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Biomedical subjects

B Augereau

Publications and source records attributed to B Augereau.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Radiological assessment before femoral and tibial osteotomies].

After recalling the good results of femoral and tibial osteotomies for lateral osteoarthritis of the knee before the age of 70 years, the author describes the usual techniques and defines the indications. He then defines the preoperative x-rays essential for such procedures: AP and lateral films of the knee in 15 degrees of flexion, AP in forced varus and valgus with 15 degrees of flexion, femoropatellar view with 30 degrees of flexion with particular attention to "stepping" gonometry, which appears to be the most physiological approach.

Femur↗
PubMed1993

[Radiological examination of knee prostheses].

After defining the respective indications for the various knee prostheses: single-compartment, three-compartment sliding and hinge prostheses, essentially based on the preoperative radiological assessment, the authors emphasise the value of such films in operative planning. They then describe the radiological criteria of correct implantation of the three different types of prosthesis. Lastly, they stress the value of regular radiological follow-up of these arthroplasties looking for possible complications such as instability, loosening, wear and infection, which may alter the patient's osteoligamentous capital and his functional prognosis.

Bacterial Infections↗
PubMed1993

[Pulmonary artery pseudoaneurysm caused by a Swan-Ganz catheter and treated by embolization].

The frequency of life-threatening complications induced by Swan-Ganz catheter is estimated at 2% to 17%. Pseudoaneurysm formation secondary to traumatic injury of the pulmonary artery is rare (0.66% to 2%), but carries a high risk of hemorrhagie. Recognition of possible lesions should be based on clinical data and predisposing factors. Diagnostic and therapeutic investigations should be rapidly performed. Embolization is the best treatment giving very good results. Should acute hemorrhage occur in the operating room, emergency vascular occlusion can be carried out by the use of the Swan-Ganz catheter.

Aged↗
PubMed1993

Methylmethacrylate plasma levels during total hip arthroplasty.

Methylmethacrylate (MMA) plasma concentrations were measured in 11 patients scheduled for total hip arthroplasty. After acetabular and after femoral cement implantation, sequential blood samples were withdrawn from pulmonary and radial artery catheters. The peak concentration of MMA (mean +/- standard error of the mean) in pulmonary artery blood occurred two minutes after cement implantation and was significantly higher after acetabulum (5.0 +/- 1.3 micrograms/ml) than after femoral cement insertion (1.9 +/- 0.6 micrograms/ml). The MMA peak in plasma was above 1 micrograms/ml in 13 cases, and the decrease fit a biexponential decay (r = 0.91). The initial half-life was 0.3 +/- 0.1 minutes, and the terminal half-life was 3 +/- 0.7 minutes. The areas under the curve (AUC) were determined for pulmonary (AUCpa) and radial (AUCra) plasma samples, and the ratio (AUCpa - AUCra)/AUCpa was computed: 55.1 +/- 7.8% of MMA was cleared during the transpulmonary passage. These results demonstrate that: (1) MMA could be determined after each cement implantation, (2) MMA plasma concentrations were higher after acetabulum than after femoral cement implantation, and (3) the half-life is short and the total pulmonary clearance is high.

Adult↗
PubMed1992

[Pathogenesis of ruptures of the shoulder rotator cuff].

Rupture of the rotator cuff occurs exceptionally in a healthy cuff and almost always in a degenerated cuff. This degeneration may be either ischaemic and secondarily conflictual or primarily conflictual. There are two zones of conflict: anteromedial and superior, resulting in two clinical presentations: small anterosuperior ruptures which are initially very painful, but minimally disabling and large posterosuperior ruptures which are initially which are immediately disabling but minimally painful.

Humans↗
PubMed1992

[Preoperative embolization of cervical bone metastasis with radio-controlled direct puncture].

Surgery of vertebral hypervascular metastasis can take advantage of preoperative embolization to make the surgical procedure easier to perform. Usually, embolizations are executed by vascular tract. We report a case of one cervical metastasis located in C4 for which embolization was executed with direct puncture of the vertebra. This method has the advantage to be feasible whatever tumoral vascularization, and more particularly in case of departure of radiculo-medullary artery or any other cephalic vessel from the tumoral site.

Biopsy, Needle↗
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↗
PubMed1991

[Reconstruction of massive rotator cuff rupture using a deltoid muscle flap].

