Biomedical subjects

Y Tropet

Publications and source records attributed to Y Tropet.

At least 55 records · Page 3Linked to original sources

PubMed1996

[Streptococcus cellulitis. Apropos of 3 clinical cases].

We report three cases of streptococci cellulitis of the hand. The characteristic clinical presentation suggested streptococcus infection; locoregional edema, rash, echymosis, phlyctena and signs of finger ischemia. Operative findings also suggested streptococcus infection: swelling of brownish subcutaneous tissue and local thrombus formation. There was no true pus formation. Streptococcus was identified in all 3 cases. Emergency surgical treatment is needed. The portal is opened, followed by extensive fasciotomy and debridement of all necrosed tissue. Partial suture is indicated. Antibiotics can be used as an adjunct but are not sufficient alone.

Adult↗

PubMed1996

[Traumatic isolated palmar dislocation of the distal radio-ulnar joint. Apropos of a case].

PURPOSE OF THE STUDY: The authors report a rare case of an isolated palmar dislocation of the distal radio-ulnar joint (DRU). Diagnosis was easily established in emergency even though this lesion is usually unknown in 50 per cent of cases, according to literature. CASE REPORT: A surgical approach was necessary because of irreducibility of the lesion: ulna and radius were hitched with no other anatomical interposition. Treatment succeeded and the functional result was good with only 25 degrees of loss of pronation. This suggests a commentary on DRU joint physiology, on the mechanism of dislocation, and on the methods of treatment.

Female↗

PubMed1995

Reconstruction of a complex defect of the dorsum of the hand.

A 37-year-old right-handed male truck driver was admitted with a severe injury of the dorsum of his right hand following a traffic accident. He had a large combined defect involving skin, tendons and bone. A complex reconstruction was performed using a large iliac crest allograft, a tendon graft and a free serratus anterior flap in one stage, 8 hours after the injury. A skin graft was performed later. 2 years later the functional and aesthetic result are good.

Adult↗

PubMed1995

[Mid-plantar pedicle skin flap. Apropos of 5 clinical cases].

The blood supply to the non-weight bearing midsole area is not derived exclusively from the medial plantar artery. This allows elevation of a subfascial mid-plantar cutaneous flap for the reconstruction of the heel. The technique of elevation of the flap is described. This plantar flap can be designed to include sensation without the need for deep dissection. Five clinical cases are discussed. This flap is useful for medium-sized chronic ulcerations of the heel.

Adult↗

PubMed1994

[Lesions of the little finger in Dupuytren's disease].

One hundred and twenty six patients (148 hands) with Dupuytren's disease of the fifth finger were reviewed with an average follow-up of 5 years. Twenty-nine dermo-fasciectomies were performed on the palmar area of the fifth finger. The improvement in the MP joint was complete in all cases. A classification in to 4 grades according to the degree of pre- and postoperative retraction is proposed. The average improvement at the PIP joint was 50 degrees. 26 recurrences were observed. The recurrence rate was similar with or without a skin graft but the functional result was better with a digital graft, as recurrences were located away from the PIP joint.

Adult↗

PubMed1994

[Results of the primary repair of the collateral palmar digital nerves].

The aim of this study was to analyse the results of primary collateral digital nerve repair as a function of several factors: age, surgeon's experience, type of lesion and associated lesions, etc. The conclusions are based on a homogeneous series of 64 patients with 83 nerve lesions treated by primary microsurgical nerve repair with a follow-up of at least one year.

Adolescent↗

PubMed1994

[Emergency cover of open fractures of the leg. Apropos of a series of 24 clinical cases].

