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Biomedical subjects

M Merle

Publications and source records attributed to M Merle.

At least 55 records · Page 3Linked to original sources
PubMed1989

Primary repair of extensor tendons with assisted post-operative mobilisation. A series of 48 cases.

Forty-eight patients with lesions of the extensor apparatus of the hand were treated by primary repair with assisted post operative mobilisation by means of a dynamic extension, low profile splint. They were divided into three groups: 25 simple wounds of the extensor tendons of the fingers; 14 simple wounds of the extensor tendon of the thumb; 9 complex lesions. The mobility of the tendinous suture and the callus displacement were monitored by means of metallic markers implanted at operation. Functional electromyographic study during physiotherapy permitted refinement of the technique of reeducation by a limitation of the range of flexion of the proximal interphalangeal articulations. The results are divided into 4 categories: excellent 33 (60%), good 9 (16.4%), average 4 (7.3%), bad 9 (16.4%). No complications (infection, loosening of suture, reflex sympathetic dystrophy) were detected in this short preliminary series. The proposed technique produced improvement of only minor significance in comparison with traditional methods, when applied to uncomplicated wounds. Significantly improved results were obtained in the group of patients with complex lesions.

Adult↗
PubMed1989

[Anatomic variations of the vascular network of the first dorsal commissure. Uses of the kite flap].

Thirty dissections were performed on fresh, unfixed, adult cadavers after vascular injection of silastic or methylene blue. Analysis of the results led to replacement of the concept of a single dorsal intermetacarpal artery, the constant pedicle of the kite flap, by that of an intermetacarpal vascular system composed of one or two supra- and/or sub-aponeurotic vessels. The existence of distinct direct skin branches of this intermetacarpal vascular system is defined. The various possible modes of vascularisation of the kite flap are listed, defining the situations at risk and leading to precise practical applications in terms of surgical technique.

Adult↗
PubMed1989

[The socio-economic costs of finger replantation. Apropos of 40 replantations of the thumb].

Microsurgical techniques are becoming increasingly important in the emergency treatment of hand trauma and in secondary reconstructive surgery. In the light of the current concern with financial feasibility, we thought it important to determine whether this surgery, sometimes wrongly described as being luxury surgery, is economically feasible. The cost of 40 reimplantations and revascularisations of the thumb treated in the context of work accidents was studied. Although the short-term cost of reimplantation is higher than that of amputation, in the long-term, a successful reimplantation constitutes a definite economy for society and justifies this type of specialist surgery.

Amputation, Traumatic↗
PubMed1989

[A single-use vascular clamp. An experimental and clinical study].

Twelve rabbit femoral arteries were clamped for one hour with a TKS2 clamp in order to confirm the atraumatic nature of the Tamai disposable clamp. After 15 or 30 minutes of revascularisation, the arteries were excised and studied by light microscopy and scanning electron microscopy. Temporary dilatation of the artery was observed after removal of the clamp, as the patency test was always positive. Light microscopy revealed parietal flattening without any cellular disorganisation and scanning electron microscopy revealed flattening of the endothelial cells without any tearing. On the basis of these favourable results, combined with the ease of use, we now use the Tamai clamp daily.

Animals↗
PubMed1989

[Effect of ornithine oxoglutarate on the duration and quality of wound healing in extensive reparative and plastic surgical methods].

Fifty-two overweight female patients hospitalized for a major plastic surgical procedure were included in a therapeutic trial designed to evaluate wound healing. Twenty-seven patients were randomized to a placebo and 25 to ornithine oxoglutarate (Cetornan). There were no statistical differences between patients concerning age, type of plasty, extent of detachment, or overall evaluation of physical condition at the time of randomisation. Evaluation was based mainly on clinical criteria, including duration and quality of healing, and type of complications. Results showed a significant improvement in time to healing in the Cetornan group (18 +/- 1 day) as compared to the placebo group (26 +/- 3 days) (p less than 0.01). Complications occurred in nine of the 27 patients under placebo (30%) and in three of the 25 patients under Cetornan (12%) (p = 0.07). Clinical and biological tolerance was outstanding. No patient was excluded during the trial.

Adult↗
PubMed1989

[Claw nails. Apropos of 16 cases treated by nail recession flap].

