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Biomedical subjects

F Dap

Publications and source records attributed to F Dap.

At least 19 recordsLinked to original sources
PubMed1992

[Lipofibroma of the median nerve. Apropos of a case].

Lipofibroma is a rare, benign nerve tumour corresponding to diffuse fibroadipose infiltration of the nerve, dissociating the fasciculi without invading them. The authors report a case of lipofibroma of the median nerve in a 32 year old man presenting with a soft swelling of the palmar surface of the thumb. Treatment consisted of intraneurodissection of the tumour arising exclusively from the medial collateral nerve of the thumb. With a follow-up of two years, there has been no recurrence of the tumour, but the patient has persistent decreased sensation of the ulnar half of the thumb pulp. The features of the lipofibroma and the therapeutic options are discussed in the light of the data reported in the literature.

Adult↗
PubMed1992

[Wrist arthrodesis: alternative to resection of the proximal carpal bones?].

The results of a series of 36 post-traumatic radio-carpal arthrodeses were compared with those of the series of resection of the first row of carpal bones reported during the round table. The advantages and disadvantages of both procedures were discussed. Arthrodesis results in: 1) loss of grip strength in all cases, averaging 41%; 2) persistent pain in 78% of cases; 3) impairment of function resulting from blocking of the wrist. After the procedure, average time off work is 15 months, level of permanent disability was 30%, and 20% of patients returned to their previous jobs. These figures could be used as arguments against arthrodesis. However, they must be taken in context: final arthrodesis, usually performed on manual workers, is often chosen when resection of the first row of carpal bones would obviously be insufficient, for example, when severe arthritis of the head of the capitate is present.

Accidents, Occupational↗
PubMed1991

[Arthrodesis of the wrist in manual workers. Apropos of 36 cases].

We present a review of 36 patients with final radiocarpal arthrodesis done between 1976 and 1987. The series was homogeneous: patients were about 40 years old and lesions were work-related. The most frequent reason for the arthrodesis was fracture of scaphoid bone, followed by Kienbock's disease complex trauma of carpus, severe carpal sprain, and articular fracture of the distal fourth of radial bone. Thirty-one arthrodeses were done by screwed-on iliac graft, 5 by nailing following Mannerfelt technique. The two main factors in functional results were pain and loss of strength. The latter averaged 41 per cent of that of the normal side, and only 8 wrists were completely free of pain. Indications for final radio-carpal arthrodesis are discussed, taking into account the poor functional results and their repercussions on social and professional life of the patient.

Accidents, Occupational↗
PubMed1991

[Partial toe transfers. Functional results: apropos of 26 cases].

We present our results from a series of 26 partial toe transfers (11 pulp transfers and 15 composite tissue transfers) performed in posttraumatic reconstruction of the thumb (22 cases) and fingers II to V (4 cases). There was one failure due to arterial thrombosis. The results for sensitivity were satisfactory after pulp transfer (Weber-average of 9 mm), less satisfactory after composite transfer. Recovery of mobility and strength usually were satisfactory. Problems with the donor foot were mainly slow healing and poor tolerance to cold; the latter was experienced by 1/3 of the patients although functional deficits were rare. Partial toe transfer is used at present for distal reconstruction of the thumb, and leaves the metacarpophalangeal joint intact. There are basically two techniques: "tailored" transfers from the big toe for amputations of the distal phalanx of the thumb, and wrap-around flap of Morrison for amputations proximal to the proximal phalanx.

Adolescent↗
PubMed1990

[The lower radio-ulnar joint in malunion of the lower end of the radius: therapeutic implications].

Malunion of the lower extremity of the radius is frequently accompanied by a lesion of the inferior radio-ulnar joint marked by inversion of the inferior radio-ulnar index. Surgical treatment must always take this parameter into account and should attempt to correct it. The authors' preference in the treatment of malunion consists of Duparc osteotomy, in which the size of the graft is calculated in order to restore the inferior radio-ulnar index. If the correction is insufficient or in the case of moderate malunion, the authors propose the Kapandji-Sauvé operation which allows better preservation of the wrist stability.

Adult↗
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

[Extensive skin losses of the upper limb].

