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 1995
Comparative Study[Anesthesia for hand surgery in patients with bullous epidermolysis].
Epidermolysis bullosa is a rare genetic disease, characterized by the formation of bullae in the skin and squamous epithelium following minimal trauma. The majority of surgical indications specific to this disease concern autosomal recessive dystrophic epidermolysis bullosa (RDEB). Hand surgery is one of the fields of surgery involved. ⋯ Regional anaesthetic techniques, particularly in the upper limb, present many advantages in addition to their feasibility in small children: efficacy, simplicity, postoperative analgesia, and outpatient comfort. In the context of the specificities and difficulties encountered in the management of these patients suffering from epidermolysis bullosa, the authors demonstrate the value of first-line regional anaesthesia, even in very young children (less than 3 years). The presence of a parent in the operating room is a valuable aid, which is still insufficiently used, but which should be used with conviction for the benefit of all concerned.
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Ann Chir Main Memb Super · Jan 1995
[Fibrolipoma of the median nerve. Review of 10 surgically treated cases with a mean recall of 8 years].
Lipofibromatous hamartoma of the median nerve and its branches is rare, but is the most frequent lesion associated with digital hypertrophy in the upper limb. We present a pediatric series of 8 patients, two of whom had bilateral involvement. Digital enlargement or true macrodactyly was the presenting complaint. ⋯ Mean follow-up is 8 years and 5 operated lipofibromas have been reviewed after 13 years. Two-point discrimination was often abnormal, but sensory impairment was stabilized, as well as soft tissue enlargement. However no objective argument can currently support more radical nerve surgery, and the superiority of nerve resection on the course of digital hypertrophy has not been proven.