The authors present 24 emergency covering procedures for 24 open leg fractures: 6 free flaps and 18 pedicled flaps. The procedure was selected according to the site dimensions and topography of the defect. Topographically, the division of the leg into 3 zones: middle, upper and lower seems to be some what artificial because in practice the junction between the middle and lower segments is still a source of error in the choice of the local flap which can be used. It is preferable to use pedicled flaps in the proximal half of the tibia and free flaps in the distal half. Many failures were observed with the use of fascio-cutaneous flaps. 18 of 24 fractures were internally fixed, which allowed emergency covering. In fact, although bony covering can wait 48 hours, the presence of osteosynthesis material means that covering must be performed at the same time. This makes the plastic and microsurgical procedures easier and ensures greater patient comfort during the consolidation period and rehabilitation. The authors present their results according to the method of soft tissue coverage, their reliability, the type of osteosynthesis, the complications, number of operations and time to bony consolidation. Encouraged by their results, the authors continue with this approach.

Emergencies↗

PubMed1993

[Treatment of extensive traumatic loss of substance of the foot and ankle by free flaps. Apropos of 7 clinical cases].

The authors report 7 cases of extensive skin defects of the foot and/or the ankle treated by using a free flap. All cases presented with major trauma of the lower limb with obvious exposure of bone and joint tissues. The skin defect was covered: as an emergency in 4 cases; within the 48 hours following the trauma in 3 cases; on the 7th day after the injury in 1 case. The free flap used was: the latissimus dorsi muscle, 2 cases; the gracilis muscle, 1 case; the serratus anterior muscle, 1 case; the greater omentum, 2 cases. Arterial microanastomoses were performed onto the anterior tibial or pedal arteries, in 4 cases, and onto the posterior tibial artery in 4 cases. Except for 1 failure on the 8th day after the operation due to thrombosis of the venous anastomosis, requiring arthrodesis of the ankle, the outcome was favorable in all other cases, free of osteitis or arthritis. The authors emphasize the importance of covering defects the lower limb as quickly as possible, ideally as an emergency, when a free flap is required.

Adult↗

PubMed1992

[Place of microvascularized tissue transplants in emergency treatment of multiple trauma of the limbs. Excluding reimplantation].

When we evoked the indications of microsurgery in Traumatology, at first, we think reimplantations performed in emergency and also secondary management of soft tissues or complex defects. In fact, we resort to microsurgery in many other circumstances. Early microsurgical reconstruction of complex trauma of the extremities yield better results than delayed free flaps. In 7 cases, free flaps were performed on the lower extremities, in 2 cases on the upper extremities. Many advantages are credited with this offensive attitude which requires an appropriate organisation of the Departments of Traumatology, the intimate collaboration of surgeons called orthopedic or plastic surgeons, improperly divided by too administrative compartmentalization of the surgical specialties.

Adult↗

PubMed1991

[Reflections on 4 cases of ante-lunar carpal luxations].

Over the past 20 years, 4 cases of ante-lunate carpal dislocation have been treated in the Traumatology and Orthopaedics Department of Besançon. During this same period, 61 cases of retro-lunate dislocation have also been treated. Ante-lunate dislocations are very rare lesions as confirmed by a review of the literature. Our cases do not illustrate the mechanisms of such injuries since 3 cases involved patients with multiple injuries Clinical symptoms may be very minor in children in whom such injuries may easily be overlooked. A thorough interpretation of X-rays is necessary for diagnosis in adults. All 4 cases showed a fracture of the lunate in a frontal plane (factor of instability). Such an instable lesion justifies either internal osteosynthesis or percutaneous trans-articular pinning when rigid internal fixation is impossible. However, in all cases in which the lesion was treated surgically, the capsular plane was not disrupted. Retrospectively, such a finding contraindicates an open surgical approach. Relationships between such dislocations and isolated fractures of the lunate are discussed. The prognosis is mainly determined by early diagnosis and management rather than the type of treatment itself.

Accidental Falls↗

PubMed1991

[Glomus tumor of the sciatic nerve].

Nervous glomus tumor is an exceptional lesion, as only one case has been reported in the literature. A case of sciatic nerve glomus tumor is described. Because of the intra-neural location of the tumor with complete loss of the fascicular structures, the tibial nerve was resected and grafted. Light microscopy clearly demonstrated a glomus tumor; the histological features of these cells are typical of this lesion.

Adolescent↗

PubMed1991

[Procedures for repairing skin losses of the knee with joint exposure].

