Biomedical subjects
J Teissier
Publications and source records attributed to J Teissier.
[Gastric adenocarcinoma].
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[Gastrointestinal stromal tumor].
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[Functional surgery of upper limb in tetraplegics since 50 years].
OBJECTIVE: Development of upper limb functional surgery in tetraplegics in the last 50 years. METHODS: The literature review relating to the years 1950-2002 was carried out with 3 data bases: Medline, Pascal, Embase. This review also involved a thorough study of non-indexed references. RESULTS: A large number of surgical procedures are described. Two priorities are stressed by the authors: safety of these procedures and duration of postoperative immobilization. CONCLUSION: This review of literature shows that the prospects for restoring upper limb function in tetraplegics are greater than ever, offering a larger number of patients the possibility to increase their independence in daily life. Functional surgery remains, nevertheless, demanding in terms of length of immobilization and presupposes requiring a multidisciplinary approach requiring rehabilitation teams to be up to date with surgical procedures.
[Problems with the metacarpophalangeal joint in the surgical treatment of osteoarthritis by inserting an ARPE type joint prosthesis].
Progressive ankylosis of the trapeziometacarpal joint in flexion-adduction with closure of the first web in advanced trapeziometacarpal osteoarthritis gradually leads to compensatory dislocation of the metacarpophalangeal joint with hyperextension in the sagittal plane and abduction in the frontal plane. This deformity of the MP joint, initially reducible, but subsequently irreducible, results in the classical 'Z' deformity of the thumb in the sagittal plane. A less well known 'Z' deformity can also occur in the frontal plane due to distension of the medial collateral ligament. Surgical treatment of trapeziometacarpal osteoarthritis by arthroplasty must correct this secondary deformity of the MP joint to obtain an optimal result. The classical sagittal 'Z' deformity of the thumb can be easily corrected while this deformity is still reductible by releasing the fist metacarpal by tightening the abductor pollicis longus. When it is irreducible, this deformity can only be treated by MP arthrodesis, which contraindicates insertion of the ARPE trapeziometacarpal implant. Correction of the frontal 'Z' deformity of the thumb requires repair of the medial collateral ligament of the MP joint by ligamentorraphy (retightening) or ligamentoplasty.
[Tetraplegia and functional surgery of the upper limb: what anesthesia for what surgery?].
Surgical rehabilitation of the upper limb in quadriplegia aims to restore prehension function. Surgical restoration always involves active extension of both elbow and wrist. Anesthesia, which first aim is to allow adequate surgical conditions, must adapt to the patient's disability. In this particular setting, regional anesthesia and especially brachial plexus block techniques represents our priority choice.
[Primary malignant lymphoma localized in the trunk of the ulnar nerve at the elbow. A case report].
The subject of this report is the exceptional observation of an ulnar nerve syndrome in the right elbow induced by the intra and extra neural development of a primary malignant lymphoma. The patient is a man of sixty-eight. The syndrome evolved over one year. The electromyogram showed marked slowing of the conduction speed on the ulnar nerve. The operation unabled us only to carry out a partial biopsy resection. Complementary chemotherapy was then carried out making a survival of two years and seven months possible without any sign of recurrence or other sites. We have only been able to locate two other published cases of primary malignant lymphoma developing on a nerve trunk and more precisely in on the level of the sciatic nerve. No other case has been described in a nerve trunk in the upper limb.
[Irreducible palmar dislocation of the metacarpophalangeal thumb joint by a skiing accident].
Amongst the large number of severe sprains of the lateral ulnar ligament of the metacarpophalangeal joint of the thumb by skiing accidents which we treat each year as a result of our geographical situation, we have encountered an original lesion on two occasions. The patients were referred with unstable palmar dislocation of the metacarpophalangeal joint of the thumb despite an attempt of reduction under local anaesthesia performed at the ski resort by practitioners particularly well trained in this form of traumatology. On examination, the thumb was globally painful and presented a defect of active extension of the MP joint suggestive of a complex lesion of the extensor apparatus. X-rays showed palmar dislocation of the MP joint of the thumb. Surgical exploration in both cases revealed identical lesions: complete rupture of the two bundles of the lateral ulnar ligament of the MP joint of the thumb, whose distal extremities could be seen as soon as the skin was opened with incarceration of the extensor apparatus between the palmar surface of the neck of the first metacarpal and the dorsal surface of the first phalanx. Perfectly classical treatment consisted of a dorso-lateral incision to reduce the extensor apparatus and to suture the two bundles of the lateral ulnar ligament; immediately restoring the stability which is usually observed in "classical" severe sprains. The current result is good, entirely comparable to that of severe sprains of the MP joint of the thumb.(ABSTRACT TRUNCATED AT 250 WORDS)
[9 cases of mucoid nerve degeneration. Complication of a tunnel syndrome?].
