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Biomedical subjects

C Mabit

Publications and source records attributed to C Mabit.

At least 19 recordsLinked to original sources
PubMed2006

Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis.

Excision is not a suitable treatment for all comminuted fractures of the radial head. In elbows where instability can be predicted, a replacement arthroplasty of the radial head is more effective. The aim of this paper was to present the medium-term results of the Judet floating radial head prosthesis. This operation was performed on 14 patients between 1992 and 2003, of whom 12 were reviewed at a mean follow-up of five years and three months (1 to 12 years). The outcome was assessed using the Mayo elbow performance score and a modified Disability of Arm Shoulder Hand (DASH) questionnaire. There were six excellent results, four good, one fair and one poor, as graded by the Mayo score. The mean DASH score was 23.9/100 (0 to 65.8/100). The only significant complication occurred in one patient who developed a severe complex regional pain syndrome. There were no patients with secondary instability of the elbow, implant loosening, cubitus valgus, osteoporosis of the capitellum, or pain in the forearm and wrist. Our experience, combined with that of other authors using this device, has encouraged us to continue using the Judet prosthesis in comminuted fractures of the elbow where instability is a potential problem.

Adolescent↗
PubMed2004

[Perforation of the sigmoid colon secondary to acetabular fracture].

Traumatic lesions of the colon associated with fracture of the acetabulum occurs in less than 2% of the cases. Direct perforation of the colon by a bony spike, which occurred in our patient, is even more exceptional. We were unable to find any other case reported in the literature. This case illustrates the importance of looking for intestinal lesions in all patients with pelvic injury presenting an unexplained infectious syndrome. Imaging provides clear evidence for avoiding late diagnosis and life-threatening situations.

Acetabulum↗
PubMed2002

[Duodenal duplication: pathologic anatomy and embryogenesis. Case report in an adult].

Duodenal duplication is a rare congenital entity and less than 100 cases have thus far been reported in the literature. This was first described by Sanger in 1880. By definition, they are located in or adjacent to the wall part of the gastrointestinal tract, have smooth muscle in 2 layers and are lined by alimentary tract mucosa. With the case report of a 18 year-old patient with pancreatitis, we expose modern imaging procedure and surgical management. Although the exact etiology of enteric duplications is not known, the two main hypothesis are dysembryogenesis and dysorganogenesis.

Adolescent↗
PubMed2002

[Mesenteric-portal confluence aneurysm].

The authors take interest in the portal aneurysm about the observation of a 52 year-old woman with an echographic lesion in the head of the pancreas. Radiological examination was done with abdominal CT and MRI. Because of no accurate diagnosis, an explorative laparotomy was done and showed an aneurysm at the junction of the portal and superior mesenteric veins. These lesions are rare: they can be acquired particularly with underlying hepatocellular diseases and portal hypertension; they can be congenital due to an incomplete obliteration of the right vitelline vein. If asymptomatic, only a close surveillance must be proposed.

Aneurysm↗
PubMed2001

[Role of the lymphatics of the diaphragm in the absorption of intraperitoneal liquids].

The diaphragm is the major site of the lymphatic absorption of the intra peritoneal liquids. Known since the middle of the last century, this lymphatic network is at present studied under transmission electron microscopy. The stomata which are intercellular sluices between adjacent mesothelial cells, are the entry of the diaphragmatic network. These stomata open into the lacunae which are dilatations the diaphragmatic subserous lymphatic network. The architecture of these structures explains their one-way character from the abdomen to the thorax and the role of the respiratory movements. This network collects the fluids into the trans diaphragmatic lymphatics. Pleural effusion appears when the quantity of liquids in the diaphragmatic lymphatic network exceeds the capacities of drainage of the lymphatic efferents, thus explaining the reactional pleural effusion caused by underdiaphragmatic inflammatory processes.

Absorption↗
PubMed2001

[Tibio-talar arthrodesis: long term influence on the foot].

PURPOSE OF THE STUDY: The aim of this study was to evaluate the long-term effect of tibiotalar arthrodesis on function, clinical and radiological tolerance, and subtalar joints. MATERIAL AND METHODS: We reviewed 37 cases of tibiotalar arthrodesis in 27 young patients who were generally manual workers. Their mean age at surgery was 46 years and mean follow-up at review was 12.8 years (range 5-26 years). Functional outcome was assessed with the Duquennoy scale. We reviewed the anterioposterior and lateral weight-bearing views as well as the lateral view in dorsal and forced plantar flexion. RESULTS: Mean functional outcome was good and very good in 66% of the cases, fair in 30% and poor in one case. Total pain relief had been achieved in 45% of the cases with a mean walking distance of 1500 m without crutches. Residual mobility at last follow-up was 13 degrees for the mediotarsal joint. This mobility allowed the arthrodesed foot to adapt to gait. Radiologically, fusion had been achieved in 83% of the cases within 3 months. The overall functional score fell off proportionally with the degree of arthrodesis valgus starting at 5 degrees. Likewise pes equinus > 10 degrees led to pain and reduced motion. The subtalar joints were affected in all cases, leading to poor adaptation of the foot on uneven ground. Grade 1 osteoarthritis affected the mediotarsal joint and was more marked in case of equine fixation. DISCUSSION: Our results are similar to those reported in the literature. We had 4 cases of nonunion in patients with risk factors previously discussed in the literature. CONCLUSION: Arthrodesis remains a useful method for treating talocrural osteoarthritis, providing good long-term results. The position of the fixation should be 90 degrees in the sagittal plane and 0 degrees to 5 degrees valgus in the frontal plane.

