
PubMed1991

[Compression of the deep branch of the ulnar nerve as it exits the pisiform-unciform hiatus: report of an anomaly not yet described].

We observed a case of compression of the deep branch of the ulnar nerve distal to the piso-hamate hiatus due to an aberrant fibrous band arising from the hamulus ossi hamatum and ending in the flexor digiti minimi muscle. An anatomical study of eleven fresh cadaver hands revealed that between the piso-hamate hiatus and the palm, the nerve passes through an osteo-fibrous tunnel in which multiple anomalies can occur. The authors think that ulnar nerve neurolysis at the wrist must always extend up to the palm.

Adult↗
PubMed1989

[Degenerative lesions of the rotator cuff of the shoulder. Current status of the surgical treatment].

With age there is a progressive deterioration in the capsulo-tendinous cuff of the shoulder: When rotator cuff lesions are limited (in general to the supra-spinatus), the cuff remains continent and functional, thereby ensuring good centering of the humeral head. At this stage antero-superior arthrolysis may be indicated for cases of failure of conservative treatment. When there is a large degree of capsulo-tendinous perforation (affecting posteriorly the supra-spinatus), the cuff no longer ensures centering of the humeral head and friction with the lip of the acromion progresses until an eccentric arthrosis of the shoulder develops. The surgical treatment of choice is then a deltoid flap procedure which fills in the loss of substance in the cuff and centers the humeral head. The course of eccentric arthrosis of the shoulder itself involves three stages: --stage I: limited to acromio-humeral friction where a deltoid flap is indicated as treatment; --stage II: extension or arthrosis to the gleno-humeral level, but without formation of a neoglenoid, where an unrestricted gleno-humeral prosthesis, centered by a combined flap procedure, is in our opinion the best surgical solution; --stage III: where the formation of an eccentric supero-medial neoglenoid produces very unpredictable functional results after arthroplastic procedures.

Adult↗
PubMed1989

[Partial or total enucleation of the talus. Value of conservative treatment. Apropos of 8 cases].

Eight cases of talus enucleations are reported. The patients ranged in age from 18 to 62 years. The follow-up period in this study extended from one year to 12 years. The talus was reduced in six cases and usually fixed with a trans-plantar pin. The main problem in the conservative treatment was represented by early infection which required a calcaneo-tibial arthrodesis. On the other hand, necrosis of the talus, although unavoidable, is usually well tolerated. That may be explained by the fact that the necrosis is dense and congruous and does not lead to severe arthritic changes. Among 5 cases of necrosis of the talus, fusion of the ankle and of the sub-talar joint was indicated in only one patient. The authors conclude that the conservative treatment should be systematically tempted and that arthrodesis should be indicated only for the infections, that usually appear early or the osteoarthritic changes which appear later.

Adolescent↗
PubMed1988

Experimental microvascular anastomoses with a CO2 laser. A series of 240 anastomoses.

In order to compare conventional microvascular suture anastomoses with CO2 laser-assisted anastomoses, 240 anastomoses were performed in Wistar albino rats. Average time required for anastomosis was 8.30 minutes in the laser group and 14.30 minutes using the conventional technique. Patency rate was the same in both groups for arterial anastomosis but in femoral veinous anastomoses, the patency rate was of 89% using laser and 75% when done by hand. Secondary vein thromboses amounted respectively to 2% with laser and 18% with conventional sutures. Scanning electron microscope examination revealed a better endothelialization in the laser group. T.E.M. examination showed an important inflammatory reaction around the threads in the conventional suture group, even at the end of the first month. In the laser group, a partial and transient necrosis of the media appeared between the second and fourth day. Laser assisted microvascular anastomosis seems to be a promising technique with potential clinical applications.

Anastomosis, Surgical↗
PubMed1988

A ten years follow-up of the results of surgery for Dupuytren's disease. A study of fifty-eight cases.

Fifty-eight patients (52 males and 6 females) operated on for Dupuytren contracture were examined by the same author with a more than ten year follow-up. At time of surgery the average was 55 years old. 69 hands (169 fingers) rated 4.33 according to the simplified Tubiana's score were treated by the same operative procedure: Mac Indoe's incision, digital Z plasty (if needed), subtotal fasciectomy and physiotherapy beginning 8 days postoperatively. At long term, recurrence appears for 49 hands (71%) one every two in the two first postoperative years, one out of five after five years. 24 of them were graded stage I. The recurrence appeared 14 times associated with an extension of the disease and the earlier, the higher was the initial stage. Some factors seem to be of a bad prognosis regarding recurrence: age (93% of recurrence under 50 years old) Ledderhose or Lapeyronie (100%) other associated diseases (Alcoholism, diabetes mellitus, epilepsy) and severe preoperative stage. Subjective results are good: 45 patients are satisfied and only 3 underwent a second operation.

Adult↗