[Metacarpophalangeal arthroplasties with silicone implants].
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Biomedical subjects
Publications and source records attributed to M Rousso.
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A semirigid silicone cuff was investigated in rats to prevent scar entrapment of the sciatic nerve. Scar was induced by crushing or burning the surrounding muscles. On one side, the nerve was covered by a longitudinally split semirigid silicone tube. On the other side, the same procedure was done without silicone coverage of the nerve. At different time periods the animals were sacrificed and the nerve with surrounding tissues examined. The protected nerve was found gliding freely during mobilization of the limb. The blood supply to the nerve was maintained through the split in the silastic cuff by formation of new mesoneurium. On the control side, the nerve was surrounded by a fibrous tissue in various stages of maturation depending upon the time postinjury. The nerve structure showed reduced vascularity and progressive degenerative changes of the axons. Clinical tests on the silicone cuff method are proposed fo selected patients with extensive soft tissue injury around nerves.
One-stage surgery in which an abdominal flap is used for coverage of the leg in the presence of fractured femur is suggested in cases of avulsion injury of the leg with multiple fractures. The efficacy of this concept was proved by experimental work.
A 19-year-old Arab woman who was previously operated on to desyndactylize her right second and third digits is presented in this case report. The patient's toes resyndactylized postoperatively and a keloid scar developed on the dorsum of her incision site. Syndactylism of digits is often discussed when involving the hand. However, it is much less frequently presented when it involves the foot, because surgical intervention is seldom necessary unless foot function is affected. Keloid scars are commonly encountered and pose a challenge to the podiatric physician because of their recalcitrant and recurrent tendency. This paper, detailing complete podiatric surgical treatment, is presented with a review of literature aiming to consolidate the presently known facts about syndactylism and keloids, and their treatment in the foot.