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Biomedical subjects

H Mestdagh

Publications and source records attributed to H Mestdagh.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Results of subtalar arthrodesis for traumatic sequelae of the hindfoot].

Sixty-seven arthrodeses of the hind foot were done for sequellae of trauma. Forty-one cases were old fractures of the calcaneus. The technique was either the use of a cylindrical bone graft, or fixation of the joint by a screw after removal of the cartilage and correction of deformity when necessary. On 12 occasions the mid-tarsal joints were also fused. Several instances of delayed skin healing were seen after a lateral approach and the use of a bone graft to correct valgus deformity. Only two-thirds of the patients had a satisfactory result. Some developed arthrosis in the joints of the forefoot. The main cause of failure was persistent deformity particularly in varus. When there was no pre-operative deformity the use of a cylindrical graft seemed better than complete excision of articular cartilage which led to two post-operative deformities. The mid-tarsal joint should not be systematically fused.

Ankle Joint↗
PubMed1984

[Treatment of fractures of the posterior axial arch. Results of 41 cases].

The authors have treated 41 fractures of the neural arch of the axis without neurological impairment. Eleven cases were treated surgically and the remainder conservatively by traction for several weeks followed by cast immobilisation. Only one fracture failed to unite. In the surgical cases, an anterior interbody fusion was performed a few weeks after the accident. Thirty cases were followed up. The functional results were satisfactory in 27 and poor in three. The residual mobility of the neck was much better after conservative management with about two thirds range of normal movement both in the sagittal and horizontal planes. A study on cadavers showed that a displacement of up to 5 mm at the fracture site was compatible with good stability because the ligaments and the discs were normal. It is concluded that most cases should be treated conservatively and that surgical treatment should be given only to cases with considerable displacement, marked instability or in cases of non-union.

Axis, Cervical Vertebra↗
PubMed1984

[Descriptive and topographical anatomy of the dorsal artery of the foot].

The authors studied the course of the A. dorsalis pedis in 67 specimens cleared up with formalin and injected with terpentine and minium. The classical statement was found in 44 cases (2/3): the A. dorsalis pedis following the course of the A. Tibialis arise in front of the upper edge of the retinaculum extensorum, ran through the first intermetatarsal space and anastomosed with the A. plantaris lateralis. In 15 cases, it divided into 2 terminale branches - A. dorsalis medialis and lateralis - at 2-3 cm cm beyond its origin. In 6 cases, the artery was tiny and the arterial supply of the dorsum of the foot was mainly provided by both the lateral malleolar and the fibular arteries. Twice, the A. dorsalis pedis ran down into the second intermetatarsal space. The knowledge of these individual variations is to be pointed out by arteriography before using either M. extensor digitorum brevis or skin of the dorsum of the foot as flaps for covering cutaneous defects at the bindfoot.

Arteries↗
PubMed1984

[Factors in the stabilization of the ulnar head].

The authors studied the stability of the ulnar head by dissections of the radio-ulnar joint and experimental ligamentous removals in 150 specimens. They emphasize the importance of the tendon of the extensor carpi ulnaris and medial collateral ligament tightened by Kuhlmann's sling which firmly apply the ulnar head against the anterior edge of the sigmoid potch of the radius. Transsection of the separate fibro-osseous tunnel of the extensor carpi ulnaris with forward creeping of the tendon out of its groove enlarges the size of the gap between extensor carpi ulnaris and extensor digiti quinti; if in addition both fibro-cartilaginous disk and medial collateral ligament are torn, the ulnar head dislocates dorsally. Such a displacement can be obtained by full supination following forced pronation. The volar dislocation of the ulnar head occurs more rarely; it might be caused by insufficient extensor carpi ulnaris and ruptured fibro-cartilaginous disk and yielded by shallow sigmoid notch and blunt anterior border. So muscular structures avoid dorsal displacement of the ulnar head actively whereas only fibro-osseous structures passively prevent from anterior displacement.

Biomechanical Phenomena↗
PubMed1984

[Arterial vascularization of the triceps sural muscle].