The development of microsurgical techniques and of pedicled local flaps has improved the prognosis of major injuries of the upper limb. Pedicled muscle-skin flaps from the latissimus dorsi muscle allow repairing losses of substance in the arm-pit and arm while restoring the function of the elbow. In the forearm, the same flap, transferred by microsurgery, ensures the rehabilitation of the wrist and hand. In the hand, the Chinese and posterior interosseous flaps allow covering the losses of substance on both the palmar and the dorsal aspects. Here, the free flaps are used only if the palmar vascular arches of these interosseous anastomoses are affected. Lastly, remote flaps are required only for the contraindications of microsurgery. Thus, using this array of donor sites, the emergent replacement of the most complex losses of sin substance can be performed, thus fostering the repair and protection of fony, neurovascular and tendon lesions.

Arm↗
PubMed1989

[The socio-economic costs of finger replantation. Apropos of 40 replantations of the thumb].

Microsurgical techniques are becoming increasingly important in the emergency treatment of hand trauma and in secondary reconstructive surgery. In the light of the current concern with financial feasibility, we thought it important to determine whether this surgery, sometimes wrongly described as being luxury surgery, is economically feasible. The cost of 40 reimplantations and revascularisations of the thumb treated in the context of work accidents was studied. Although the short-term cost of reimplantation is higher than that of amputation, in the long-term, a successful reimplantation constitutes a definite economy for society and justifies this type of specialist surgery.

Amputation, Traumatic↗
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

Tendon transfers for treatment of the paralyzed hand following brachial plexus injury.

The correction of functional deficits of the hand after a brachial plexus lesion is difficult; treatment should be provided by a well-knit team of surgeons and therapists. The patient should be fully aware of the limitations of surgical treatment before surgery, and should be entrusted to the care of a physical therapist during the critical period of nerve regeneration after initial surgical treatment to ensure optimal results. This article presents therapeutic possibilities and discusses specific problems of tendon transfers in brachial plexus palsy.

Brachial Plexus↗
PubMed1988

Hyperostotic macrodactyly.

There is a rare and special type of macrodactyly that is called the hyperostotic variety. This disease occurs later than the classical forms of macrodactyly and shows massive osteocartilaginous deposits around the joints. A new case is reported. The cause of this disease could be previous trauma.

Adult↗
PubMed1988

[Miniaturized osteosynthesis of articular fractures of the fingers. Results of a series of 60 cases].

The importance of anatomical reduction of articular fractures and early mobilisation of these severe forms of trauma which frequently damage the extensor apparatus (58% of cases, led us to propose direct miniaturised osteosynthesis as described by the Nancy-Strasbourg team. Of the 1,000 cases of osteosynthesis performed between 1978 and 1985, we selected 12 fractures of the MP joint, 38 fractures of the PIP joint and 10 fractures of the DIP joint, differentiated into 4 stages according to the condition of the skin and tendons and into 9 categories according to the anatomical type and the site of the fracture. Direct osteosynthesis (screw, bolt, pin) was used in every case. The clinical results were evaluated in terms of the Total Active Range of Movements, the local trophic state, the amount of pain and return to work, for each joint. When well conducted and with effective skin cover, this technique allows almost normal reconstruction in simple fractures and is valuable in more complex fractures by preserving sliding of the tendinous apparatus due to early mobilisation.

Adolescent↗
PubMed1988

[Littler's operation (SORL = spiral oblique retinacular ligament) in the treatment of "swan neck"].

The surgical treatment of "swan-neck" deformities secondary to mallet finger using Littler's technique (Spiral Oblique Retinacular Ligament) in a series of 35 cases, led to a complete correction of the PIP joint hyperextension in 95% of the cases and a correction of the DIP joint flexure in 70% of the cases. This active tenodesis restores the physiology of the extension of the PIP and DIP joints as far as the surgical technique has been strictly respected.

Adolescent↗
PubMed1988

Automated photography in microsurgery.

An automated method is proposed for photographing a microsurgical field that avoids missed photographs and time-consuming manipulations. The basic principles applied to microscopic photography are briefly reviewed and instructions are provided for standardized, reproducible, high quality photographs. A limitation at present is that auto-focusing cameras have not yet been adapted for use with surgical microscopes. One type of microscope is discussed and details about the only camera system currently suitable for such a microscope are described.

Humans↗