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Biomedical subjects

C Dumontier

Publications and source records attributed to C Dumontier.

18 recordsLinked to original sources
PubMed1992

[Clinical examination of lesions of the rotator cuff].

Although unable to reach any formal conclusions, clinical examination remains an essential prerequisite in the assessment of a rotator cuff lesion, as it guides the diagnosis, evaluates the severity of the functional impairment and often the extent of the lesions and eliminates the differential diagnoses. The principal clinical tests of shoulder conflict are recalled, but as they are painful, they should only be performed at the end of a complete clinical examination.

Humans↗
PubMed1992

[Instability of the carpal bones].

The understanding of carpal instability and their radiological signs are based on a knowledge of the anatomy and complex physiology of the wrist. This article successively deals with the physiological anatomy, radiological technique, normal static and dynamic radiological features, radiographic signs of various types of instability and therapeutic principles.

Carpal Bones↗
PubMed1992

[Kienböck's disease. Current data].

Aseptic osteonecrosis of the lunate bone is a rare disease of unknown aetiology. The mechanical theory of shearing of the lunate underneath the radius is generally accepted, especially in the presence of a short ulna, even if it is insufficient. The diagnosis is exclusively radiographic and requires, in the early stages, the use of MRI which is more sensitive and specific than bone scan. Plain X-rays allow the disease to be classified into various stages, which determine the therapeutic indications. Many treatments have been proposed, but the follow-up is often inadequate. Simple immobilization is atraumatic, but its efficacy is highly controversial. Equalization of the two bones, usually by shortening the radius, is the most widely used technique and, with a follow-up of more than 20 years, appears to be effective in 80% of subjects. Revascularization of the lunate has been proposed in the early forms. Partial arthrodeses are indicated in the advanced forms. Radio-carpal arthrodesis or denervation of the wrist are indicated in the presence of osteoarthritis. Functional sequelae are frequent in these young subjects, who are often manual workers.

Carpal Bones↗
PubMed1992

[Distal radio-ulnar joint. Traumatic and degenerative diseases].

The distal radio-ulnar joint participates in the biomechanics of the wrist both by transmission of carpal stresses and by its role in the mobility of the wrist. Fractures of the distal radio-ulnar joint are often missed as they are frequently only a radiation of fractures of the radius to the distal radio-ulnar joint. Computed tomography is the most useful examination to assess the severity of these lesions. Distal radio-ulnar dislocations may also be associated with fractures of the radius, but usually occur in isolation. The diagnosis is difficult, as the slightest rotation on plain X-rays interferes with the evaluation criteria. A CT scan in the neutral position and in pronation and supination is the examination of choice for dislocations and subluxations, but must be interpreted according to strict criteria. In contrast, a tea of the triangular ligament can only be assessed on arthrography and the distinction between traumatic and degenerative rupture is difficult. The patient's age, the site of the perforation and the length of the ulna are important elements in the diagnostic decision. MRI appears to be a promising examination for investigation of this joint, but the quality of the images is not yet perfectly reproducible.

Arthrography↗
PubMed1992

[Reconstruction of distal loss of substance in the nail-bed by a de-epithelialized flap from the digital pulp].

Twelve patients, presenting with traumatic avulsion of the distal nail bed, repaired by a de-epithelialized palmar advancement flap, were reviewed with an average follow-up of 23 months. Subjective results were considered excellent in two cases, good in seven, fair in two and poor in one patient. Nail adherence with the de-epithelialized flap was observed over almost 90% of the new nail bed. Nail dystrophy was observed in three patients, but was severe in only one. Two patients had slight curvature of their nail, while one had a severe hook-nail deformity. Mobility in the finger was always complete, and only one patient had a slightly decreased two-point discrimination on the flap.

Adolescent↗
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↗
PubMed1990

[Cold sensitivity after median or ulnar nerve injury based on a series of 82 cases].

