PubMed Health⌕ Search

Biomedical subjects

D Le Viet

Publications and source records attributed to D Le Viet.

At least 19 recordsLinked to original sources
PubMed2006

Extensor carpi ulnaris injuries in tennis players: a study of 28 cases.

Pain on the ulnar side of the wrist is common among elite tennis players. Ten years of experience has allowed identification of a pathology involving the extensor carpi ulnaris (ECU) tendon. On the basis of 28 clinical cases seen over the last five years, three clinical patterns are described: (a) acute instability of the ECU; (b) tendinopathy; (c) ECU rupture. Each of these clinical entities requires a different therapeutic approach. A review of the relevant anatomy is provided.

Adolescent↗
PubMed2005

Closed rupture of the thumb flexor tendon pulleys.

Closed flexor tendon pulley ruptures are relatively rare injuries. All previously reported cases have been in the long finger pulleys. To our knowledge, there has not been a case of closed thumb flexor tendon pulley rupture reported in the literature. This paper presents two cases of this pathology and discusses appropriate treatment of it.

Adult↗
PubMed2005

Extensor carpi ulnaris problems at the wrist--classification, surgical treatment and results.

Twenty-eight extensor carpi ulnaris lesions at the wrist were treated surgically between 1990 and 2002. Fifteen patients had an isolated extensor carpi ulnaris tenosynovitis or tendinopathy, five had extensor carpi ulnaris dislocation, four had an extensor carpi ulnaris subluxation and four had an extensor carpi ulnaris rupture. Seventeen patients first developed their symptoms while playing sports. At a mean follow-up of 23 months, twenty-two patients had returned to their previous activities. Seven of the 27 patients had lost more than 30% of their grip strength and five had restricted wrist motion. Two needed an extensor carpi ulnaris tenolysis. Pure isolated extensor carpi ulnaris lesions are rare and associated ulnar sided lesions (eleven triangular fibrocartilage complex tears and four lunotriquetral ligament tears), as well as possible predisposing factors (seven anomalous tendon slips, four ulnar styloid non-unions and one flat extensor carpi ulnaris tendon groove), were frequent. A classification of extensor carpi ulnaris tendon and subsheath lesions was developed to allow the surgeon to adequately evaluate the different components of these lesions.

Adolescent↗
PubMed2005

[Pathological fragmentation of the sesamoid bone of the index due to repetitive micro trauma: a case report and review of the literature].

Pathology of the sesamoid bones have been rarely described in the literature especially those of the index. We present the case of a 45 years old amateur tennis player who presented with pain on the radial border of the index finger at the level of the metacarpophalangeal joint. The clinical examination and the operative findings allow us to conclude that the symptoms were due to tendinitis of the flexors of the index associated with fracture of the sesamoid and cartilaginous degenerative changes. We also present a review of the literature.

Cartilage Diseases↗
PubMed2004

Trigger finger treatment by ulnar superficialis slip resection (U.S.S.R.).

Surgical release of the A1 pulley for treatment of trigger finger normally produces excellent results. However, in patients with long-standing disease, there may be a persistent fixed flexion deformity of the proximal interphalangeal joint. This is sometimes due to a degenerative thickening of the flexor tendons and may be treated by resection of the ulnar slip of flexor digitorum superficialis tendon. One hundred seventy-two patients (228 fingers) who had undergone this procedure were reviewed at a mean follow-up of 66 months. Mean pre-operative fixed flexion deformity of the proximal interphalangeal joint was 33 degrees. All but eight fingers were improved by surgery and there was an average gain of 26 degrees in passive extension (7 degrees residual fixed flexion deformity) of the proximal interphalangeal joint. Full extension was attained in 141 of the 228 fingers, and in all 101 fingers with a pre-operative loss of passive extension of 30 degrees or less. This technique is indicated for patients with loss passive extension in the proximal interphalangeal joint and a long history of triggering.

Adult↗
PubMed2001

[Osteogenic exostosis of the capitate bone. Case report and review of the literature].

The occurrence of an osteochondroma in the carpus is very rare and its excision is indicated in the case of significant symptoms or change in its appearance. The diagnosis is often made in adulthood due to the onset of a functional problem even though development of the tumour occurs during skeletal growth. We report the case of a 38 year old patient, with no antecedent trauma, who presents with simultaneous exostoses on the dorsal and palmar surfaces of the capitate, which has not been previously described in the literature. The existence of a bipolar lesion extending anteriorly and posteriorly in the carpus is a possibility which may not be apparent and renders plain radiograph insufficient in the investigation of such a lesion. CT scan and MRI scan are indispensable in the investigation of this kind of carpal lesions, allowing better visualization of the base of the tumour, the expansion of the tumour and relation to the neighbouring soft tissues and the presence of malignant degeneration.

Adult↗
PubMed2001

Subcutaneous herniation of tendon interposition after trapeziectomy in three cases: explanation and implications.

