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Biomedical subjects

F Moutet

Publications and source records attributed to F Moutet.

At least 19 recordsLinked to original sources
PubMed1991

[Urgent nature and severity of lesions due to high pressure injections in the hand].

High pressure injections in the hand and fingers are relatively rare accidents, but are responsible for serious lesions. Only extremely urgent treatment can minimise the aesthetic and functional sequelae. This treatment must include debridement of the portal of entry, exposure of all the contused and devitalised tissues and broad spectrum antibiotics. The postoperative course must include long and patient rehabilitation for these lesions which actually correspond to severe contusion of the hand and fingers associated with a high risk of septic dissemination. The authors describe these lesions based on a series of 20 consecutive cases.

Amputation, Surgical↗
PubMed1991

[Role of neurolysis of the posterior tibial nerve in plantar perforating diseases of diabetic origin].

Perforating ulcers of the foot in diabetics constitute a difficult therapeutic problem. In a series of 17 cases, the authors stress the value of tibial nerve neurolysis associated with periarterial sympathectomy which results in cure of the 15 patients treated within 30 days. Although no electromyographic improvement was observed, perfusion studies and oxymetry demonstrated an improved local vascular situation which promoted healing.

Adult↗
PubMed1990

[Three-dimensional imaging of the carpus].

Since 1987, the authors have developed three-dimensional (3D) imaging of carpus. This reconstruction based on 30 CT scans of the carpus is a new approach to imaging and allows spatial visualisation of the complex shapes of the carpal skeleton from all angles and views. The development of this technique should lead to a better understanding of the intimate physiology of the carpus and should allow the development of a real simulator of the wrist for precise planning of surgical procedures (osteotomy, intracarpal arthrodeses, etc.). It also helps to elucidate complex pathological images which are not always easy to interpret on CT scans.

Carpal Bones↗
PubMed1990

[Three-dimensional imaging in plastic surgery. Application to the carpal bones and skull].

Since 1987, the authors have developed three-dimensional (3D) imaging of the carpus. This new application of imaging allows spatial visualization of the complex shapes of the carpal skeleton from all angles and from all illuminations. The development of this technique should lead to a better understanding of the intimate physiology of the carpus, allowing the construction of a model of the wrist enabling precise planning of operative procedures. It also helps to elucidate complex pathological images which are sometimes difficult to interpret on computed tomography scans. In parallel, the same process has been developed for the skull. It is particularly useful in cranio-facial surgery, especially in congenital deformities. Progress in this technique should allow surgical simulation on a video screen in the very near future.

Carpal Bones↗
PubMed1990

[Three-dimensional imaging of the carpus].

Since 1987, the authors have developed three-dimensional (3D) imaging of the carpus. This reconstruction based on 30 CT scans of the carpus is a new approach to imaging and allows spatial visualisation of the complex shapes of the carpal skeleton from all angles. The development of this technique should lead to a better understanding of the intimate physiology of the carpus and should allow the development of a real simulator of the wrist for precise planning of surgical procedures (osteotomy, intracarpal arthrodeses, etc.). It also helps to elucidate complex pathological images which are not always easy to interpret on CT scans.

Carpal Bones↗
PubMed1989

Metacarpo-phalangeal thumb sprains based on experience with more than 1,000 cases.

The metacarpo-phalangeal thumb sprains are very frequent. They mostly occur during sports (50%), and the ulnar collateral ligament is the structure most frequently ruptured (86%). Surgical repair of all severe lesions and/or bony fragment avulsions has led to 90% of good, and excellent results, when the operation is followed by a proper physical therapy. Criteria for evaluation are considered and so is the management of the old or neglected sprains.

Adolescent↗
PubMed1989

[Shearing splints].

The splint proposed here is designed for patients undergoing extensive tenolysis of the long fingers in zone 5. Based on the anatomy, the principle of this splint is to place the flexor tendons of one finger in a short position and its neighbour in a long position and vice versa. This promotes the formation of "long" adhesions allowing independent movement of each finger.

Equipment Design↗
PubMed1989

[Joint lesions of the first column of thumb].

Lesions involving the thumb from the interphalangeal joint to the trapezo-metacarpal (TM) joint are very frequently the result of sports injuries. The authors discuss the most frequent lesions: 1) Dislocations of the metacarpo-phalangeal (MP) joint of the thumb which can be reduced in almost every case by means of well conducted orthopaedic manoeuvres. 2) Sprains of the MP joint of the thumb, very common lesions the severity of which must not be underestimated and which always require surgical treatment in the serious lesions, regardless of the compartment involved (radial or ulnar). 3) Bennett's fractures or fracture-dislocations of the TM joint; when neglected inadequately treated, these lesions lead to disabling post-traumatic arthritis of the TM joint. A poor result of treatment for any one of these three lesions always compromises opposition of the thumb and/or the strength of pollico-digital grip.

