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Biomedical subjects

R Debry

Publications and source records attributed to R Debry.

14 recordsLinked to original sources
PubMed1995

[Hemi-arthroplasty of the shoulder: radiological, functional and dynamic studies].

From September 1973 to October 1992, forty-three shoulder arthroplasties were performed in forty-one patients with complicated fractures or degenerative disease. Radiological and functional assessment with a mean follow-up time of forty-five months permitted us to review twenty patients with fifteen Neer II prosthesis, three isoelastic prosthesis and two total shoulder replacements. Of these, eleven presented with traumatic injuries and four with degenerative disease. The mean age at operative time was 61 years. Radiological evaluation showed that all cases had a retroversion of about 30 degrees. Normal humeral length and lateral shifting were not achieved in most patients; in fact only one had a restored length and lateral shifting. The mean scapulothoracic range of motion was found to be half that of a normal gliding shoulder (angle 30 degrees instead of 60 degrees). The subacromial space was diminished by one third in all cases. Relief of shoulder pain was the most significant finding. Mobility was restored to a level of about 75% of normal according to Constant's Scale. Dynamometric measures showed an important loss of force (47% of normal) despite a normal external rotation force. Recent improvements in implant conception (modular prosthesis) and a better understanding of physiological shoulder mechanisms should improve the functional results of this arthroplasty in the future.

Adult↗
PubMed1990

[Coxa vara. Isolated growth of the greater trochanter. Prevention-treatment].

Prevention of avascular complications is a primary aim. The ischemic insult to the femoral head provokes different types of morphologic deformities depending on its location. When the lateral part of the growth plate is affected, the head will be in valgus with a short neck, on the contrary, when the medial part is affected, a coxa vara occurs. The sooner the growth is stopped, the shorter the neck will be. Nevertheless, the greater trochanter will continue its growth and under certain conditions, will extend beyond the head. The Articulo-Trochanteric Distance is a measurement of the deformity which may be checked regularly. Early recognition permits prevention and adequate treatment. Treatment options include epiphysiodesis of the greater trochanter before the age of 8 to 10 years, trochanteric repositioning with osteotomy, and valgus osteotomy (Pauwels' Y-osteotomy).

Bone Diseases, Developmental↗
PubMed1989

[Comparative study of a series of normal knees and a series of knees with patellar instability].

In studying the long-term follow-up of 39 cases of patellofemoral instability operated in our department for recurrent dislocation, we also analyzed their morphological appearance on X-ray. We compared the data given by Maldague and Malghem, Dejour and Walch for the pathological conditions of our cases with the same number of normal knees. This comparative analysis showed that measuring the bulging of the upper part of the trochlea and the depth of its groove on a lateral view is a reliable method to evaluate patellar instability. The classical axial view gives less useful information to quantify the instability. However, this axial view shows a particular aspect in the cases of severe instability: the fulcrum of the trochlea is displaced inwards while the inner trochlear facet is smaller or even absent. This precise radiological examination and the complete clinical examination with an analysis of the "morphotype" (Lerat) are necessary in the screening, diagnosis and treatment of severe patellofemoral instability.

Follow-Up Studies↗
PubMed1989

[Treatment of major patellar instability. Results of the Fèvre-Dupuis operation].

In the treatment of recurrent subluxation and dislocation of the patella in adolescents and young adults, the authors describe a method consisting of: --a modified Roux procedure for internal transposition and advancement of the anterior tibial tuberosity; --the Lecène technic for over-the-top reinsertion of the vastus medialis on the lateral aspect of the patella. All the patients had a plaster cast for 10 days followed by rehabilitation until normal knee function was achieved. Stiff knees were mobilized under general anesthesia. Normal activity was progressively resumed 6 weeks after surgery. Out of the 31 patients (41 knees) available for objective follow-up evaluation, 26 were women and 5 men, with an average age of 19 years. The mean follow-up period was 9 and a half years with a minimum of 2 years and a maximum of 23. End results in terms of relief of pain, patellar stability and knee function were gratifying. Thirty knees were rated good, 8 fair and 3 poor. No recurrence of subluxation or dislocation was found.

Adolescent↗
PubMed1989

[Pathology of the anterior peroneus tendon and that of the intermetatarsal bone].

The inconstant peroneus tertius is the fourth muscle in the antero-lateral aspect of the leg. Its tendon crosses the fourth tendon of the extensor hallucis brevis on the dorsal aspect of the cuboïdo-metatarsal joint. If an impingement occurs it may provoke a painful condition and a typical synovial cyst. The anatomy and the pathology of the condition are described. The treatment is very simple: the inconstant tendon should be removed when it produces symptoms. An accessory bone, the intermetatarsal bone, located at the proximal part of the first intermetatarsal or intercuneiform space, may have various shapes. It can provoke pain in the first space when pressure is exerted on capsulo-ligamentous structures or on neuro-vascular elements. The treatment is excision of the accessory bone.

Foot Diseases↗
PubMed1985

[Hueston's flap for reconstruction of loss of distal thumb substance].

The classical rotation flap described by J. Hueston involves the advancement of a denervated skin area on the distal stump. In distal amputations of the thumb, this flap should only be used on the lateral side in order to avoid creating a blind medial pulp. Furthermore, this leaves a proximal skin defect thereby exposing the neurovascular bundles. This secondary defect is best covered by a lateral triangular rotation flap.

Humans↗
PubMed1984

Toe-to-hand transfers in reconstructive surgery of the hand. Experience with seventy-one cases.

Based on a homogeneous series of 71 toe-to-hand transfers performed between February 1975 and December 1982 the same surgeon, the authors have tried to define their present day indications. Technical modifications have been described for the second toe transfer : isolated dorsal approach of the toe with early-stage resection of the second metatarsal bone, utilisation of the plantar metatarsal artery of the second interosseous space, utilisation of the volar vessels for the anastomosis at the recipient site, dorsal subcutaneous tunnel for the venous anastomosis of the hand. Aside from the usual indications for thumb reconstruction (11 cases) and 26 cases of transfers for reconstruction in long finger injuries, the indications for partial transfers have become more and more frequent : pulpar (9 cases), pulp + bone + nail (10 cases), isolated nail (1 case), nail + bone (2 cases), first web space (1 case), double twisted toe (5 cases) and articular (6 cases) transfers.

Adult↗
PubMed1982

[The reversed de-epithelialized flap].

The reversed deepithelialized flap was used by Clodius for the lower limb and Pakian was the first to report on the use of this procedure in the hand. In the operation a classical cross-finger is deepithelialized and turned over on to an adjacent finger. The dermal part comes in contact with the exposed structures of the defect to be covered. This technique increases the indications for the cross-finger flap to many cases, where the classical flap is not possible.

Finger Injuries↗