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[Thenar and hypothenar flaps for covering distal and dorsal digital amputations].
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[Restoration of the upper limb in tetraplegic patients by tendon transfers].
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Vascularization, cellular behavior, and union of vascularized bone grafts: experimental study in the rabbit.
The rabbit fibula was used as the experimental model in this study of the biological changes in nonvascularized and vascularized bone grafts (N = 72). Radiological study showed that the time required for union was about the same for both types of graft. Histological study with tetracycline as a marker showed that there were cellular changes in these two types of graft: moderate hematopoietic and osteocytic loss associated with an increase in bone porosity in vascularized grafts and virtually total osteocytic renewal and marrow necrosis in nonvascularized bone grafts. Quantitative study of vascularization by flow measurement using labeled microspheres showed a brief initial phase of hypervascularization in vascularized grafts, while revascularization took place early in nonvascularized grafts and was followed by hyperemia from the first to the third month. Calcium uptake curves for the two types of graft were quite closely superimposable upon blood flow rate curves. However, the comparative results presented in this study may be tempered by the fact that all grafts were applied to a recipient bed of excellent quality, consisting of well-vascularized muscles.
[Annular nails, a rare congenital malformation of the hand. Presentation of a case and general review of the literature].
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[Restoration of elbow extension in the tetraplegic by transplantation of the posterior deltoid. Study of 21 cases].
The authors have transferred the posterior part of the deltoid muscle to the triceps in 21 tetraplegics. A modification of Moberg's technique has been employed utilising a strip of fascia lata reinforced by Dacron sutures to allow rehabilitation after only 3 weeks. Despite limited active extension of the elbow and diminished power, results were considered to be satisfactory by the patients. They benefited from a greater range of movement of the hand, an improved possibility of bearing weight, improvement in the use of wheelchairs and better ability to express their bladder.
[Suture of the extensor tendons of the hand with assisted mobilization. Apropos of 120 cases].
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Rupture of the flexor tendons of the little finger in fractures of the hook of the hamate bone. Report of two cases.
Two cases of rupture of the flexor tendons of the little finger associated with a fracture of the hook of the hamate bone are presented. The preoperative diagnosis had not been made. Excision of the fractured hook and repair of the tendons by a short graft from the palmaris longus in one case and by the transfer of the superficial flexor of the ring finger in the other case gave a good final result. The authors remark on the rarity of reports of this fracture in the literature, the frequent occurrence of nonunion and the two complications which are exceptional; rupture of the flexor tendons and compression of the deep branch of the ulnar nerve. The fracture is mainly encountered in sports that require the grasping of a handle (tennis, golf, hockey, squash). The diagnosis is often missed at the onset because of not using the correct X-ray positioning: special incidence for the carpal tunnel view and a 3/4 view with the wrist in 45 degrees of supination and forced radial deviation.
[Biological behavior of a vascularized cortical bone graft. Experimental study of the rabbit fibula].
The study of the biological course of a vascularized osseous graft was performed on 64 fibulae in rabbits. Using radiography, standard histology, tetracyclines markage and study of 47-calcium incorporation as means of control. The time-limits of control are fixed at the 5th, 10th, 15th and 21st day and at the 1st, 2nd, 3rd and 5th month. The results show that if they are vascularized or not, the osseous grafts are not subjected to the rule: everything or nothing: "everything is not living in a vascularized osseous graft and everything is not dying in a conventional osseous graft". As for the good quality of the recipient bed, there is no significant difference between the healing time of those two types of grafts.