Fractures, Bone↗
PubMed1988

[2 cases of early "siliconitis" (silicone synovitis)].

Two cases of early silicone synovitis, 12 and 18 months after surgery for partial scaphoid implant arthroplasty (Swanson design) are reported. None of the implants had been fixed by Kirschner wire or sutured to the radius or an other carpal bone. Both implants had been immobilized for six weeks. Initially the result in both cases was good. Pain and loss of range of movement gradually increased, and a large erosive osteolytic defect of the radius was seen on the X-ray after 12 months for the first case and 18 months for the second one. Surgical revision consisted of implant removal, synovectomy with a proximal row carpectomy in the first case and a soft tissue interposition arthroplasty for the second one. The histologic examination showed a foreign body reaction with birefringent material in multinucleated giant cells. All reports about this type of silicone implant complication emphasises the role of compression forces and micro-fragmentation of the silicone. Should we continue to perform partial scaphoid implant arthroplasty from whom microparticles are creating a severe foreign body reaction?

Adult↗
PubMed1987

Metacarpal fractures.

We have treated 1,080 fractured metacarpals between January 1972 and December 1982. Supported by ten years of experience and this homogenous series, we explain our choices of treatment. With early mobilization of hand and fingers a constant preoccupation to prevent joint stiffening, two main points stand out: active immediate mobilization, considered not as a dismissal but as a treatment, is managed by a specialized physiotherapist and supervised by the surgeon. We applied it in 32% of our cases. Internal fixation is sometimes tricky and always done with great attention to detail. If so, it enables quick recovery of normal amplitudes of movement through the active mobilization allowed by a stabilized fracture. This is what we did in 47% of our cases, using either plates and/or screws, or fine Kirschner wires following G. Foucher's technique. The other techniques used in 21% of our cases are reviewed along with the complications we came across while treating these fractures. The final data review of this series shows 93.2% god or very good, 4.7% fair and 2% poor results.

Fracture Fixation, Internal↗
PubMed1987

[Principles for the functional assessment of the hand].

In the first part, the authors define the parameters needed for a functional evaluation of the hand. Geometric data are analysed in detail and an equi-angular curve used as a model of digital flexion. Mechanical analysis of the thumb using the same method produces a novel evaluation method for thumb movements. Lastly, the authors consider sensibility evaluation problems and the difficulties of obtaining objective data are emphasized. In the second part, the authors stress the necessity of a physiological and global approach and suggest a global evaluation based on elementary patterns of prehension.

Hand↗
PubMed1987

[10 congenital trigger fingers. Apropos of a case report].

Ten congenital triggers fingers have been treated on a 3 years old girl after correction of congenital bilateral club feet. Such a case, without any other congenital malformation seems to be unique in the French literature and only found twice in the English one. This child in spite of a normal growth and good psychomotor development, presents an unusual face, with a mouth a little bit too small, but her karyotype is normal. No trismus and no microstomia were found to enable this case to be classified in a specific syndrome. The right diagnosis may be a non evolutive arthrogryposis of the extremities. Dividing the ten proximal pulleys (A1) let 10 voluminous nodules pass through and allowed full range of motion in nine out of ten fingers. A remaining flexion deformity of the proximal interphalangeal joint needed an anterior arthrolysis, the final result was good.

Abnormalities, Multiple↗
PubMed1986

Reanimation of thumb opposition by the extensor pollicis longus. Report of sixteen cases.

Among some 65 techniques for restoring thumb opposition found in literature, the authors chose the extensor pollicis longus transfer (EPL) onto the abductor pollicis brevis (APB) through the interosseous membrane. This technique described by Duparc et al. in 1971 was codified by Bureau et al. in 1980 using a series of 9 cases. The sufficient force and length of this transfer, associated with its direct course by redirection through the interosseous membrane make it a docile, reliable motor unit as shown by the 16 cases studied. Performed on 11 median-ulnar palsies, 6 isolated median palsies and on one complete avulsion of lateral thenar muscles, only 16 of these 18 transfers could be satisfactorily followed and reviewed from 7 to 35 months later. In our series, 14 of the 16 cases have recovered functional opposition and are using it. After a review of the surgical technique the authors emphasize some practical aspects: dissection of the EPL which may be delicate, resection of the IM which should be adequate, and choice of the reflexion pulley and how to construct it. Results as well as sequelae linked to the choice of the EPL are then analysed.

Adolescent↗