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Biomedical subjects

H Mestdagh

Publications and source records attributed to H Mestdagh.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Extensive coxo-femoral resection with preservation of the thumb for prosthesis. An alternative to disarticulation at the hip].

To avoid the severe mutilation of a hip disarticulation and to improve limb-fitting, a method of partial limb preservation is proposed. Two cases of septic arthritis of the hip with neurological and atrophic lesions sufficient to justify disarticulation are described. Disarticulation was avoided by partial conservation of the thigh with an extensive resection of the upper end of the femur, a through-knee amputation and a large posterior musculo-cutaneous flap including the triceps surae whose muscle provided a good cover for an end-bearing myoplasty. The stump obtained was of good quality which, though a little unstable, was firm and well provided with muscle which allowed early mobilization with a temporary prosthesis and later limb-fitting with much more satisfactory function than that in a hip disarticulation.

Adult↗
PubMed1987

[Catheterization of the jugular vein (vena jugularis interna). The advantage of Boulanger's technic].

The present study was designed to emphasize the technical accuracy of the percutaneous internal jugular vein approach in operative reanimation (Boulanger Technik). In 18 specimens with hyperextended neck, the cannulation of the internal vein was achieved from a puncture point situated 7.3 cm lateral to the sternoclavicular joint, at level of the top of the thyroid cartilage; then the catheter was pushed slanting downwards an laterally by 50 degrees with respect to the inner border of the sternomastoid muscle toward the union medial third-middle third of the clavicle. The acknowledge of the distance between the puncture point and the right auricle allows to ascertain the proper location of the catheter. The use of the internal jugular vein can be recommended in operative reanimation because its cannulation is harmless and easy to carry out and both its large size and deep situation lower the usual risks of more distal venous catheterizations.

Catheterization↗
PubMed1987

[Results of ventral spondylodesis of the cervical spine (C2-C7)].

The author reports of 130 anterior intercorporeal fusions in unstable and/or displaced injuries of the inferior cervical spine (C2-7). Reduction was achieved preoperatively by progressive skull traction in four-fifths of the cases and in the remainder by gentle manual mobilization just before surgery. As a whole, flexion/extension and rotation were found to be reduced by one-fourth despite compensatory mobility below and above the graft; fusions were well tolerated if only one intervertebral space at the lower cervical spine was involved. Robinsons technique, together with anterior plate fixation, yields immediate stabilization, avoids graft migration and redisplacement of the spine, and provides the best functional outcome.

Cervical Vertebrae↗
PubMed1985

Organization of the extensor complex of the digits.

On the basis of 150 dissections the authors show that, on the back of the hand, the tendinous formations ensuring the extension of the fingers can be arranged in four groups of a least two tendons for each finger, excepting the thumb. In the little finger the group comprises a constant tendon, the extensor proper, and two variables, the common extensor and the expansion of the extensor carpi ulnaris. In the index finger the extensor proper and the common extensor nearly always coexist. In the middle finger the great common extensor, sometimes divided, can be accompanied at depth, by an extensor tendon. Finally, in the ring finger, two or three more or less intricate slips are found forming the common extensor. The presence of anastomoses and the numerous slips originating in the tendon-forming band can reduce functional deficiency following the section or rupture of a tendon. On account of these variations the surgeon should operate with caution in tendon transplantations.

Fingers↗
PubMed1985

[Functional results of tibio-tarsal arthrodeses. Apropos of 52 reviewed cases].

Fifty-two patients with ankle arthrodesis were reviewed after an average follow-up of 7 years with a range between 2 and 22 years. Two-thirds of the patients had good results and 1 in 4 had fair results. In 4 cases there were bad results. Thirty-seven patients could walk without any limitation thanks to mobility of the mid-tarsal joint. Most of the patients developed radiological arthrosis of the subtalar joint with limited movement in 29 instances. In contrast, hypermobility of the mid-tarsal joint was present in almost half of the cases. Good functional results were related to the preservation of mobility in the subtalar and mid-tarsal joints. The time required to obtain a good functional result was about one-and-a-half years. After this the results were stable, provided that the ankle fusion was in a good position. Most of the poor results were related to arthrosis of the sub-talar joint or trophic changes. Secondary extension of fusion to other joints was deceptive. It is concluded that combined arthrodesis of the tibio-talar and sub-talar joints should be done only in cases of severe arthrosis. In other cases, the mobility of the sub-talar and mid-tarsal joints should be preserved.

Ankle Joint↗
PubMed1985

[Acetabular fractures and sacroiliac dislocations].

Involvement of the sacro-iliac joint is frequently associated with acetabular fractures. It was noted on 23 occasions in fractures of both columns of the acetabulum. Tomodensitometry is a key examination which shows lesions which could be missed on standard X-Rays. Dislocations of the sacro-iliac joint diminished the possibility of exact reduction. In 23 cases, only three sacro-iliac lesions were anatomically reduced and 13 hips were well centered. The results obtained after surgical treatment were better than after conservative treatment. This explained the finding that 10 hips developed arthrosis in 14 patients treated conservatively and only 3 in 9 treated surgically. The sacro-iliac involvement was either an anterior opening of the joint leading to an antero-posterior excentration of the hip, or an inferior opening leading to a lateral shift of the iliac bone and a vertical orientation of the acetabulum. In several cases, both types of displacement were present. The diagnosis of the sacro-iliac joint lesion is helped by tomodensitometry though it can also be made by good antero-posterior pelvic radiographs. Conservative treatment using traction was unable to reduce the sacro-iliac lesion, and in some cases it increased the displacement of the iliac bone. Treatment should be by reduction, either using external fixators or by internal fixation.

Acetabulum↗
PubMed1984

Vascular anatomy of the pisiformis bone.

The authors examined 41 dried pisiform specimens; it was found that the vascular apertures were situated on the lateral aspect, in the proximal half of the ridge occupied by the ulnar artery, on the medial aspect and at the distal tip of the bone. An average number of 6.9 foramina were encountered, their mean diameter attained 40/100 mm. In 34 injected specimens the nutrient vessels of the pisiforme were traced from the ulnar artery and its carpal dorsal and deep volar branches; all the tiny bony twigs anastomosed with one another and contributed to an arterial circle running around the pisiforme. The carpal dorsal artery which provides at least 2 descending branches toward the proximal tip of the bone, can be called the main pedicle; when its superficial branches are ligated, the pedicle is long enough (3 cm) to make the replacement of the lunate by the pisiform attached to the flexor carpi ulnaris quite safe in Kienböck's disease, without any risk of osteonecrosis.

Arteries↗
PubMed1984

[Habitual forward luxation of the head of the ulna. Apropos of a case].

The author has reported a case of volar dislocation of the ulnar head. This exceptional lesion occurred in a young woman with Crouzon's disease. No past history of trauma was found; the ulnar head was not avulsed and the triangular articular disk was not torn. The instability of the ulnar head was due to a flattened sigmoid cavity of the radius and aplasia of the extensor carpi ulnaris muscle. Recovery was made after a low resection of the diaphysis combined with lower radioulnar arthrodesis. This operation restored both power and a full range of movements to the wrist as well as preserved the normal appearance of the wrist.

Adult↗