Adult↗
PubMed2000

[Elastofibroma in the scapular region. A case report and review of the literature].

PURPOSE OF THE STUDY: We report a case of elastofibroma and have collected 280 cases in the literature. MATERIAL AND METHODS: A 56 year-old man presented with a right subscapular mass. The patient was asymptomatic but he reported a "clicking"sensation associated with mobilization of the shoulder. Physical examination revealed a round mass clearly demonstrated with forward elevation of the arm. The MRI scan showed a heterogeneous soft tissue composed of inhomogeneous density with areas of more intense signal suggesting adipose tissue. The tumor was surgically excised and the diagnosis of elastofibroma was established by histopathologic examination. RESULTS: Six months after removal of the mass, there were no functional complications. DISCUSSION: Elastofibromas usually occur in active patients generally older than 55 years of age. They are typically located in the right subscapular region. The tumor remains asymptomatic in more than 50 percent of cases. 25 percent of the patients may report a simple discomfort sometimes with a "clicking" or "catching" sensation associated with mobilization of the arm. Pain is present in less than 10 percent of cases. Physical examination may reveal a rubbery, asymptomatic mass located in the subscapular region and barely noticable when the arm lies again the chest. Plain radiographs and preoperative laboratory data were unremarkable. CT scan or MRI scan may show an heterogeneous fibrous mass of intermediate density with entrapped signals of higher intensity. However, a definitive diagnosis requires a biopsy showing the distinctive feature of elastofibroma: elastic fibers in a collagenized fibrous tissue with entrapped adipose tissue. Pathogenesis of elastofibromas may result from the friction of the scapula against the thorax thus generating tumor growth. CONCLUSION: Complete surgical excision in symptomatic patients is considered to be the treatment of choice. However, once the diagnosis of elastofibroma has been established, excision of lesions smaller than 5 cm can be avoided in asymptomatic patients.

Bone Neoplasms↗
PubMed1997

Anatomic and MRI study of the subtalar ligamentous support.

The diagnosis of subtalar instability remains difficult both clinically and radiographically. The authors present an anatomic and MRI study of the subtalar ligamentous support. The anatomic study has consisted in dissections and sections of cryoconserved hindfeet (15 cases) which precises the organisation of ligamentous bundles in the lateral (sinus tarsi) and central (canalis tarsi) subtalar compartments, mainly represented by the trilayered inferior extensor retinaculum, the cervical talo-calcaneal ligament and the interosseous talo-calcaneal ligament. MRI study (1.5 tesla) of anatomic specimens was performed according to defined types of sections: sagittal, coronal, coronal oblique, axial transverse. The correlations of anatomic and MRI sections allowed a precise interpretation of the subtalar ligamentous support as anatomically described. A complementary clinical MRI study was performed which allowed the validation of "the inversion test": this test optimizes the visualization of the different ligamentous structures. Relative to the difficulties of conventional imaging procedures, MRI appears of clinical relevance in the diagnosis of subtalar instabilities. This technique allows direct visualization of ligaments (or their rupture) and therefore a better evaluation of subtalar involvement in ankle sprain. This paper present a functional concept in MRI articular ligamentous restraints concern.

Humans↗
PubMed1996

[Ligamentoplasty using the peroneus tertius in the correction of lateral laxity of the ankle. Surgical technique].

INTRODUCTION: The authors present an original procedure for lateral ankle ligamentoplasty using peroneus tertius. MATERIAL AND METHODS: This muscle inconstantly present (90 p. cent), lies from the distal third of the anterior aspect of the fibula to the base of the fifth metatarsal with a caracteristic "hockey stick" shaped insertion. The width of the tendon is related to its length: in 60 per cent of cases the width exceeds 4 mm and makes the tendon biomechanically reliable. The procedure is carried out through a lateral approach. The tendon of the peroneus tertius is easily located under the extensor retinaculum. It is then dissected up to the muscle belly and its arterial supply. The neck of the talus and the lateral malleolus are exposed. A tunnel is drilled through the talar neck and the lateral malleolus and cautiously widened with a rasp. The tendon is passed through the malleolar and the talar tunnel. The transplant is thightened with the foot in neutral position (or fairly eversed) and sutured to it self. DISCUSSION: Therefore this transplant restores in an anatomical position the anterior bundle of the lateral ligament of the ankle. It can be used for a ligamentoplasty of the subtalar joint as well: the transplant after crossing the talar neck is fixed at the lateral margin of the calcanus restoring the course of the cervical talo-calcaneal ligament. CONCLUSION: This technique which is limited by anatomical consideration constitutes an alternative procedure compared with periosteal or peroneus brevis ligamentoplasty.

