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Biomedical subjects

K Guelmi

Publications and source records attributed to K Guelmi.

8 recordsLinked to original sources
PubMed1992

[Dorsal tenolysis and arthrolysis of the proximal interphalangeal joint. 19 cases].

18 patients suffering from PIP stiffness in extension were treated by dorsal teno-arthrolysis. PIP joint stiffness was due to 3 cases of fracture of P1, 2 cases of fracture of P2, 2 cases of extensor tendons, 8 fractures of P1 associated with section of the extensor tendon, 2 cases of PIP closed trauma (1 sprain, 1 dislocation), and 2 crush injuries of the extensor tendon at the PIP joint. The surgical technique combined a dorsal sinuous approach, tenolysis of the extensor tendon on the dorsum of first phalanx dorsal capsulotomy, and more rarely (3 cases), section of collateral ligaments. The mean pre-operative active flexion was 44 degrees and the mean post operative active flexion was 78 degrees, which represents a gain of 34 degrees of active movement. Thanks to a classification which incorporates the range of active flexion in PIP joint, and the lock of active extension we rated 3 results as excellent, 4 as good, 8 as useful and 4 as insufficient. We therefore improved the range of movement in 15 out of 19 cases, which seams very encouraging.

Adolescent↗
PubMed1991

[Emergency pulp reconstructions].

Pulp reconstructions use numerous techniques ranging from simple debridement to local and microsurgical flaps. The authors analyse the various treatments, in which directed healing still retains numerous indications. Local flaps have a definite place, but they are not devoid of risks (iatrogenic stiffness). The indications are presented schematically in table form together with several examples. A wide range of techniques is necessary in order to treat the various lesions appropriately. Large defects are best treated by microsurgical transfer of great toe pulp with satisfactory results, which justifies their management in specialised centers.

Amputation, Traumatic↗
PubMed1991

[Foot replantation followed by tibial lengthening. Apropos of a case].

The authors present a foot replantation case at the ankle level followed six months later by a tibial lengthening using the Ilizarov procedure. Performing the aforementioned lengthening following a replantation enables good nervous and vascular sutures, tension-free and ensures a satisfactory result.

Adult↗
PubMed1989

[Functional treatment of closed boutonnière deformity using a dorsal digito-palmar dynamic extension splint].

We advise dynamic extensor splintage put on as early as possible within the first 6 weeks after the diagnosis of boutonniere deformity. This splintage runs from the dorsal aspect of the hand to the DIP joint which is left free to flex actively. This apparatus is left on for at least six weeks post injury. Sixteen patients have been treated in this way. Seven of them were monitored carefully. Only one had a bad result with DIP flexion still preserved. The others averaged a mean extension loss of 23 degrees, and no loss of extension in DIP joints. Active flexion both in PIP and DIP was perfectly preserved. The functional treatment without surgery seems to be a good technique in management of fresh rupture of the extensor mechanism in PIP joints.

Equipment Design↗
PubMedDate not supplied

Alkalinization of 0.5% lidocaine for intravenous regional anesthesia.

Although remaining a controversial issue, alkalinization of lidocaine or bupivacaine may shorten the time to onset and increase the duration of the sensory block. The aim of this study was to evaluate the effect of pH adjustment on the sensory and motor blocks during intravenous regional anesthesia (IVRA) with lidocaine. Thirty-one patients scheduled for minor hand surgery performed under IVRA were randomized into two groups: Group 1 (n = 14): 1% lidocaine, 3 mg/kg, diluted with the same volume of physiological saline solution (pH = 6.63 +/- 0.05), and Group 2 (n = 17): 1% lidocaine, 3 mg/kg, diluted with the same volume of 1.4% sodium bicarbonate (pH = 7.34 +/- 0.05). final concentration of lidocaine was thus 0.5% in both groups. Sensory block was assessed by pinprick every 2 minutes in areas corresponding to six terminal nerves: ulnar, median, radial, musculocutaneous, medial cutaneous nerve of arm and intercostobrachial, and medial cutaneous nerve of forearm. The time between release of tourniquet (at the end of surgery) and appearance of pain was recorded. Motor blockade was evaluated by asking the patient to squeeze strongly a blood pressure cuff previously inflated to 40 mmHg. This maneuver was performed before and every 2 minutes after injection. No statistical differences were found between the two groups whatever the parameter studied. In conclusion, there is no advantage (over plain solutions) to using pH-adjusted lidocaine during IVRA for hand surgery.

Adult↗