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Biomedical subjects

G Raimbeau

Publications and source records attributed to G Raimbeau.

At least 19 recordsLinked to original sources
PubMed2006

[Acute closed injuries of the digital proximal interphalangeal joints].

Acute closed injuries of the digital proximal interphalangeal (PIP) joints are frequent and can leave sequelae because of imprecise diagnosis of the lesions, poorly adapted treatment, or insufficient follow-up. The therapeutic options proposed in this presentation are advocated by all of the participants and are based on their personal experience and evidence reported in the literature. After a brief anatomic review necessary for the understanding of PIP joint pathophysiology we have presented the longterm outcomes of PIP joint injuries, which are central to the therapeutic decision-making process in terms of risk benefit ratio. To facilitate the presentation, we have separated lesions "with" and "without" fracture. A specific chapter is devoted to surgical approaches essential for successful management of these injuries and another to particular problems related to the seldom reviewed topic of traumatic injury of the PIP joint during bone growth.

Finger Injuries↗
PubMed2003

[Occupational risk factors for radial tunnel syndrome in factory workers].

STUDY: The purpose of the study was to evaluate the professional and extraprofessional risk factors for radial tunnel syndrome (RTS) in employees of three large companies. METHOD: Twenty-one cases of RTS were compared to 21 controls, matched for age, sex, and activity. In nine cases, RTS was associated with carpal tunnel syndrome. The analysis considered medical history, extraprofessional activity, and the ergonomic and organisational aspects of work. RESULTS: The study demonstrated three risk factors of RTS related to work conditions. The regular use of a force of at least 1 kg (OR = 9.1 (1.4-56.9)) more than 10 times per hour is the main biomechanical risk factor. Static work (OR = 5.9 (1.2-29.9)) as well as work with the elbow constantly extended 0 degree to 45 degrees, is strongly associated with an increased risk of RTS (OR = 4.9 (1.0-25.0)). Complete extension of the elbow associated with pronation and supination of the forearm may cause trauma to the radial nerve in the radial tunnel. On the other hand, we found no personal factors and no extraprofessional activities which were associated with an increased risk of RTS. CONCLUSIONS: This study shows that motions of the forearm requiring intense effort and performed with the elbow in extension and the forearm in pronation and supination increase the risk of RTS.

Adult↗
PubMed2003

[Costs of hand emergencies].

In France at the present time, there is no comprehensive registry of hand injuries. Three types of occurrences; motor vehicle accidents, work accidents, and accidents incident to activities of daily living, are covered by different types of insurance. It is the individual insurance companies, payers of the indemnification, who maintain registries of these accidents. Statistics on work accidents are very detailed and consistent, but they are oriented toward risk management. The aggregate cost of traumatic injuries to the hand is not known. Only large financial institutions are equipped to determine appropriate preventive measures and to establish premium rates based on loss experience. In 2001, hand injuries accounted for 27% of work accidents causing loss of work of at least 1 day. About 29.8% of these work accidents caused permanent partial impairment. About 17.7% of total days lost and 18.2% of the total costs of permanent impairment were due to hand injuries. In the system of compensation for work accidents, there is a major difference in the cost according to the severity of the impairment. If the permanent impairment is equal to or less than 9%, a lump sum payment is made, but if the permanent impairment is over 9%, the worker receives regular payments for the rest of his life. In 2000, the average cost of a work injury with partial permanent impairment of over 9% was [symbol: see text] 85,405, while the average cost of a lump sum settlement was only [symbol: see text] 1479, a ratio of 57 to 1. The compensation costs represent 80% of the cost of work accidents, while the cost of treatment, including all providers and institutions, makes up only 20% of the cost. Compensation for sequelae of accidents in the course of daily life is new for the insurance companies, although these accidents are frequent and often cause significant repercussions in the professional lives of victims because of the loss of hand function. Provision of optimal treatment for these traumatic injuries from the very first moment is the best strategy for the third party payers. Better results of treatment not only reduce the costs of compensation for permanent partial impairment, but also greatly diminish the psychological impact on the injured worker. In the future, the management of the costs of these work injuries will become a priority. Pressure from consumers, which is growing, will favor this trend through the intermediary of private insurance companies.

Accidents, Occupational↗
PubMed2001

[Gouty arthritis of the wrist. Five case reports].

Gout is rarely localized to the wrist. Based on five new cases of this condition and literature review, the authors outline the clinical and radiographic signs which differentiate gout from other causes of isolated unilateral chronic synovitis of the wrist. On the clinical basis, this localization was the first appearance of the disease in three of the five cases. On the X-rays, large defects and joint destructions were present. A scapholunate dissociation was evident in 4/5 cases with sometimes bone condensation. Other diagnoses should be eliminated as chondrocalcinosis, rheumatoid arthritis or wrist infections in subacute forms. Final diagnosis is provided by histological examination, demonstrating specific microcrystals.

Adult↗
PubMed2000

Occupational risk factors for radial tunnel syndrome in industrial workers.

OBJECTIVES: The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. CONCLUSIONS: The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination.

