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Biomedical subjects

G Frère

Publications and source records attributed to G Frère.

10 recordsLinked to original sources
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↗
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↗
PubMed1984

Controlled postoperative mobilization of sutured extension tendons of the long fingers.

The authors describe a technique of controlled postoperative mobilization of extensor apparatus. They make use of Levame splint in all injuries of extensor-tendons of the last four fingers except for "mallet finger" and "buttonhole". This technique is issued of the so called Kleinert primary suture technic for flexor-tendons and its effectiveness was controlled by electromyography. The Levame splint is used for thirty days and the active flexion is immediately authorized. From 1976 to 1981, 80 cases were treated with this technique and no rupture had happened, and the good results amount to 86%.

Finger Injuries↗
PubMed1983

[Crises in adolescence. Value of a specialized hospitalization unit].

Hospitalization of a disturbed adolescent is not necessarily a distressing experience. It may provide the opportunity for the separation-individuation process to develop. The various possibilities offered by the Adolescent Psychiatric Unit at the Salpêtrière Hospital are described. The outcome of hospitalization is often gradual autonomy of the adolescent in his family. The functioning of the Unit is illustrated by three clinical reports.

Adolescent↗
PubMed1983

[Vertical fractures of the hamate bone].

Two cases of a fracture of the hamate bone are reported. Diagnosis has been made with the help of tomography. The first case was treated by operative intervention and the second by a closed method. The authors clarify the mechanism of this rare fracture, which is caused by a direct stress, on the closed fist. They present two therapeutic possibilities.

Adult↗
PubMed1979

[Controlled therapeutic "evisceration" in so-called "terminal" peritonitis (author's transl)].

Absence of closure of the abdominal wound following reoperation for severe peritonitis is an additional therapeutic technique in dealing with peritoneal infection. However, this technique poses the problem of covering the loops of the small intestine in order to avoid fistulisation in the exposed viscera. The loops are initially protected by a "wound protector" or covered with a plate of polyurethane foam. Secondarily, when the peritoneal cavity is clean, the open wound is converted to an incisional hernia by a thin dermo-epidermal graft in strips, applied to the granulation tissue. This technique is effective and would seem to be simpler than detachments, plasties and relieving incisions.

Abdominal Muscles↗