We report a complication following trapeziectomy and tendon interposition. Subcutaneous herniation of the tendon interposition occurred in 3 of 412 cases in which trapeziectomy, ligament reconstruction, and tendon interposition were performed. This herniation occurred posterolaterally in the early postoperative period and resulted in dorsal swelling and superficial pain. Magnetic resonance imaging was helpful in confirming the diagnosis and excision of the herniated interposition material resulted in satisfactory pain relief and functional outcome as long as metacarpal stability was present.

Aged↗
PubMed2001

Responsiveness of the Cochin rheumatoid hand disability scale after surgery.

OBJECTIVE: To assess the responsiveness of the Cochin functional disability scale for the rheumatoid hand after surgery. METHOD: In a prospective study, patients with rheumatoid arthritis (RA) scheduled for surgery of the wrist and/or fingers were evaluated within 48 h before surgery and at least 6 months after surgery. Clinical outcome measures included duration of morning stiffness, total score for tenderness, total score for swelling, visual analogue scale score for pain in the hands and wrists, a score for overall mobility of the wrist and the fingers, grip and pinch strength, the Hand Functional Index (HFI), the Kapandji index and the Cochin scale. Responsiveness was assessed with the paired t-test, the effect size (ES), the standardized response mean (SRM) and the non-parametric Spearman rank correlation coefficient (r(S)). RESULTS: Fifty patients (42 women) were evaluated twice at an interval of 7.16 +/- 2.10 months (mean +/- s.d.) (range 6-15 months). Thirty-six patients (72%) were very satisfied or satisfied with the results of surgery, seven (14%) were not satisfied or dissatisfied and seven (14%) were dissatisfied or very dissatisfied. The Cochin scale score improved at the second visit (P < 0.0001), with SRM and ES values of 0.66 and 0.58 respectively. The correlation of the change in Cochin score with patient overall satisfaction was r(S) = 0.40. Among the impairment measures, grip strength showed the best responsiveness (SRM = - 0.43, ES = - 0.36, correlation with patient overall satisfaction r(S) = 0.46). The change in Kapandji index had the best correlation (r(S) = 0.51) with patient overall satisfaction but its SRM and ES values were low (- 0.19 and - 0.10 respectively). CONCLUSION: The Cochin scale is responsive and appropriate for the assessment of the effects of surgical treatments on disability in RA hands.

Adult↗
PubMed2001

Hemangiomas of the fingers: MR imaging evaluation.

PURPOSE: To report the magnetic resonance (MR) imaging features of finger hemangiomas. MATERIALS AND METHODS: Sixteen patients clinically suspected of having hemangioma of the finger underwent 1.5-T MR imaging with a customized local gradient coil. The location, size, margins, signal intensity, and enhancement patterns of the lesions were noted. In accordance with the literature on MR imaging of deep hemangiomas, the authors' findings could be divided into those with typical features-that is, high signal intensity at T1- and T2-weighted imaging, lobulated appearance, strong enhancement, and heterogeneous pattern with flow void artifacts-and those with atypical features. The reference standard was surgery (n = 12) or clinical outcome (n = 4). RESULTS: One posttraumatic hematoma was excluded. Most lesions were in the fingertip (n = 10), with involvement of the nail bed and/or the pulp (n = 5). Hemangiomas were classified as typical in ten cases and atypical in five. The mean size of typical lesions was larger than that of atypical lesions. The unique imaging features of atypical hemangiomas included a masslike appearance, which was either homogeneous with diffuse enhancement-suggestive of hypervascularity (n = 2)-or heterogeneous with poor enhancement (n = 3). CONCLUSION: MR imaging characteristics of finger hemangiomas can be classified as typical or atypical. Knowledge of both patterns can be helpful in the distinction of soft-tissue abnormalities at this location.

Adolescent↗
PubMed2000

Surgical treatment of compression of the lateral antebrachial cutaneous nerve.

We describe an operation to relieve compression of the lateral antebrachial cutaneous nerve at the elbow. Between 1987 and 1997 we operated on seven patients, one with bilateral compression. In two the compression was associated with injury to biceps. A longitudinal or a transverse incision was carried out and the nerve was released from the deep fascia. Partial excision of the biceps aponeurosis was undertaken in the patients who did not have injury to biceps; some additional procedures were required for those patients with injuries. All patients had symptomatic relief.

Adult↗
PubMed1999

A glomus tumour with four recurrences.

A case of a glomus tumour of the distal segment of the ring finger, with four apparent recurrences in an 8-year period, is described. The patient was treated by two different surgeons (two and three times respectively) and obtained pain free intervals of between 4 and 11 months before recurrence. Histological examination confirmed the diagnosis of a glomus tumour in all five procedures. The location of the glomus tumour was defined preoperatively by high resolution MR imaging.

Adult↗
PubMed1999

Primary synovial osteochondromatosis of the hand and wrist. Report of a series of 21 cases and literature review.

