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Biomedical subjects

Y Allieu

Publications and source records attributed to Y Allieu.

At least 19 recordsLinked to original sources
PubMed1991

[Idiopathic aseptic osteonecrosis of the capitate bone. Literature review apropos of 3 new cases].

The authors report 3 cases of idiopathic avascular necrosis of the capitate and review them together with published reports of 16 further cases. The patients are normally young and the diagnosis delayed. The radiographs may demonstrate an eggshell appearance, a sequestrum, marked sclerosis, or cystic changes. A classification is proposed based on the portion of the bone involved. Early osteoarthritic changes occur and carpal instability may develop. It is suggested that there are features in the blood supply which may be significant. Treatment is by operation, involving either excision of the capitate with replacement with a prosthetic spacer, or else by arthrodesis.

Adult↗
PubMed1991

[Role of scapho-trapezo-trapezoidal arthrodesis in the treatment of Kienbock disease. 11 cases].

11 patients with Decoulx stage III Kienböck's disease with rotatory subluxation of the scaphoid were treated with scapho-trapezo-trapezoid arthrodesis. The associated procedures were lunate implant resection arthroplasty in 6 cases, lunate resection in 3 cases, shortening of the radius in 1 case. The average follow-up was 40 months (12 to 84 months). There was no complication of the arthrodesis. Relief of pain is satisfactory in 7 of the 11 patients. The average grip strength is 66% of that observed on the affected side. The range of movement was decreased especially for radial deviation. There was a positive correlation between, the exact scaphoid reduction, a wrist without preoperative degenerative arthritis and the good clinical results. No differences were observed in the results between the associated lunate procedures. STT fusion seems to be a useful procedure in the treatment of stage III Kienböck's disease with carpal malalignment as it removes compressive stress from the diseased lunate and treats, the accompanying rotatory subluxation of the scaphoid.

Adult↗
PubMed1991

[Segmental arterial sympathectomies at the level of the fingers].

The authors relate their experience of thirty digital artery sympathectomies in twenty-four fingers. Ten men and two women were operated: six crush injuries to fingers, three Raynaud's disease and two Buerger disease and one scleroderma. All presented digital vascular insufficiency. The pre-operative arteriogram always revealed more extensive thrombosis than suspected by the clinical symptoms. In this way we performed a segmental arterial sympathectomy depending on the site of the thrombosed artery. The follow-up was five years. The immediate postoperative results were excellent. Five years later the results depended on the nature of the initial disease.

Angiography↗
PubMed1991

["Desensitization" technique in the rehabilitation of the painful hand].

Hand injury patients fairly frequently develop, soon after the injury, hypersensitivity phenomena on contact of the hand with the environment, which may lead to exclusion of the hand. The authors attempt to explain this syndrome on the basis of the pathophysiological theories concerning pain. American authors have proposed an original desensitization treatment based on simple and varied techniques, which provides extremely encouraging results.

Desensitization, Psychologic↗
PubMed1991

[The inguinal pedicle flap in emergency traumatic hand surgery: value of the long pedicle permitting an early rehabilitation].

The main drawbacks of the use of a groin pedicle flap in emergency surgery for hand injuries are the declivitous position of the upper limb with a tendency towards oedema and the difficulty of instituting early rehabilitation because of the fact that the injured hand is fixed to the abdomen. Based on an extensive experience of 76 emergency flaps out of more than 100 flaps performed over the last ten years, the authors describe their flap raising technique which allows the formation of a long, closed tube compatible with early rehabilitation and also allowing the possible use of splints.

Emergencies↗
PubMed1991

[Current techniques and indications of pedicled groin flap for hand surgery. Apropos of 100 cases].

Based on an analysis of the anatomical and physical data reported in the literature, the authors describe their personal technique based on an experience of 100 pedicled inguinal flaps. The authors define the current indications for this flap in reconstructive hand surgery. The quality of pedicled inguinal flaps makes this procedure a technique of choice in the emergency treatment of wounds of the hand.

Adolescent↗
PubMed1991

[The neurological forms of thoracic outlet syndrome: the role of the middle scalene].

The authors discuss the pathogenesis of neurological involvement in the thoracic outlet syndrome. They emphasise a factor which has been neglected up until now: the tendon of scalenus medius, around which the primary inferior trunk of the brachial plexus forms a curve with a postero-inferior concavity. An anatomical study reveals this close relation which is only apparent in the horizontal plane. Thirteen clinical cases of pure neurological forms, confirmed by Aran-Duchenne amyotrophy of the hand, illustrate the role of scalenus medius in this nerve lesion. The therapeutic application of this new concept consists of middle scalenectomy and posterior release of the nerve trunks by cervicotomy.

Adolescent↗
PubMed1990

[Amyloid arthropathy of the hand in patients on chronic hemodialysis].

