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S Dojcinovic

Publications and source records attributed to S Dojcinovic.

4 recordsLinked to original sources

[Surgical treatment for distal rupture of the biceps tendon].

PURPOSE OF THE STUDY: Avulsion of the distal biceps brachii tendon at the elbow is uncommon. We analyzed cases operated in our department in order to define etiological factors and surgical treatment outcome. MATERIAL AND METHODS: We reviewed retrospectively eleven patients, ten male patients, average age 43 years (range 37-59) with distal biceps tendon ruptures repaired anatomically with a double-incision technique and one other male patient whose tendon was attached to the brachialis anterior. Nine patients were seen for clinical assessment at least two years after operation. RESULTS: Average follow-up was 7 years (range 1-10). Patient satisfaction was good and all stated they would opt for surgical treatment again. The most common mechanism of injury was heavy weight lifting with the elbow at 90 degrees flexion or excentric loading on a flexed elbow. The dominant limb was injured in all patients. Eight patients had sustained injury during domestic activities and three during sports activities. Clinical diagnosis was the rule. MRI was useful in patients seen late after injury. We found nine cases of avulsion located at the bicipital tuberosity. All subjective results were good. Strength testing of the injured limbs revealed a loss of 30% supination strength and 40% supination endurance for the anatomic reinsertions. For the non-anatomic reinsertion, there was a 50% decrease in strength and 60% decrease in endurance. Clinical follow-up after seven years showed no nerve damage or heterotopic bone formation. DISCUSSION: Anatomic repair of distal biceps tendon rupture provides consistently good results. Attachment of the brachial tendon to the brachial anterior muscle cannot restore supination force. The two-incision technique with the extensor mass-splitting approach described by Boyd and Anderson lessens the risk of radial nerve plasty. CONCLUSION: Early anatomic reconstruction can restore more strength and endurance for supination. Attachment of the brachialis muscle must be considered in the event of late reconstruction. Subjective satisfaction with functional outcome has been excellent for all patients.

Adult↗

[Surgical indications and techniques in Basedow's disease, multinodular goiter and thyroid cancers].

This is a retrospective study of 47 near total and 30 total thyroidectomies for multinodular goiter, Graves' disease and thyroid cancer. Complications are rare: one permanent recurrent nerve palsy out of 154 nerves at risk, one definitive hypoparathyroidism. For a benign pathology, the former bilateral sub-total thyroidectomy should be replaced by a near-total thyroidectomy which leaves one unilateral thyroid remnant the size of a cherry. Using this technique, we did not observe any recurrence. Among 42 patients controlled after more than one year 1/3 have a normal thyroid function. Systematic substitution is not indicated. Thyroxine should be used only if hypothyroidism develops after the operation or if an increase of the thyroid remnant is demonstrated. Thyroid cancer should be treated by total thyroidectomy, except for noninvasive papillary cancer without node metastasis for which a total lobectomy is sufficient.

Goiter, Nodular↗

[Thyroid nodules. Surgical aspects].

This is a restrospective study of 176 thyroid nodules operated between 1977 and 1990, excluding bilateral goiters. 145 were benign with 111 cold and 34 hot nodules; 31 were cancers. Fine needle biopsy (FNB) is useless in hot nodules. For the cold ones, even in recent series, FNB can give false positive or negative results. This means that the answer of FNB should be closely related to the clinical and US findings. The surgical treatment of thyroid nodules must be a total lobectomy including the isthmus. The recurrent laryngeal nerve must be followed entirely. There was no permanent nerve palsy among the 122 total lobectomies. The risk of developing another controlateral nodule later is low (2/110 cases). It is very difficult to distinguish a follicular cancer from an adenoma on frozen section. For this reason, the patient should be warned that a second operation might be necessary some days later if the definitive diagnosis is a follicular cancer. For a non-invasive and non-metastatic papillary cancer, total lobectomy is sufficient. More advanced papillary and all other thyroid cancers should be treated by a total thyroidectomy.

Adult↗

[Study of the plantar arch: correlations between podometrical and radiological parameters. results of a prospective study of 79 cases].

The authors present a prospective study on the potential correlations between eight footprint parameters and three radiological parameters in the study of the plantar arch. Seventy nine patients were evaluated in 2001. The eight footprint parameters were as fellows : the arch angle, the Chippaux-Smirak's index, the Quamra's contact index 2,3 and 4, the Schwartz's footprint angle, the Staheli's arch index and the arch length index. The three radiological parameters were as fellows : the Djian-Annonier's angle, the Méary's angle and the calcaneal inclination. This prospective study confirms the best correlation, found in others studies, obtained between the Djian-Annonier's angle and the Chippaux-Smirak. The use of the Méary's angle and the calcaneal inclination is not justified because they have bad correlations with footprint parameters.

Adolescent↗