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 1992
[Techniques of continuous nerve block at the level of the wrist].
Functional treatment without pain is a condition for good results after operations at gliding structures (tendons) or periarticular structures. Good analgesia of the arm and hand is obtained with continuous axillary nerve blocks. Often there is concomitant paralysis and active motion is not possible. ⋯ We use a prefabricated catheter set to introduce the polyethylene catheter and to place it near the nerve as in single shot wrist block. This technique for continuous analgesia of the hand can be used for functional treatment after tenolyses, arthrolyses and stable osteosyntheses of fingers. Median, radial and ulnar nerves can be blocked all at the same time or alone.
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Ann Chir Main Memb Super · Jan 1992
Review Case Reports[Three rare fractures of the radius associated with an ulnar slipped epiphyses].
Over a period of 7 years, three adolescent boys had an associated diaphyseal fracture of the distal third of the radius with separation of the distal ulnar epiphysis. The fracture involved towards early epiphysiodesis of the growth plate of the distal ulna leading to a shortened ulna without any severe functional disability. ⋯ The treatment of this associated lesion is classical emergency, but the radiological follow-up must be extended in time because the growth potential of the forearm bones is important even during adolescence. The onset of a growth disturbance requires rapid surgical epiphysiodesis of the radius to prevent the development of deformity.
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Ann Chir Main Memb Super · Jan 1991
Review[Local and regional anesthesia of the upper limb in emergency hand surgery].
The very conditions of the emergency led the authors to define the indications for the various modalities of local and regional anaesthesia: intravenous regional anaesthesia, nerve trunk blocks, plexus blocks, interdigital block and local infiltration. The parallel development of anaesthetic drugs with variable systemic toxicity and a duration of action inversely proportional to the toxicity now allows precise adaptation of the anaesthesia to the type of lesion, the patient's general condition, the practical conditions of the emergency and the surgical technique selected, provided the anaesthetist is fully aware of the traps to be avoided, which can only be based on a long practice of local and regional anaesthesia in elective surgery.
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46 victims of projectile accidents or explosions were treated over a 5 years period between 1984 and 1989. 3 categories were distinguished: injuries due to a single projectile (12 cases), only inducing serious bone damage and, apart from 3 immediate amputations, the final result was satisfactory. Injuries due to multiple scattered projectiles (11 cases), less severe in terms of the initial lesions, not requiring any amputations, with good results in 8 cases. Explosion injuries (23 cases) in which the effect of the explosion induced considerable initial lesions leading to one hand amputation and 33 finger amputations; the association of skeletal and soft tissue lesions raises the problem of excision and primary cover, requiring large flaps. The course is long and 8 out of 26 hands had serious sequelae, while the reconstruction of an elementary pinch can be considered to be an acceptable result in the other cases.
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Ann Chir Main Memb Super · Jan 1990
Case Reports[Heterotopic ossification and ulnar nerve compression syndrome of the elbow. A report of two cases].
Heterotopic ossification is a well known complication in patients after longterm coma following CNS trauma. The association of heterotopic ossification and a nerve compression syndrome situated near the calcifications is less common. The authors present 2 CNS traumatised patients who secondarily developed the association of heterotopic ossification of the elbow with a compressive syndrome of the ulnar nerve. Although heterotopic ossification does not appear to be the direct cause of the nerve compression, it certainly promotes compression it because of the flexion it causes.