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Biomedical subjects

T Dubert

Publications and source records attributed to T Dubert.

33 records · Page 2Linked to original sources
PubMed1997

Very distal finger amputations: replantation or "reposition-flap" repair?

Management of very distal finger amputations is still controversial. Successful replantation results in an almost normal finger but is not without problems, such as technical difficulty, risk of failure and cost. "Reposition-flap" repair is a simpler procedure: it consists of distal bone and nail bed "graft-reposition" and pulp reconstruction by a flap. We compare ten successful replantations and six reposition-flap reconstructions. Replantation has several advantages over reposition-flap repair in terms of less finger shortening, longitudinal nail curvature, absence of PIP flexion contracture and shorter time off work. The results of reposition-flap repair are less satisfactory, but it is nevertheless a useful alternative when replantation is impossible or has failed.

Adolescent↗
PubMed1997

-Arthrography and computed tomography arthrography of the wrist-.

After a brief review of the pertinent anatomy of joint compartments and main ligaments of the wrist, the authors present the technique of wrist arthrography and CT arthrography. They discuss the normal and pathological patterns. The main indications are the chronic painful wrist and posttraumatic wrist. Imaging can reveal ligament defects (particularly scapholunate ligament, or lunotriquetral ligament), triangular fibrocartilage tears, capsular defects, cartilage thinning, foreign bodies, synovial ganglia or synovitis of the wrist.

Arthrography↗
PubMed1996

Complications of flexor tendon repair in the hand: MR imaging assessment.

PURPOSE: To determine if magnetic resonance (MR) imaging enables differentiation of adhesions from tendon rupture after repair of digital flexor tendon injuries. MATERIALS AND METHODS: The reference group comprised eight tendon sutures with a good clinical outcome. Axial and sagittal spin-echo sequences and three-dimensional gradient-echo sequences with curved reconstructions were analyzed in 63 injured fingers. Reoperation was performed in 41 fingers. RESULTS: MR imaging depicted isolated peritendinous adhesions (n = 31), most often with a continuous, uniform tendon (sensitivity 91%, specificity 100%). There were two types of rupture: frank rupture (n = 140; sensitivity 100%, specificity 100%) or elongated callus (n = 18; sensitivity 100%, specificity 94%). Tendon gap was significantly longer in frank rupture (P = .0011). Thin fibrous continuity existed with elongated callus. Tenolysis was sufficient when the callus was short and mature with predominant new collagen fibers. Axial spin-echo sections were essential, as they showed the maturation of the callus. CONCLUSION: MR imaging may enable distinction among several complications that occur after repair of an injured digital flexor tendon.

Adolescent↗
PubMed1994

[Stabilized arthroplasty of the 5th metacarpal bone. A therapeutic proposal for the treatment of old fractures-luxations of the 5th metacarpal bone].

The goals of the surgical treatment of fracture-dislocations of the fifth ray are length restoration of the fifth metacarpal, release of impingement and preservation of the carpo-metacarpal mobility. Our technic of "stabilised arthroplasty" satisfies theoretically to these three goals. It consists in resection-arthroplasty of the base of the fifth metacarpal associated with stabilisation by arthrodesis between fourth and fifth metacarpal.

Adult↗
PubMed1994

Acute trauma of the extensor hood of the metacarpophalangeal joint: MR imaging evaluation.

PURPOSE: To assess detectability of the components of the extensor hood, especially the sagittal bands, with magnetic resonance (MR) imaging in normal and injured metacarpophalangeal (MP) joints. MATERIALS AND METHODS: T2*-weighted, T1-weighted, and contrast material-enhanced T1-weighted images were obtained of 54 normal MP joints (108 sagittal bands). The ability to detect the sagittal bands with each sequence was rated for three observers. These same sequences were used for MR imaging of nine patients with acute MP injury. Seven patients underwent surgery. RESULTS: The sensitivity of MR imaging for the detection of normal sagittal bands was 0.89-0.92 for T2*-weighted images, 0.80-0.88 for T1-weighted images, and 0.81-0.91 for contrast-enhanced T1-weighted images. MR imaging findings in patients with extensor hood injury included irregularity, poor definition, and increased signal intensity or uptake of contrast material by structures in and around the extensor hood. All MR imaging findings correlated well with those of surgery. CONCLUSION: MR imaging is accurate for determination of the presence and severity of injury to the extensor hood.

