PubMed Health⌕ Search

Biomedical subjects

P Cuénod

Publications and source records attributed to P Cuénod.

6 recordsLinked to original sources

Osteoligamentoplasty and limited dorsal capsulodesis for chronic scapholunate dissociation.

Treatment of chronic scapholunate dissociation remains unsatisfactory. As the dorsal part of scapholunate interosseous ligament (SLIL) seems to be the "critical corner" of the scapholunate stability, its replacement by an analogous structure could restore scapholunate stability. A procedure is described which combines reconstruction of the dorsal region of the SLIL by means of an osteoligamentous autograft, harvested at the carpus (dorsal trapezoidometacarpal II ligament) and limited dorsal capsulodesis. The limited dorsal capsulodesis is performed using the scaphotriquetral head of the dorsal intercarpal ligament left attached to the distal pole of the scaphoid and fixed with a bone anchor on the dorsal aspect of the lunate. The osteoligamentous autograft prevents scapholunate dissociation and dorsal scaphoid subluxation. The dorsal capsulodesis limits scaphoid flexion and allows synergistic scapholunate mobility. This combination should stabilize the scaphoid in the horizontal as well as sagittal planes. The advantages of this technique are: 1) a single incision; 2) replacement of a ligament by an analogous autograft; 3) faster healing by bone-to-bone apposition; 4) more anatomic and physiologic reconstruction. Three patients are presented to illustrate the technique.

Adult↗

[Psychogenic spastic hand].

Twelve patients seen over a 8-year period with psychogenic spasms of the hand are reported. Six elderly patients presented with extrinsic flexion of the two or three medial fingers with sparing of the thumb and index. Six other patients had various hand attitudes following coincidental but not causal trauma to the upper extremity. Because of the differences in clinical presentation, age of patients and coincident trauma in some cases, the former patients were characterized as type I psychogenic spasms and the latter as type II. A major recurrent depression was the commonest psychiatric diagnosis (DSM-III-R, Axis I) with a concurrent dependent or borderline personality (DSM-III-R, Axis II). The diagnosis of psychogenic spasm of the hand is a diagnosis of exclusion, that requires a multidisciplinary approach including surgeon, neurologist, psychiatrist and rehabilitation therapist. Electromyographic studies are used to rule out a neurological or muscular etiology of the condition. Surgical treatment was uniformly unsuccessful and is probably contraindicated. Only one patient had a nearly complete spontaneous recovery.

Adult↗

Open dislocation of the trapezoid.

Isolated dislocation of trapezoid is rare. We report here a new case of open dorsal dislocation of the trapezoid following a high energy crush injury of the left hand in a factory worker. It was associated with multidigital mutilation and metacarpal fractures.

Adult↗