The triceps surae muscle, the dorsal and medial leg skin constitute a very important reserve of muscular and myocutaneous flaps. The material on which the study was carried out consisted of 20 legs from standard cadavers. The superficialis femoral artery was injected with terebenthene and minimum mixture. The medial head of gastrocnemius is 23.3 em long, 6.9 cm wide, 1.25 mm thick at distal third. Its dominant blood supply is carried by the medialis gastrocnemius artery. It rises from popliteal artery 1.2 cm above the femoral tibial articulation with 1.9 mm diameter. It runs 3 cm down before entering muscle where it provides 2 or 3 mean branches. These branches give musculocutaneous arteries to the skin of the dorsal leg. The same study was performed for the lateral head of gastrocnemius and soleus. We studied also arteries of dorsomedial leg skin. The characteristics of long saphenous and short saphenous arteries were described. These muscles and dorsomedial leg skin can be used as muscular or myocutaneous flap for covering defects between the lower leg and the lower thigh.

Arteries↗
PubMed1983

Long-term results in the treatment of fracture-dislocations of Galeazzi in adults. Report on twenty-nine cases.

The authors report 29 cases of a true Galeazzi fracture, (i.e. displaced fracture of the radial shaft and disruption of the distal radioulnar joint). In 1/4 of the cases, dislocation was overlooked and the injury was mistaken for a so-called "isolated" fracture of the radius. By accurate open reduction and compression plating of the fracture, both the torn radioulnar ligaments and the articular disc could be repaired and healed. Additional percutaneous Kirschner pinning across the ulna and the radius in order to avoid redislocation, does not seem to be necessary. It is important, however, to hold the reduction of the radioulnar dislocation in a plaster cast for 4-6 weeks, since the 8 persistent displacements of the ulnar head always resulted in a lack of pronosupination of more than 25 degrees. In these cases, pain and disability may require later surgical management. Late resection of the ulnar head or a Sauve-Kapandji procedure which yield an obvious cosmetic and functional improvement, are preferred to any immediate surgical repair of the radioulnar ligaments. This operation was carried out 3 times, but failed twice. Nevertheless out of 25 patients reviewed after a mean follow up time of 6.5 years, the results were gratifying in 20 who could resume their previous occupation 4 to 12 months postoperatively.

Adult↗
PubMed1983

[Cinematic study of the cervical spine during flexion-extension movements].

By means of dynamic roentgenographic study (5 to 7 X-rays) of the cervical spine in sagittal plane, the authors were able to define: amplitudes of each intervertebral joints. C4, C5 and C6 are the more mobile levels, position of instant centers of rotation for each intervertebral joint in healthy and pathologic individuals. This method allows a kinematic diagnosis of discopathies.

Biomechanical Phenomena↗
PubMed1983

[The arterial blood supply of the skin flap of the dorsal foot].

The dorsal foot skin supplied by the arteria dorsalis pedis the dorsal venous arch, the peroneal sensory nerves and the musculus extensor digitorum brevis is a very good myocutaneous flap. The material on which the study was carried out, consisted of 20 feet from standard cadavers, injected with a mixture of terebenthene and minium through the arteria tibialis anterior. The m. extensor digitorum brevis is 6.1 cm long, 1.7 cm wide, 3.9 mm thick. It is mainly supplied by the a. dorsalis pedis and its branches: the a. tarsea dorsalis (constant) and the a. metatarsea dorsalis (12 of 20 specimens). The average diameter of the a. dorsalis pedis at the upper limit of the m. extensor retinaculum was 2.14 mm and this was chosen as the most proximal limit of the dorsalis pedis flap. The a. tarsea dorsalis was present in all the specimens, with a diameter of 0.95 mm at its origin and a length of 35 mm. On average, this artery divided into four branches to the m. dorsalis pedis. The a. metatarsea dorsalis was present in 12 of 20 specimens, with an average diameter of 0.53 mm and a length of 22 mm. On average, this artery divided into three branches to the m. dorsalis pedis. We drew three lines in the proximal, middle and distal third of each flap design and calculated the sum of arterial branch sections with our lines. We think this provides a reasonable indication of the comparative richness of the cutaneous blood supply in the flap. The mean number of cutaneous branches was 10 in the proximal third, 6.7 in the middle third (13 if branches supplying the m. extensor pedis brevis are included) and 5 in the distal third. The myocutaneous dorsalis pedis arterialized flap can be safely used as an island flap to cover the ankle or heel and as a free flap for palm defects.

Arteries↗
PubMed1982

[Paralysis of the femoral nerve complicating ilio-psoas hemorrhage after iliac bone transplantation (author's transl)].