Cold sensitivity often occurs after upper limb nerve injuries. 82 patients were reviewed retrospectively with an average follow-up of 42 months. Cold sensitivity occurred after 50% of median nerve injuries and after 75% of ulnar nerve injuries. Symptoms are localized to the damaged sensory nerve territory, and are related to the level of the lesion after median nerve injury. They are increased by associated arterial damage even when it is repaired. The less attened is the two-point discrimination lest, the less severe are the disorders. The origin is not really known, but we think that cold sensitivity is related to a disturbance of sympathetic and sensory fibers.

Adolescent↗
PubMed1990

Traumatic brachial plexus palsy in children.

We have reviewed 25 children with traumatic brachial plexus palsy during the last fifteen years. Motor vehicle injury was responsible for 17 of these cases. Associated lesions were noted in 68%. All lesions were supraclavicular, including C5-C6 in 5 cases, C5-C7 in 5 cases and C5-T1 in 13 cases. Precise data was not available for two patients. Root avulsion was noted in 63% of our patients. Neurotization was performed in eight of the sixteen patients who had surgical repair. Tendon transfers were performed in 9 patients, 5 of which have had a previous surgical plexus repair. Elbow flexion was restored in all but one, and protective sensation of the hand in 40% of the patients undergoing plexus surgery. We conclude that surgery should be performed on children who have no evidence of nerve regeneration three months following traumatic brachial plexus palsy.

Adolescent↗
PubMed1990

[Nerve graft of collateral branches of fingers. Report of a series of 16 reviewed cases].

Sixteen digital nerve grafts (14 patients) were reviewed with an average follow-up of 43 months. Average age was 27 years (7-53 yrs). Eleven grafts were performed on the thumb or the index finger. The nerve lesion was always proximal to the proximal interphalangeal joint, and associated with a tendinous lesion in one case out of two. One graft was done in emergency, 6 for failure of sutures and 7 for neglected wounds. Delay before grafting was on average of 4 months (0-16 months). The n. cutaneus antebrachii medialis was used in 11 patients. An hypoesthetic area of an average of 78 cm2 was noted, at the inferomedial part of the forearm, but only one patient complained with discomfort. At follow-up 3 patients, all under 20, had discriminative sensibility, 4 had protective sensibility and 5 only some sensibility to touch. Half of our patients complained with little discomfort, but 9 of 14 suffered with cold among which two suffered daily.

Adolescent↗
PubMed1990

[Isolated ulnar nerve lesions. Results and sequelae after treatment at a specialized unit: apropos of 40 cases].

77 patients with an isolated traumatic ulnar nerve lesion were operated on between 1972 and 1982. 40 patients with more than 18 months of follow-up were reviewed with a new clinical quoting. 37.5 p. cent of satisfactory results were achieved with nerve sutures done in emergency, 56.3 p. cent with secondary nerve grafting. Factors influencing the results were age, level of the lesion and use of the microscope. 80 p. cent of the patients recovered a protective sensibility, but only one third discrimination. Patients considered sensory deficit as little cumbersome. Wartenberg's sign was noticed in 60 p. cent of our patients and a claw hand in 46 p. cent. Power grip was only 70 p. cent of the contralateral hand due to poor interosseous muscle recovery. The main disability was an instable thumb metacarpophalangeal joint in 70 p. cent. Subterminal pinch grip was weak and was improved by the transfer of the flexor digitorum superficialis of the ring finger. Cold hypersensitivity was noticed in 73 p. cent of our patients, but its frequency diminished with sensory recovery. Motor deficiencies were the most important and required early tendon transfers in older patients.

Adolescent↗
PubMed1989

A practical radiographic comparison of short board technique and Kendrick Extrication Device.