16 patients (75% women) were operated for a claw nail involving one of the three middle fingers. In 14 cases out of 16, a traumatic amputation, treated by directed healing in 60% of cases, was responsible for the deformity. The average loss of bone substance was 49% (range: 0-90%). The average shortening was 5 mm. The loss of substance was repaired by a local flap in 14 cases. Two early recurrences led to one failure and one good result after a second recession flap. One case of arthritis of the distal interphalangeal joint and one case of septic necrosis of the nail bed were also observed. Eleven subjects were reviewed with a mean follow-up of 4 years (1-7 years). The range of movement of the distal interphalangeal joint was always normal. The pinch force and the growth of the nail were normal in 75% of cases. The finger was cumbersome in one half of cases and 60% of patients complained of pain. Recurrences were observed in 50% of cases and the patients were disappointed in 64% of cases. This is a minor operation in terms of vascular elements, but it is associated with a high rate of recurrence and leaves a short finger. Its indications should be limited to losses of bone substance less than 50%.

Adolescent↗
PubMed1989

[Aortic calcification in CT. Correlation with risk factors and cardiovascular diseases].

Computed tomography is a much more sensitive method of identifying aortic calcification than conventional radiographic methods. The present study was undertaken to explore the importance of various cardiovascular risk factors with regard to their calcifying effect on the aorta. A total of 2,130 individuals, aged 8-88 years, were included. In all cases continuous 8-mm-thick CT slices were obtained from the thoracic inlet caudally to the adrenal glands. There was a significant relationship between aortic calcification and age, smoking habits, hypertension, diabetes, relative body weight, hyperlipidemia and alcohol consumption. Aortic calcification was demonstrated to be strongly associated with vascular disease.

Adolescent↗
PubMed1989

Tendon transfers for treatment of the paralyzed hand following brachial plexus injury.

The correction of functional deficits of the hand after a brachial plexus lesion is difficult; treatment should be provided by a well-knit team of surgeons and therapists. The patient should be fully aware of the limitations of surgical treatment before surgery, and should be entrusted to the care of a physical therapist during the critical period of nerve regeneration after initial surgical treatment to ensure optimal results. This article presents therapeutic possibilities and discusses specific problems of tendon transfers in brachial plexus palsy.

Brachial Plexus↗
PubMed1989

[Limitations of replacing the semilunar with a Swanson's implant].

Nineteen patients have had an arthroplasty of the semilunar by Swanson's prosthesis at stage III of Kienbock's disease. They have been reviewed after an average period of 4 years. The clinical evaluation finds 14 good and excellent results, two fair and 3 poor ones. Its analysis shows a persistence of a non limiting pain 15 times; a fair muscular strength which reaches 65 per cent of the strength of the healthy side and articular amplitudes reduced by 36 per cent of the normal amplitude. Radiologically, the study of the wrist as a whole shows that the prosthetic implantation avoids the aggravation of the collapse of the wrist, whereas its cubital sliding increases by about 15 per cent. The analysis of the evolutive mode of the wrist shows a subluxation of the scaphoid which leads 15 times to a scaphoradial arthrosis; 17 times were observed lytic signs which in 4 cases have evoked a synovitis. It seems therefore that the clinical results are favourable more than 3 times out of 4, but radiological signs of osteoarticular degeneration show the necessity to stabilize the external column of the wrist, in order to avoid the deterioration of the Swanson's implants.

Adolescent↗
PubMed1988

Effects of the ligands of beef tryptophanyl-tRNA synthetase on the elementary steps of the tRNA(Trp) aminoacylation.

Tryptophanyl-tRNA synthetase catalyzed formation of Trp-tRNA(Trp) has been studied by mixing tRNA(Trp) with a preformed bis(tryptophanyl adenylate)-enzyme complex in the 0-60-ms time range, on a quenched-flow apparatus. Analyzing the data gives an association rate constant ka = (1.22 +/- 0.47) X 10(8) M-1 S-1, a dissociation rate constant kd = 143 +/- 73 S-1, and a dissociation constant Kd = 1.34 +/- 0.80 microM for tRNA(Trp). The maximum rate constant of tryptophan transfer to tRNA(Trp) is kt = 33 +/- 3 S-1. When starting the aminoacylation reaction with a mono(tryptophanyl adenylate)-enzyme complex, one obtains different kinetic profiles than when using a bis(tryptophanyl adenylate)-enzyme complex. Over a 0-400-ms time range, the monoadenylate-enzyme complex yields an apparent first-order reaction, while the bis-adenylate-enzyme complex yields a biphasic aminoacylation of tRNA(Trp). Analysis of Trp-tRNA(Trp) formation from both complexes according to simple reaction schemes shows that the dissociation of tRNA(Trp) from an enzyme subunit carrying no adenylate is 6.9-fold slower than from an enzyme subunit carrying an adenylate. The apparent rate constant of dissociation of nascent tryptophanyl-tRNA(Trp) is 4.9 S-1 in the absence of free tryptophan, which is much slower than its rate of formation (33 S-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Acylation↗
PubMed1988