The author reported an unusual complication of iliac bone transplantation for grafting of a tibial pseudarthrosis. In a patient having anticoagulant therapy, a large iliac haematoma developed in the donor site and extended deep to the iliacus muscle and through the osteomuscular gap into the retroperitoneal space. Moreover it spread downwards and entrapped the femoral nerve as it lies behind the iliac fascia, above the inguinal ligament. Both a paralytic ileus and a femoral nerve injury commanded surgical exploration through an oblique iliac approach; emptying of the clotted haematoma, section of the inguinal ligament and liberation of the femoral nerve enable to avoid definitive sequelae to the quadriceps but the time required is varying: three years after the accident, recovery is not complete in the operated patient probably owing to delayed surgery (three weeks).

Femoral Nerve↗
PubMed1982

Long-term prognosis of tarsal dislocations.

Eighty tarsal dislocations treated between 1954 and 1979 are presented. Our of 48 cases reviewed after a mean follow-up time of 7 years, satisfactory results were achieved in 30 (62%). Osteonecrosis of the talus was not recorded whereas necrosis of the navicular developed in 5 patients. Failures are to be related to significant osteoarthritic changes which occurred after a long period particularly in compound injuries with associated fractures of the tarsal bones. Early closed reduction and immobilization in a below-knee cast for 4 weeks is recommended in pure luxation; associated fractures of the talus and navicular require surgical fixation as far as possible. Except in total open dislocation of talus or navicular replacement was by far preferred to removal and primary arthrodesis.

Adolescent↗
PubMed1982

[Arterial vascularization of the semilunar bone].

The gross examination of 41 dried lunates and the dissection of 50 minimum injected forearms allowed the author to give a general statement of the blood supply of the lunate. On the volar aspect of the hand, 2 or 3 vessels coming from the ramus carpeus volaris and/or the radial artery run downward and penetrate the bone through a big foramen and several smaller around. On the dorsal aspect, 2 or 3 minute branches arise from the dorsal carpal arch and penetrate the triangular posterior surface of the lunate beneath the carpal joint; more infrequently 2 twigs may be traced along both scaphoid-lunate and triquetrumlunate joints. The interosseous artery sends some conspicuous branches to the posterior margin of the radius and the dorsum of the lunate. The volar group appeared to be the most important contributor to the blood supply and the big volar foramen should be named "hilus" of the lunate. It must be emphasized that the nutrient vessels enter the foramen above the upper margin of the transverse carpal ligament; so, no crowding in the carpal tunnel can be liable for "avascular necrosis" of the lunate.

Arteries↗
PubMed1981

[Contribution to the study of the vascularization of the fascia lata tensor muscle].

The tensor fascia lata is a short flat muscle arising from the anterior superior iliac spine and inserting into the fascia lata at mid thigh. It is supplied by three arterial pedicles of unequal importance, branching from the external iliac, gluteal and deep femoral arteries. The 'dominant' blood supply is carried by the lateral circumflex femoral artery which comes from the deep femoral and enters the muscle, approximately 8.8 cm beneath the anterior superior iliac spine. This vessel varies in size from 2 to 3.5 mm; it is 8 cm long but can be lengthened by ligating the branch for the vastus lateralis. On the deep sheath of the iliotibial tract it gives off three branches which supply each third of the fleshy body. The upper branch runs vertically to the iliac insertion of the muscle but not so far as the iliac crest and provides no cutaneous twig. On the contrary, the mid branch runs transversally through the muscle and sends perforating vessels to the skin overlying the fascia lata 6--7 cm below the anterior superior iliac spine. The descending branch runs parallel to the muscular fibers of the muscle and supplies the skin of the lateral lower thigh down to 8 cm above the knee. So the pedicle supports an area of the skin which is double the length (22 cm) and triple the width (9.5 cm) of the fleshy body. The tensor fascia lata including the two layers of the iliotibial tract but excluding its upper insertion, together with the skin of the lateral aspect of the thigh can be safely used as a myocutaneous flap for covering defects of the trochanteric, ischial and sacral areas.

Fascia↗
PubMed1980

[Contribution to the study of the sensory innervation of the heel].

The purpose of the present work was to contribute to the knowledge of the subcutaneous innervation of the heel. The small branches arising from both tibial and sural nerves below the ankle joint were studied by means of a dissecting microscope; this study was combined with a histological examination of the nerve endings. In spite of many individual variations, it may safely be assumed that the nervus tibialis supplies the plantar area of the heel; thin anastomoses with branches of the sural nerve were found along the lateral aspects of the heel and Achilles tendon. Moreover, based on the density of Pacinian corpuscles, the heel may be divided into three functional areas of increasing sensitivity: the Achilles area, the apex and the bearing area.

Calcaneus↗