Cervical spine immobilization is necessary during the prehospital care of most trauma patients. Earlier studies performed in controlled, indoor settings suggested short board technique (SBT) was the standard against which other methods of cervical stabilization should be measured. Our study approximated the prehospital setting by comparing the use of tape, SBT, and Philadelphia collar (PC) with tape, the Kendrick Extrication Device (KED), and PC after immobilization in and extrication from a compact car. Seven men were immobilized with KED and SBT in addition to PCs and tape. These subjects were extricated and then taken by ambulance stretcher across a 50-yd length of concrete to the radiology suite. Flexion, extension, lateral bending, and rotation were measured. KED-PC (16 degrees +/- 8 degrees) was statistically superior to SBT-PC (41 degrees +/- 5 degrees) in limiting rotation (P less than .001). KED-PC and SBT-PC were similar in their abilities to limit extension (8 degrees +/- 4 degrees vs 6 degrees +/- 5 degrees), flexion (4 degrees +/- 2 degrees vs 4 degrees +/- 4 degrees), and lateral bending (13 degrees +/- 5 degrees vs 17 degrees +/- 6 degrees). In an approximation of the prehospital setting, tape, a PC, and either KED or SBT substantially limit extension, flexion, and lateral bending of the normal cervical spine. KED-PC is more beneficial in rotation.

Adolescent↗
PubMed1989

[A single-use vascular clamp. An experimental and clinical study].

Twelve rabbit femoral arteries were clamped for one hour with a TKS2 clamp in order to confirm the atraumatic nature of the Tamai disposable clamp. After 15 or 30 minutes of revascularisation, the arteries were excised and studied by light microscopy and scanning electron microscopy. Temporary dilatation of the artery was observed after removal of the clamp, as the patency test was always positive. Light microscopy revealed parietal flattening without any cellular disorganisation and scanning electron microscopy revealed flattening of the endothelial cells without any tearing. On the basis of these favourable results, combined with the ease of use, we now use the Tamai clamp daily.

Animals↗
PubMed1989

[Claw nails. Apropos of 16 cases treated by nail recession flap].

16 patients (75% women) were operated for a claw nail involving one of the three middle fingers. In 14 cases out of 16, a traumatic amputation, treated by directed healing in 60% of cases, was responsible for the deformity. The average loss of bone substance was 49% (range: 0-90%). The average shortening was 5 mm. The loss of substance was repaired by a local flap in 14 cases. Two early recurrences led to one failure and one good result after a second recession flap. One case of arthritis of the distal interphalangeal joint and one case of septic necrosis of the nail bed were also observed. Eleven subjects were reviewed with a mean follow-up of 4 years (1-7 years). The range of movement of the distal interphalangeal joint was always normal. The pinch force and the growth of the nail were normal in 75% of cases. The finger was cumbersome in one half of cases and 60% of patients complained of pain. Recurrences were observed in 50% of cases and the patients were disappointed in 64% of cases. This is a minor operation in terms of vascular elements, but it is associated with a high rate of recurrence and leaves a short finger. Its indications should be limited to losses of bone substance less than 50%.

Adolescent↗
PubMed1989

[Cartilaginous tumors in children].

For the last 15 years, 44 cartilaginous bone tumors had been treated in children aging from 2 to 15 years. 80% were chondromas, either isolated (27), or multiples in enchondromata (9). Treatment varied from simple biopsy to extensive excision with cancellous bone graft. Two of these patients experienced postoperative recurrence but have been cured by another surgical excision. One chondromyxoid fibroma of the big toe and 2 chondroblastomas of the femur had been treated by excision with no recurrence. Three young boys (mean age 5 years) who had a metachondromatosis with chondromas of the extremities had been treated with one recurrence. Two children had a chondrosarcoma and both of them died from lung metastasis. Surgical treatment is indicated for all these tumors and is discussed with our results for each of them.

Adolescent↗
PubMed1988

[Perforations of the small intestine and intestinal parasitic diseases. Apropos of a case of peritonitis caused by the perforation of the small intestine combined with Taenia saginata infection].

A case is reported of peritonitis from perforation of the small intestine found on operation to be due to Taenia saginata. A review of the relevant literature of the last 20 years failed to find many similar cases, parasites, particularly Taenia being an exceptional direct cause of perforation. In the case reported, however, a direct cause/effect relation is highly probable.

Adult↗