Hyperostotic macrodactyly.

There is a rare and special type of macrodactyly that is called the hyperostotic variety. This disease occurs later than the classical forms of macrodactyly and shows massive osteocartilaginous deposits around the joints. A new case is reported. The cause of this disease could be previous trauma.

Adult↗
PubMed1988

[Matev's digit lengthening technic. Apropos of 20 cases].

The authors reviewed 20 lengthening procedures according to Matev performed between 1982 and 1985 at SOS Main Strasbourg. They developed a special device which has proved to be simple and easy to use. Indications are limited to a few congenital malformations and traumatic mutilations. In children a free vascularized epiphysis transfer has been used to allow normal growth. Results are analysed and short-comings are outlined: lengthening is limited (47.8%); frequency of complications mainly trivial account for 25%; treatment period is lengthy (2.8 m in children and 4.2 m in adults).

Adolescent↗
PubMed1988

[Miniaturized osteosynthesis of articular fractures of the fingers. Results of a series of 60 cases].

The importance of anatomical reduction of articular fractures and early mobilisation of these severe forms of trauma which frequently damage the extensor apparatus (58% of cases, led us to propose direct miniaturised osteosynthesis as described by the Nancy-Strasbourg team. Of the 1,000 cases of osteosynthesis performed between 1978 and 1985, we selected 12 fractures of the MP joint, 38 fractures of the PIP joint and 10 fractures of the DIP joint, differentiated into 4 stages according to the condition of the skin and tendons and into 9 categories according to the anatomical type and the site of the fracture. Direct osteosynthesis (screw, bolt, pin) was used in every case. The clinical results were evaluated in terms of the Total Active Range of Movements, the local trophic state, the amount of pain and return to work, for each joint. When well conducted and with effective skin cover, this technique allows almost normal reconstruction in simple fractures and is valuable in more complex fractures by preserving sliding of the tendinous apparatus due to early mobilisation.

Adolescent↗
PubMed1988

[Trans-triquetral triquetral-lunate arthrodesis].

Transtriquetral triquetro-lunate arthrodesis is an original technique for partial arthrodesis of the wrist. This operation is indicated in the treatment of certain forms of triquetro-lunate instability and represents a new approach to the treatment of Decoulx's stages I and II of Kienböck's disease. The incision is medial and limited. The use of a special trephine guided by a pine allows the extraction of a triquetro-lunate osteocartilaginous cylinder. A cancellous bone graft is then performed to fill in the loss of substance. This new, simple surgical procedure, but demanding in terms of its technique, should decrease the failure rate and should improve the chances of lunate revascularisation.

Arthrodesis↗
PubMed1988

[The kite flap].

Explore the source record for details and available documents.

Adolescent↗
PubMed1988

Use of glutaraldehyde stabilized mammalian pericardium in hand surgery.

Initial feasibility studies of glutaraldehyde-stabilized bovine pericardium show promise for use in hand surgery. The pericardium exhibits excellent handling characteristics with no obvious biologically adverse reactions. Testing in the experimental models show a decrease in adhesion formation and an increase in tendon gliding. Clinical use of the bovine pericardium in selected cases appears to be confirm the experimental results.

Animals↗
PubMed1988

[Littler's operation (SORL = spiral oblique retinacular ligament) in the treatment of "swan neck"].

The surgical treatment of "swan-neck" deformities secondary to mallet finger using Littler's technique (Spiral Oblique Retinacular Ligament) in a series of 35 cases, led to a complete correction of the PIP joint hyperextension in 95% of the cases and a correction of the DIP joint flexure in 70% of the cases. This active tenodesis restores the physiology of the extension of the PIP and DIP joints as far as the surgical technique has been strictly respected.

Adolescent↗