Chirurgie de la main
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Chirurgie de la main · Dec 2011
[Neurotization of the deep branch of ulnar nerve with anterior interosseous nerve: anatomic study].
The paralysis of the deep branch of ulnar nerve has major consequences on the motricity of the hand that will be felt as more handicapping by the patient than the sensory deficit. The current treatment of ulnar nerve lesions is suture or nerve graft in first intention and is essentially palliative in case of failure. We were interested in the anatomy of the anterior interosseous nerve and the deep branch of ulnar nerve to know if neurotization using direct suture of these two branches was possible in every case. ⋯ Neurotization of the deep branch of ulnar nerve with the anterior interosseous nerve has no major functional loss and gives possible recovery of all the intrinsic muscles innervated by the deep branch of ulnar nerve. This neurotisation can be considered as an alternative to the usual techniques of direct suture or nerve graft, in case of lesion above mid forearm.
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Chirurgie de la main · Oct 2011
Evaluation of the risk factors for acute occupational hand injuries.
To evaluate the effect of demographic and occupational factors on the severity of the acute occupational hand injuries. ⋯ The potentially modifiable factors such as the working conditions, safety training and use of gloves are important in the etiology of occupational acute hand injury. Most probably, in this study the size of the sample was not large enough to be able to demonstrate any relation between these and the injury severity. However, attempts to modify these factors by various strategies may reduce the incidence of acute hand injury at work. Precautions and widespread educational programs can prevent occupational acute hand injury.
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Chirurgie de la main · Sep 2011
[Induced membrane technique for the reconstruction of bone defects in upper limb. A prospective single center study of nine cases].
Bone defect in the upper limb remain infrequent with few reported in the literature. Their reconstruction raises the problem of bone union of non weight-bearing segments as well as the function of adjacent joints. We report a monocentric continuous series of nine patients treated with the induced membrane technique (Masquelet technique). ⋯ The technique of the induced membrane allows filling of a large bone defect, while avoiding vascularised bone autografts and their morbidity. It requires two procedures but can be used in emergency or after failure of other interventions. It is a reliable, and reproducible technique where the only limit is the cancellous bone stock. Following the series of Masquelet, Apard and Stafford in the lower limb, and the series of Flamans in the hand, this is the first report of reconstruction of defect in the upper limb using this technique.
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The combination of elbow dislocation and perilunate dislocation is rare. The prognosis of this condition depends mainly on that of the wrist. ⋯ The treatment was surgical at the wrist. The functional result is similar to cases reported in the literature.
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Chirurgie de la main · Apr 2011
Case Reports[Dislocation of the carpometacarpal joint of the thumb associated with trapezium and Bennett's fractures].
We report a case of a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. To our knowledge, no such case was found in the literature. The patient had open reduction internal fixation with pins and screws, with good functional outcome.