Adult↗
PubMed1996

[Rupture of extensor tendons due to an isolated lesion in the distal ulnar extremity].

Rupture of the extensor tendons is a well known complication of rheumatoid arthritis involving the wrist or any form of diffuse arthrosis. It is much less common in the context of isolated arthrosis of the distal radioulnar joint. The authors report ten cases of this disease in patients without rheumatoid arthritis. All patients in this series were over sixty years of age and reported insidious development of an extension deficit of the little finger, followed by the ring finger. The typical radiographic image of erosion into the sigmoid notch of the radius should be noted and should lead to arthrography in order to determine the status of the joint capsule. Surgical intervention should be performed before major tendon rupture occurs. The results presented here were adversely affected by the delay in surgical treatment. Once rupture of the extensor digiti minimi has occurred, the articular and tendinous pathology must be both be treated, including tendon repair and plasty of the dorsal retinaculum.

Aged↗
PubMed1994

[Late flexor synovitis induced by the use of a fabric lace].

A thirty year old woman underwent trigger finger release of her left middle finger after two injections failed to give relief. Several months later, she developed an area of nodular tenosynovitis localized to the operative site. Her finger had recovered full function, her general health was good, and routine lab work was normal. Because of the persistent mass, flexor tenosynovectomy was performed. Histologic examination revealed synovial hyperplasia associated with a filamentous birefringent foreign material. The bluish color of the foreign material indicated that it came from a fabric retraction loop used during the original operation. She made an uneventful recovery, and three years later her hand remained normal. As a result of this unusual complication, we recommended the use of retraction loops made of plastic rather than fabric. Whenever a micro-foreign body remains in the flexor tendon shealth, there is risk of aseptic tenosynovitis.

Adult↗
PubMed1990

[Radial tunnel syndrome. Study of a continuous and homogenous series of 35 cases].

Thirty-five patients in a continuous and homogenous series of radial tunnel syndromes treated surgically between 1980 and 1987 were re-examined by an independent observer with a follow-up greater than six months. Electromyographic studies in each case had confirmed the presence of a neurological lesion and such studies were considered to be of value when nerve compression was combined with other local painful conditions. Neurolysis was performed with optical magnification through a lateral approach. The clinical results were assessed using the criteria of Roles and Maudsley. Apart from one case which showed an inadequate result, there were 14 excellent, 11 good and 9 fair results. Post-operative electromyographic studies were performed in 30 cases and showed a significant improvement in the shape and adequacy of the tracings compared with the pre-operative condition. Among the fair or poor results, 60 per cent showed an associated radiculopathy of C7 compared with 16 per cent in the good and excellent results.

Adult↗
PubMed1986

Analysis of twenty-eight recurrent pseudarthroses of the carpal navicular after the Matti-Russe operation.

The authors present a review of 28 cases of failure of consolidation of the carpal navicular after the Matti-Russe operation (multicentric study of 106 cases). The causes of the failures are analysed. Among the non significant factors, we find the delay, the radiographic character of the pseudarthrosis, the donor site of the graft, the time of immobilization and the site of the fracture. The superior polar fractures do not have a bad prognosis in this series. Five causes seem to be in direct relation with the failure of consolidation: the age, the failure of an initial surgery procedure, the presence of radiologic "necrosis", the quality of the technical performance of the Matti-Russe operation, and finally dorsal carpal instability that seems to be a fundamental cause in the failure of bony union. The future of these pseudarthroses is analysed concerning: the functional results (64% of poor results); the evolution towards the pseudarthrosis (30%); the surgical reoperations (12 cases out of 28) with eight repeat Matti-Russe operations that finished in five consolidations.

Adult↗
PubMed1985

[Comparative study of 3 implanted micrografts placed in the abdominal aorta of the rat].

A comparative study was conducted on three micrografts of 2 mm diameter: a frozen umbilical artery, a bovine heterograft and an inert P.T.F.E. material graft. These were implanted in the infrarenal aorta of 158 Wistar rats. Each graft was examined on eight occasions: after 4, 24 and 48 hours, one and two weeks, and 1, 2 and 6 months. Excluding 46 animals that died within 24 hours, the overall permeability rate for all grafts was 87.7% (88.9% for umbilical arteries, 82.8% for bovine heterografts and 85.4% for P.T.F.E.). All grafts were examined by optical and electron microscopy. The inert material showed excellent parietal stability. In contrast, alteration and resorption of the primary matrix were moderate in extent for bovine heterografts, and major for frozen umbilical arteries which appear to be a very unstable grafts.

Animals↗
PubMed1985

[Pseudarthrosis of the femur neck and ununited ipsilateral diaphyseal fracture. Value of an adjustable 2-piece nail plate].

The authors have treated four patients presenting in the same limb a pseudarthrosis of the neck of the femur and an ununited fracture of the femoral shaft. All the cases were treated by fixation of the diaphyseal lesion and valgus osteotomy of the femoral neck. To achieve this, the authors recommend the use of a two-piece nail plate sufficiently long to bridge the lower fracture site. In all the cases, union occurred without necrosis of the femoral head.

Adult↗