OBJECTIVES: To define the characteristics of synovial osteochondromatosis of the hand and wrist. PATIENTS AND METHODS: Retrospective study of 21 patients, including 11 with intraarticular and 10 with tenosynovial disease. Cases secondary to degenerative joint disease were excluded. Surgery consisted in removal of the osteocartilaginous bodies and of the adjacent synovial membrane. Mean follow-up was seven years (range, three to 18 years). The relevant literature was reviewed in part. RESULTS: Recurrence was seen in four patients and was multiple in two of these four. Most recurrences occurred within five to ten years after surgery. All four patients with recurrences had intraarticular disease. No cases of malignant transformation were seen. The characteristics of synovial osteochondromatosis at the hand and wrist are reviewed. CONCLUSION: Detailed preoperative investigations including computed arthrotomography and magnetic resonance imaging should be performed to increase the likelihood of complete excision.

Adolescent↗
PubMed1999

[Glomus tumor of the nail area. Apropos of a series of 55 patients].

PURPOSE OF THE STUDY: Glomus tumors are infrequent in the hand. We have review 55 cases, localized in the nail area to discuss their diagnosis and surgical approach. MATERIAL AND METHODS: Out of 80 glomus tumors of the hand seen in two hand units, 55 were located around the nail area, 33 in the nail bed area, 8 at the nail root and 14 laterally. The population was predominantly female (42 cases) and the mean age 43 years. The mean delay before presentation was 37 months. Pain was the main symptom (97 per cent) increased by trauma and cold. A blue spot was visible in 15 cases and diagnosis was performed on clinical ground in all cases except two. A notch was present on X-ray in 16 cases. A prospective study with MRI allow a diagnosis in 18 of 21 cases. All tumors were removed through a lateral approach elevating the nail complex and confirmed histologically. RESULTS: The diagnosis was per-operatively confirmed in 53 cases and performed in one case. The last case of supposed hemangioma was modified at histological examination. No case of nail dystrophy (not existing pre-operatively) or residual pain was seen at the 81 months of follow up. Seven recurrences were observed, 4 of them having been operated initially in our units. DISCUSSION: Clinical diagnosis could be performed on clinical grounds. MRI is to be reserved to recurrences or multi-operated patients. Risk of recurrence has to be mentioned pre-operatively to the patient. CONCLUSION: Lateral approach with nail complex elevation is safe, allowing excision of the tumor without nail dystrophy.

Adolescent↗
PubMed1997

Intraneural mucoid cysts of the upper limb.

Intraneural mucoid cysts are uncommon. They usually affect middle-aged men, presenting with pain and symptoms of nerve compression. We report on our series of six patients, three of whom had cysts involving the digital nerves. We compare our series with others and discuss controversies concerning the existence, aetiology, treatment and outcome of these cysts. We believe MR scans can aid in the preoperative diagnosis and follow-up of these patients and that, if possible, careful cyst excision using an operative microscope is the treatment of choice.

Aged↗
PubMed1996

Stabilized resection arthroplasty by an anterior approach in trapeziometacarpal arthritis: results and surgical technique.

Resection arthroplasties were performed through a carpal tunnel incision in 72 hands of 57 patients with trapeziometacarpal joint arthritis and coexistent pathology of the anterior hand or wrist. Sixty-nine hands were followed for an average of 44 (range, 12-74 months). Pain relief was excellent in 60 hands, good in 7, and fair in 2, and thumb motion was satisfactory in 64 hands. Mean strength increase was 30%. Scaphometacarpal space loss was 0.5 mm each year, and residual space averaged 3.1 mm at 60 months. There were two failures. The study corroborated the frequent coexistence of other pathology of the anterior area of the hand and wrist, specifically, carpal tunnel syndrome and flexor carpi radialis tenosynovitis. Furthermore it demonstrated the possibility of an anterior approach to treat these conditions via the same incision. After 5 years, functional results remained good despite progressive collapse of the scaphometacarpal space.

Aged↗
PubMed1996

Diagnosis of digital pulley rupture by computed tomography.

Seven patients who presented with a rupture of the digital pulley were investigated by computed tomography. The rupture involved the A2 and A4 pulleys in four cases, the A2 pulley in two cases and, in the final case, the A4 pulley alone. A sagittal-plane CT scan gave a precise analysis of the rupture in all cases. Two cases were surgically repaired and CT scanning was used in their postoperative assessment. When performed by a radiologist with an interest in musculoskeletal pathology, we have found CT scanning to be an excellent imaging procedure in the investigation and diagnosis of digital pulley injury. This can be useful when the diagnosis of digital pulley rupture cannot be made by history and physical examination.

Adult↗
PubMed1994

[Fractures and luxations of the fingers].

Fracture and luxation of the long fingers are particularly frequent in hand trauma. Untreated or poorly treated, they may leave highly disabling sequelae. The aim of treatment is two-fold: to repair the anatomical lesion and to obtain movement as rapidly as possible, the only means of avoiding joint stiffening. It is important to underline that the metacarpo-phalangeal joints usually stiffen in extension and that the proximal interphalangeal joints on the contrary stiffen in flexion. Thus, in case of immobilisation of the hand, an attempt should be made to obtain an "intrinsec plus" immobilisation, that is, with the metacarpo-phalangeal joints in flexion and the interphalangeal joints in extension.

Finger Injuries↗