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Biomedical subjects

B Wack

Publications and source records attributed to B Wack.

9 recordsLinked to original sources

[Plastic surgery of the thoracic wall (malformations and tumors) using a sliding splint-stapler].

Chest wall instability, created surgically by correction of a chest deformity (funnel chest or, more rarely, pigeon chest) or by resection of a tumour of the chest wall, is serious as it can jeopardize the immediate vital prognosis because of paradoxical respiration and, in the long term, the functional and aesthetic prognosis due to progressive impaction of the unstable segment of the wall. The polyvalent and adaptable material which we have developed (sliding splint-staple) and which we also use in thoracic traumatology (thoracic flaps), has allowed us to perform audacious corrections for deformities or wide resections for tumours since 1980. We have used this material on 13 occasions for contention after sternochrondroplasty, with an excellent result in each case both in terms of the immediate stability and in terms of the aesthetic result. The sliding splint-staples, generally two, are placed in staggered positions behind the sternum (11 cases--funnel chest) or in front of the sternum (2 cases--pigeon chest). The material is left in place for at least one year. We have used this material on 8 occasions after various tumour resections: 3 times after subtotal resection of the sternochrondral breastplate and 5 times after lateral or anterolateral resection removing at least 2 ribs.

Adult↗

[Surgical treatment of flail chest by sliding staples].

The authors have compared the results obtained in two series of patients with flail chests treated by internal fixation. In the first series of 36 patients, Judet rib staples were used. The average time of artificial ventilation was 5.8 days. In the second series of 43 patients, gliding staples were used. The average time of artificial ventilation was only 2.6 days, a significant reduction. Thanks to this new technique, the indications for artificial ventilation in the treatment of flail chests have been reduced from 47 per cent to 33 per cent. The technique of fixation has also been used in seven cases of operative treatment of funnel chests. In five other cases it has been used to reinforce plastic mesh inserted after extensive resection for malignant tumour.

Adolescent↗

[Compression of the brachial plexus by a pseudarthrosis of the 1st rib].

The authors have described the case of a thoracic outlet syndrome with costoclavicular compression of the brachial plexus, secondary to non-union of a first rib fracture. Treatment consisted in transaxillary removal of the first rib, as described by Roos. Intrafascicular neurolysis of the posterior and medial trunks was performed at the same time, and was followed by quick clinical and electromyographical recovery.

Adult↗

[Lateral calcaneal flaps].

The authors have studied the cutaneous vascularization of the lateral side of the ankle. Different technics of vascular injection have identified a cutaneous flap based on the lateral calcaneal artery, a collateral branch of the posterior peroneal artery. This flap can be used to cover the chronic ulceration of the achilleen region.

Calcaneus↗

[Roos' axillary approach to the brachial plexus].

An anatomic study of five cadavers, that were dissected on a level with the two shoulders, was made to explore the possibilities of the Roos ' axillary surgical approach. This surgical approach permits almost complete resection of the first rib and dissection of plexus brachialis's inferior roots. (T1, C8 and C7).

Axilla↗

[Osteosynthesis for fracture of the trapezium. One case (author's transl)].

Fractures of the trapezium are rare but their clinical and radiological features are perfectly known. By contrast, their treatment (orthopaedic or surgical) is less clearly defined. The authors wished to make their contribution to the study of this fracture by presentation of a case of fracture-dislocation of the 1st radiation of the hand. Such lesions are generally unstable and require osteosynthesis. In the present case, the latter was facilitated by the use of mini-screws which made it possible to begin physiotherapy almost immediately and to obtain an excellent result.

Bone Screws↗