Acute Disease↗
PubMed1993

[Epiphysio-diaphyseal unicondylar reduction osteotomy for the treatment of clinodactyly due to proximal interphalangeal joint malunion].

Epiphysio-diaphyseal unicondylar reduction osteotomy is a simple technique for correcting clinodactyly due to intra articular proximal interphalangeal joint mal-union, with preservation of pre-operative joint mobility. This technique is based on equilibration of the articular surfaces. By means of a conservative approach, a strong osteosynthesis allows immediate rehabilitation. In the two cases presented here, there was realignment of the overall finger axis and preservation of the pre-operative range of movement.

Adolescent↗
PubMed1993

Partial replantation after traumatic proximal lower limb amputation: a one-stage reconstruction with free osteocutaneous transfer from the amputated limb.

A case of immediate stump reconstruction following proximal leg amputation below the knee is reported. Additional length and sensation are conferred to the stump by free autotransplantation of a composite flap taken from the unsalvageable amputated leg. This flap provided 13 cm of vascularized tibia invested in the skin of the foot. This operative procedure facilitated the fitting of a prosthesis and preserved knee function despite an initial very proximal amputation.

Adult↗
PubMed1991

[Free-flap coverage technique with double vascular bypass in the lower limb].

In thirteen patients, the repair of a soft tissue defect of the lower limb required a free tissue transfer revascularized by microvascular grafts. The indication of vascular grafting was either the absence of vessels or inadequate recipient vessels. Proximal anastomoses were performed on the femoral artery and the femoral vein or the long saphenous vein. All the transfers were done in one stage procedure. In two cases, a transitory arteriovenous shunt was established. Three flaps out of thirteen have been lost by thrombosis. The discussion concerns the causes of the failures and the indication of the establishment of a transitory or a temporary arterioveinous shunt prior to free flap transfer.

Adult↗
PubMed1991

[An unusual dislocation of the elbow: convergent dislocation].

A case of dislocation of the elbow, combining convergent dislocation of the proximal radio-ulnar joint with posterior dislocation of the ulno-humeral joint was reported. This particular combination has not, to the knowledge of the authors, been reported previously. Diagnosis was based on anterioposterior X ray of the joint associated with a clinical finding of a loss of supination following reduction of the ulno-humeral joint. This unusual lesion has to be recognised for a missed diagnosis may lead to compromise of the result in the long term.

Adult↗
PubMed1990

[Anatomy of the articular nerves of the wrist. Implications for wrist denervation techniques].

The knowledge of the anatomy of the wrist articular nerves is at the base of the denervation technique. After a dissection of 12 adult wrists, we specify the situation and the relation of these nerves at the level where they are accessible to a surgical approach. The 10 articular branches of Wilhelm are described successively. The posterior interosseous is the most voluminous and most constant. Some branches need a specific surgical approach: anterior and posterior interosseous nerve, lateral cutaneous nerve, articular branch of the first web. Other nerves are cut blindly after skin undermining (perforating branches from cutaneous nerves). Some branches appear inaccessible to a cautious surgery because they are closely tight to other motor branches (deep branches of the cubital nerve). Finally some branches described by Wilhelm were not found in our dissections: branches of the median palmar cutaneous nerve, and direct branch of the cubital nerve.

Classification↗
PubMedDate not supplied

[A new cause for iatrogenic lesion of the ulnar nerve at the arm: contraceptive hormonal implant. Report of two cases].

The authors describe two cases of iatrogenic lesions of the ulnar nerve at the arm level after insertion of contraceptive hormonal implants. The presence of only a thin subcutaneous fat layer on the medial side of the arm in slim women, exposes the ulnar nerve to danger during the insertion or withdrawal of the implant. We therefore advise the insertion of such implants on the medial side of the thigh in slim women. We equally recommend that withdrawal of non-tangible devices implanted on the medial side of the arm or in case of neurologic symptoms, even transitory, be done by a trained microsurgeon.

Adult↗
PubMedDate not supplied

[Perinephretic phlegmon of pseudotumor form].

The authors report a case of perinephric phlegmon simulating a tumor. Ultrasound and CT scan were unable to provide grounds for correct diagnosis. It was only after incision of the mass and drainage of the purulent matter that a correct diagnosis could be made.

Aged↗