Ankle Joint↗
PubMed1996

[The lateral retromalleolar groove: a radio-anatomic study].

The anatomy of the malleolar peroneal groove is presented. The results are based on a coupled osteological and CTscan study of 20 samples of fibulae. The average distal fibular torsion was 64 degrees. The peroneal groove was oriented posteriorly (mean value: 78 degrees). Three types of morphological variations were found: concave, flat, convex (the convex shaped groove was the most frequent one: 70%). The average width of the groove was 9 mm. These morphometric results were compared to "clinical" ones performed on patients with a peroneal tendons dislocation syndrome: CTscan study showed an osseous dysplasia concerning the groove depth (flat or convex) and/or a torsional insufficiency. Hypothesis of a bone dysplasia in peroneal dislocation syndrome is discussed.

Fibula↗
PubMed1994

Non-union of a midshaft anterior tibial stress fracture: a frequent complication.

We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entity. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy. If after 4-6 months no sign of union is present, surgical management is indicated, in the form of excision of the fracture site with or without bone graft.

Adult↗
PubMed1994

[Recent fractures of the base of the 1st metacarpal bone. A study of a series of 138 cases].

Fractures on the base of the first metacarpal are uncommon lesions, affecting young subjects and have major social repercussions (an average of 3.5 months off work). The authors have analysed the clinical and radiological results of a series of 138 recent fractures of the base of the first metacarpal with a mean follow-up of 7 years (12 month-14 years). They used a classification into 5 types (Bennett's with a large fragment = 22%, Bennett's with a small fragment = 20%, Rolando = 15%, extraarticular fractures = 36%, Comminuted fractures = 6%) which are easy to recognize on standard x-rays, or preferably on Kapandji views, allowing a standardized therapeutic approach. 70% of patients were younger than 40 and in one half of cases the causal accident was a motor vehicle accident. 12% of fractures were open and 45% were associated with other traumatic lesions. In this series, 35% of cases were treated orthopedically, 57% according to Iselin's technique, 5% by direct osteosynthesis and 3% by external fixation with a mean immobilization of 40 days. A number of clinical and radiological criteria were studied in the 88 patients reviewed. A 100-point grading system was established and, independent of the type of treatment, the authors obtained 61% of very good results, 23% of good results, 12% of moderate results, 2% of poor results and 2% of very poor results. Articular lesions constituted a factor of severity and failure to respect opening of the commissure appeared to be more pejorative than a small imperfection of reduction. The authors noted that simple treatment according to Iselin's technique still has many indications despite progress in miniaturized osteosynthesis.

Adult↗
PubMed1994

Ilizarov's technique in correction of ankle malunion.

A case is reported of ankle malunion corrected using Ilizarov's technique. The malunion, resulting in a varus ankle deformity (30 degrees), was a consequence of a posttraumatic epiphysiodesis of the distal growth plate of the tibia (McFarland's fracture). Ilizarov's procedure is described, and the radiological evolution of the regenerate is presented. Indications of corrective surgery in ankle malunion are discussed. The advantages of Ilizarov's technique (bloodless technique, cosmetic advantage, full weight-bearing capability, immediate talotibial joint rehabilitation) are illuminated.

Adolescent↗
PubMed1993

[Epidermoid carcinoma arising in femoral osteitis. A case].

The authors report a case of malignant degeneration arising from a fistula in a patient with chronic osteomyelitis of the femur. This rare complication (0.2 per cent-1.6 per cent) most frequently involves the lower limb. A review of the literature reveals that it is associated with long-standing osteomyelitis (30 years), is most frequently a squamous cell carcinoma or rarely a sarcoma, and is principally treated by surgical amputation. The frequency of metastatic spread is low (30 per cent). Malignant degeneration appears to be a local phenomenon, and if diagnosed early, has a rather favorable outcome following complete excision.

Aged↗
PubMed1991

[Osteoid osteoma of the spine. The experience of the Rizzoli Institute].

The authors report their experience at the Rizzoli Institute in treating osteoid osteomas localized to the spine (40 cases). This clinical study confirms that osteoid osteomas are tumors of adolescence, which are often diagnosed late due to their spinal localization. The role of additional investigations, dominated by bone scan and computed tomography is discussed. Their use should decrease the diagnosis delay. Mean follow-up in this series was 4 years, and confirmed that surgical excision had a favorable outcome. The outcome of associated scoliosis was also studied (8 cases). After tumor excision, there were 6 complete or partial corrections. Two cases remained unchanged. Curvature worsening after excision was not encountered.

Adolescent↗
PubMed1990

[Foot localization of a Kaposi's sarcoma. Apropos of a case].

With regard to a foot localization of a cutaneous Kaposi's Sarcoma, the Authors briefly evoke the manifestations of this acquired immuno deficiency syndrome (AIDS). Some clinical aspects of the AIDS, commonly looking, but often revealing the disease, may lead the patient to an orthopaedic surgeon.

Adult↗