In extensive rotator cuff tears with rupture of the supra- and infraspinatus muscles, we have obtained good and very good results persisting for 3 years or longer only in 40% of cases treated by resection and debridement, and in 25% of our cases the head of the humerus was found to be no longer centrally located in the joint socket on X-ray examination 10 years after treatment. It was therefore proposed that an active muscle flap taken from the anterior part of the deltoid muscle (part III according to Fick) should be used to span the trophic defect in the rotator cuff, being sutured into healthy tissue following freshening up. This seems logical, since the transferred muscle flap remains innervated and vascularized and also works synergistically with the rest of the rotator cuff. The flap interposed in this way between the greater tubercle of the humerus and the acromion functions in the same way as a double-bellied muscle and prevents displacement of the head of the humerus. In this way an active rotator cuff is produced, which also takes over the function of stabilizing the humeral head. After follow-up of at least 1 year (average 19 months), the result is aesthetically satisfactory in all 50 shoulders treated in this way; 47 are free of pain or painful only some of the time; in 32 active elevation of over 120 degrees is possible; 21 have symmetrical force ratios in elevation and 15 for outward rotation in 90 degrees abduction. All reconstructed shoulders were characterized by fatigability in elevation.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1990

[Rupture of the rotator cuff].

Spontaneous or traumatic ruptures almost always occur in a cuff that has degenerated due to overuse. Despite the lack of absolute anatomico-clinical correlation, two clinical types can be described: a conflictual, often hyperalgesic shoulder with its painful arch corresponding to a small anterosuperior rupture, or a pseudo-paralytic shoulder betraying a major posterosuperior rupture. Standard radiography with Leclercq's manoeuvre is performed primarily to find out whether the cuff is continent or incontinent. Modern medical imaging (ultrasonography or MRI) adds precision to the lesions when surgery is contemplated. When medical treatment has failed, partial ruptures are treated by arthrolysis; ruptures of the superficial and deep layers of the cuff without calcification benefit from endoscopy; ruptures involving tendons or associated with calcifications are treated by surgery. Small and medium ruptures with a continent cuff require endoscopic or surgical anterior decompression combined, in cases where the intra-articular long head of the biceps is exposed, with repair, usually by suture. Extensive ruptures with an incontinent cuff are treated by muscle transfer alone of combined with arthroplasty, or by semi-constrained total prosthesis when arthrosis of the humeral joint is present.

Humans↗
PubMed1990

[Anterosuperior instability of the shoulder. Apropos of a case].

One case of antero superior instability, isolated, without traumatic history, revealed by blocking when raising arm in internal rotation, without hyperlaxity is reported. The radiographs in blocking position, on axillary view, revealed an asymetric antero superior subluxation of the humeral head, superimposed with the horizontal portion of the coracoid. During operative procedure by a deltopectoral approach, there was a gap between anterior border of the supraspinatus and the superior border of the subscapularis, increasing in internal rotation. A coracoidoplasty was made, in association with a stay suture between supraspinatus and subscapularis. The follow up was nineteen months, the result was good, with a stable and painfree shoulder and a normal motion.

Adolescent↗
PubMed1990

[Repair of unstable cuffs with a deltoid flap].

We have found that upper arthrolysis for major ruptures of the cuff affecting the supraspinatus and infraspinatus muscles yielded only 40% of excellent and good clinical results at three years, with 1/4 of cases of exenteration of the humeral head on radiographs after 10 years, so that, as early as 1984, we had the idea of using a "tailor-made" active muscle flap taken from the anterior fibers of the middle deltoid muscle (Fick's fibers n degrees III) and sutured to the edges of the trophic perforation after exeresis reaching to the healthy tissue. In our opinion, this procedure is logical as we use a synergic transplant of the ruptured muscles of the cuff, preserving its nerves and blood vessels. This forms a living interposition material between the acromion and the greater tuberosity of the humerus, forming a real "three-bellies" muscle resisting the ascent of the humeral head. In fact, it reconstructs a contained cuff, which plays an important role to lower the humeral head. After a minimum of one year and an average of nineteen months for fifty shoulders, all of these have an esthetically satisfactory appearance, forty-seven are painless or painful only episodically; thirty-two have an active elevation exceeding 120 degrees; twenty-one have a symmetrical muscular strength for elevation and fifteen for outward rotation with 90 degrees abduction. Thirty-nine patients (78%) show satisfactory clinical results. Seventeen humeral heads are realigned. Electromyograms performed after six months showed that the flap contracted synchronously with the supra- and infraspinatus.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
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

[Arthroscopy in the treatment of primary acute pyogenic arthritis of the knee in adults. Apropos of 12 cases].

Twelve arthroscopies have been performed in the treatment of acute septic arthritis of the knee. This gave an early visualisation of the cartilaginous and synovial lesions and treatment by lavage, drainage and irrigation of the joint. Using this technique, all the patients were cured of the infection and only one patient showed ultimate limitation of movement of the knee. Arthroscopy made it possible to confirm the diagnosis and to treat the arthritis effectively at an early state and to reduce the mortality and poor functional results of arthrotomy.

Acute Disease↗