Among 70 patients treated by hemodialysis for renal failure and operated for carpal tunnel syndromes, 17 presented with bone and joint lesions. Seven of them had destructive arthropathies of the distal interphalangeal joint, bilateral in 6 cases. Two radiological stages are described. Radiolucent lesions of the carpal bones were present in all the patients ("carpal amyloidosis"). The most frequent sites were around the radius-scaphoid-lunate and scaphoid-lunate joint spaces. Scaphoid-trapezoid-trapezium arthropathy was frequent with dynamic instability in one case. One patient had a pathological fracture of the lunate and scaphoid. Carpal tunnel syndrome was associated in all cases and dorsal wrist tenosynovitis in three cases. Amyloid arthropathy is more frequent in old patients on long-term hemodialysis. Amyloid deposits were shown in tendinous and joint synovial biopsy. The pathogenesis of amyloidosis is discussed.

Aged↗
PubMed1990

[Subcutaneous avulsion of the flexor digitorum profundus and flexor digitorum superficialis tendons of the ring and little fingers caused by blast injury].

The authors report a case of subcutaneous avulsion of flexor profundus and flexor superficialis tendons of the ring and little finger, caused by a blast injury. Treatment consisted of excision of the flexor superficialis tendon with transosseous reinsertion of the flexor profundus tendon. The functional result was good. Subcutaneous traumatic rupture of flexor tendons occurs infrequently, but simultaneous rupture of both flexor tendons is extremely rare. Knowledge of the subject is limited and treatment of this disorder is poorly defined.

Adult↗
PubMed1990

[Long-term results of the Swanson implant for the treatment of basal joint arthrosis].

The authors present a review of Swanson's trapezium implants used in the surgical treatment of arthrosis of the basal joint of the thumb. 32 patients operated between 1970 and 1979 were invited to consultation, and 22 were examined again after an average period of 9.8 years. The clinical findings seemed to be good, with satisfactory subjective results in 95 per cent of all cases. On the contrary, radiographs showed 50 per cent of luxations and subluxations, and implant wear in 70 per cent of cases, increasing with time. In 39 per cent of cases, intracarpal cavities secondary to an adverse reaction to the silicon implant were noted. However, no second operation was needed. In spite of the good clinical results, the authors reserve Swanson's implants, considering the radiological findings, to subjects older than 65 years, because of the risks of long-term intolerance. Trapezectomy seems to be preferable in younger patients.

Female↗
PubMed1990

[Juvenile aponeurotic fibroma (Keasbey tumor) with metastatic course. Apropos of a case].

Juvenile aponeurotic fibroma, isolated in 1953 by Louisa Keasbey is a rare tumour which is characterized by its recurrence and infiltration, but which has no tendency to metastasis. The case we report differs in its long-term outcome. The tumour diagnosed in a seven-year-old child has recurred locally for seven years, necessitated hand amputation, and finally developed a fibroblastic process extending to lung and pleura which caused the child's death. This new finding in Keasbey's disease led us to reconsider the nosological situation in juvenile fibromatoses and its reputation for benignity.

Child, Preschool↗
PubMed1989

A double nidus osteoid osteoma in a finger.

The diagnosis of an osteoid osteoma in the proximal phalanx of the right index finger was suggested by the patient's history and the initial radiographs. The diagnosis was histologically confirmed postoperatively. One year later, however, persistent symptoms and typical radiographic findings, again suggested the presence of an osteoid osteoma. Subsequent en bloc resection of the second nidus, which was again histologically confirmed as an osteoid osteoma, was followed by complete resolution of the symptoms. The definitive diagnosis of a double-nidus osteoid osteoma was suggested after careful analysis of the initial radiographs demonstrated the existence of two distinct intracortical nidi.

Child↗
PubMed1989

[Juvenile aponeurotic fibroma (Keasbey's tumor) with metastatic progression. Apropos of a case].

The juvenile aponeurotic fibroma, isolated in 1953 by Louisa Keasbey is a rare tumour which is characterized by its recurrence and infiltration, but which has no tendency to metastasis. The case we report differs in its long-term outcome. The tumour diagnosed in a seven-year-old child has recurred locally for seven years, necessitated hand amputation, and finally developed a fibroblastic process extending to lung and pleura which caused the child's death. After this new finding in Keasbey's disease, we are led to reconsider the nosological situation in juvenile fibromatoses and its character of benign disease.

Adolescent↗
PubMed1989

[Blast injuries of the 1st commissure].

Explosions are responsible for severe hand injuries. Due to their extremely important functional role, lesions of the thumb and first commissure must be identified separately during assessment of the lesions. No classification of these injuries has been proposed since the one defined by Mac Gregor and Jackson. Based on their experience of 11 injuries, the authors propose a classification divided into four stages of increasing severity. In the emergency situation, the severe forms with disruption of the blood supply have a very poor prognosis. In the other forms, the degree of opening of the first commissure is of fundamental importance. Secondarily, the functional prognosis of the hand is dominated by retraction of the first commissure, ankylosis of the trapezo-metacarpal joint or its preservation during amputations.

Adolescent↗
PubMed1989

Post-operative Doppler evaluation of 48 arterial reconstructions at the wrist.

C. W. Doppler ultrasound was used for the assessment and follow-up of 35 ulnar or radial arteries, repaired in emergency, and 13 secondarily repaired arteries, after traumatic section. Doppler examination appeared to be more sensitive than Allen test, because it can distinguish, among non functional arteries, those with or without Doppler signal. Moreover, when a Doppler signal is present, the compression test of the other artery can increase or not this signal. Thus, Doppler examination gives an help for surgical decision.

Adolescent↗