The authors analyse the various procedures for covering skin defects at the knee region exposing either the bones or the joint. Actually, various local flaps allowed in most cases coverage in this area using either a pedicular muscle flap or fasciocutaneous, or even an island flap. For every local flap, its vascularisation, its technique of elevation and its arc of rotation are described. Occasionally, free flaps or cross leg flaps have been used. Indications depended on the patient age, topographic size of the defect, time of covering in emergency or secondarily, trophicity of the surrounding soft-tissues and also the eventual associated vascular injuries.

Humans↗

PubMed1990

Closed traumatic rupture of the ring finger flexor tendon pulley.

We report an unusual case of closed traumatic rupture of the ring finger flexor tendon pulley not previously reported in the literature. This injury occurred in a 21-year-old athlete during rockclimbing. Lack of flexion of the distal interphalangeal joint was accompanied by a palpable subcutaneous cord on the palmar side of the proximal phalanx. A simple repair of the pulley was done. The postoperative functional result was satisfactory.

Adult↗

PubMed1990

[Carpal tunnel syndrome before 20 years of age. A report of 7 cases].

Seven cases of carpal tunnel syndrome before 20 years old are described: 4 were associated with an increase in the patient's athletic activities. In five cases, no etiology was found, marked median nerve stenosis was observed in three cases and hypertrophy of the median nerve was observed in two cases. Flexor retinaculum was thickened in four cases.

Adolescent↗

PubMed1990

[Tangential injuries and hematoma. Application of liposuction combined with biological glue].

The authors report an unconventional method of management in hematomas complicating tangentiel trauma. They use the application of liposuction within the first days, this procedure allow complete removal of the clots. It is associated with a biological glue sprayed all over the skin detachment. This simple operative technique is carried out under local anaesthesia and minimizes the recurrence of hematoma. The long term morphological result is satisfactory, avoiding the sequelae of conventional procedures.

Hematoma↗

PubMed1990

[Free-flap transfer of the omentum to the lower leg].

The authors describe an unusual procedure for closure of a large skin defect of the lower limb exposing the tibia. Due to the severity of the vascular and cutaneous lesions, a greater omentum free flap was used with micro-anastomosis onto the contra-lateral leg: heeling was satisfactory after release of the flap.

Female↗

PubMed1990

[Pedal cutaneous island flap. Apropos of 6 case reports].

The authors report their experience using the dorsalis pedis island flap, described by MacCraw, for coverage of soft tissue defects of the heel, and both lateral and medial areas of ankle. The operative technique is recalled and six cases are presented. The authors analyse the several indications of the island flap. Its disadvantages are emphasized.

Adolescent↗

PubMed1990

[Surgical treatment of suppurative axillary hidradenitis: value of a musculocutaneous island flap of the latissimus dorsi. Apropos of 3 cases].

We report our experience of the surgical management of severe, extensive, medically intractable axillary Hidradenitis suppurativa in three male patients. Under general anaesthesia, all patients underwent large, deep and full excision of the disease prone areas, i. e. zones of apocrine sweat gland distribution and not only of the skin involved at the time of surgery, for the best possible prevention of recurrence. The operation was bilateral in two patients and unilateral in one. In all cases closure was achieved using the latissimus dorsi flap technique. In the two patients with bilateral lesions surgery was carried out in two steps at about two months' interval. At present, after a follow-up of about two years, none of the patients have relapsed and their shoulder mobility is perfectly preserved with a normal abduction allowed by the total absence of axillary scar contracture. The latissimus dorsi flap technique consists of transplanting into the recipient's axillary defect the pedicellated lateral margin of the latissimus dorsi muscle with (2 patients) or without (1 patient) a cover of attached skin palette vascularized by the underlying muscle tissue. Mainly used hitherto for reconstructive mammary surgery, this technique perfectly fits axillary diseases, such as Hidradenitis suppurativa, which can only be cured by creating wide surgical skin defects. It is particularly reliable: covering of the defect is easy and the immediate muscle interposition effectively protects the otherwise widely exposed neurovascular pedicle. The need for a skin palette cover associated with the latissimus dorsi flap is discussed.

Adult↗