Annales de chirurgie de la main et du membre supérieur : organe officiel des sociétés de chirurgie de la main = Annals of hand and upper limb surgery
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Ann Chir Main Memb Super · Jan 1998
Case ReportsIrreducible dorsal dislocation of the interphalangeal joint of the thumb due to the palmar plate. A case report.
Dorsal dislocation of the thumb interphalangeal joint is rare. Only very few cases of irreducible dislocation has been reported at this joint. The authors report a case of compound irreducible dislocation due to the palmar plate interposition. The sesamoid, the flexor pollicis longus have been reported to block reduction of the dorsal dislocation of the thumb interphalangeal joint doctors on casualities should not insist if reduction is not easily obtained, the patient should then be guide towards a surgical team for surgical treatment.
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Ann Chir Main Memb Super · Jan 1997
Review[Retrosternal luxation of the clavicle. Apropos of 4 cases surgically treated using a temporary screwed anterior plate and review of the literature].
The authors report 4 new cases of retrosternal dislocation of the clavicle operated by capsular and ligament restoration, and temporary stabilization by anterior plating. The 4 patients were men with a mean age of 17.5 years. The lesion was caused by a sports injury (football, rugby) in 3 out of 4 cases and was related to an indirect mechanism. ⋯ One third of attempts fail, and cases of delayed diagnosis and serious vascular complications, then require surgical treatment. The costoclavicular ligament is repaired either by Burrows's ligamentoplasty or by bone suture; the clavicle is stabilized by bone suture or by anterior plating. The authors do not advocate either joint fixation by Kirschner wire, or resection of the medial end of the clavicle.
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Ann Chir Main Memb Super · Jan 1997
[Wrist impaction syndrome after distal radial or forearm fractures treated by ulnar osteotomy. Surgical techniques and results in 26 cases].
Twenty-six of 27 patients in whom an ulnar shortening osteotomy had been performed to treat ulnar impaction following distal radius (20 patients) or forearm (6 patients) fractures were evaluated at an average follow-up of 21 months. All but 3 patients were satisfied with the end-result and according to a modified Gartland-Werley score there were 1 excellent, 10 good, 10 fair and 5 poor results. ⋯ Bony union of the osteotomy was achieved at 12 to 16 weeks postoperatively except for 2 cases and there was no difference between transverse (13 cases) and oblique osteotomies (13 cases). We therefore prefer the technically easier transverse osteotomy and recommend the use of 3.5 dynamic compression plates for stabilisation which resulted in a low complication rate in our series and enables early active wrist mobilisation.
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Ann Chir Main Memb Super · Jan 1997
Case ReportsTreatment of recurrent digital scar contracture in paediatric patients by proximal phalangeal island flap.
Despite adequate medical treatment, digital palmar burn scar contractures can still occur in children. Surgical treatment basically consists of scar release and skin grafting or Z-plasty. However, recurrence of deformity can occur, especially in children. ⋯ The palmar scars were released and the defects covered by proximal phalangeal island flap. All flaps survived completely and no recurrence was observed, even 5 years after surgery. These promising results encouraged us to propose proximal phalangeal island flap as first choice in the treatment of recurrent digital scar contractures in paediatric patients.
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Ann Chir Main Memb Super · Jan 1996
Comparative StudySurgical treatment of the ulnar nerve entrapment neuropathy: submuscular anterior transposition or simple decompression of the ulnar nerve? Long-term results in 79 cases.
The surgical treatment of the ulnar nerve entrapment neuropathy at the elbow is controversial. None of the presently advocated procedures (simple decompression of the ulnar nerve, medial epicondylectomy, subcutaneous or submuscular anterior transposition of the ulnar nerve) has proven optimal regarding long-term results. We studied the outcome in 79 patients whose ulnar nerve had been operated on for the first time, either by simple decompression (31 cases) or by submuscular anterior transposition (48 cases). ⋯ Irrespective of the surgical method, roughly 90% of the patients considered their postoperative condition to be improved. However, one specific group of patients (people with habitual ulnar luxation or subluxation of the ulnar nerve) experienced a distinctly better result when treated by anterior transposition than by simple decompression. Our results show that simple decompression of the ulnar nerve can be recommended in all patients without cubital (sub)luxation of the nerve, whereas people with a tendency of cubital (sub)luxation of the ulnar nerve should be treated by submuscular anterior transposition.