Chirurgie de la main
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Chirurgie de la main · Sep 2006
Review Comparative Study[Pain perioperative in surgery of the hand].
Pain has to be treated during the perioperative period. The recent improvement in pain treatment results from a better understanding of pain mechanisms, strict evaluations and appropriate protocols for pain management. ⋯ Preventive treatments have to be considered first as the best pain treatment. Basically, perioperative pain has to be understood as a standard quality management by the medical and surgical team.
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Chirurgie de la main · Oct 2005
Intraoperative Bier's block as supplement to insufficient axillary block anesthesia in upper extremity surgery.
The authors reviewed 52 patients who underwent Bier's block, as supplementary anesthesia for insufficient axillary block in upper extremity surgical procedures. Prior to proceeding to the Bier's block, the mean value of pain using the visual optical analogue scale (VAS) was 7.0. ⋯ In the remaining four patients supplementation with narcotics and sedatives via the other i.v. line was required. Intraoperative Bier's block provides a safe and effective alternative way of successfully compensating for an insufficient axillary block in upper extremity surgical procedures.
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Chirurgie de la main · Jun 2005
[Treatment of scaphoid waist fractures by shape memory staples. Retrospective evaluation on 60 cases].
In carpal scaphoid fractures, treatment with screws is considered the gold standard: ostheosynthesis with mini-staples is not the usual choice of treatment. The authors report a study on fractures of the middle third of the scaphoid treated by mini shape memory staples, in order to test the quality of reduction and ostheosynthesis, functional results, time of union and complications. ⋯ Our results show the safety and the practicality of ostheosynthesis with mini shape memory staples in fresh unstable fractures of the middle third of the scaphoid. Stable fixation, continuous compressive force on fragments and the ability to allow early active movement, are the main advantages.
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Crucifixion was developed and abolished during the roman empire. The historical and pagan works are rare, and the story of Christianity gave us the firsts elements of knowledge of this punishment. ⋯ The anatomical work of the artists was then widely used, but it is only during the twentieth century that anatomists and surgeons studied with precision the fixation of the upper limbs on the cross. Lastly the modem imagery with computerised reconstruction allowed a direct vision of the nail in the different structures of the wrist.
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Chirurgie de la main · Jun 2005
[Scaphoid percutaneous osteosynthesis by screw using computer assisted surgery: an experimental study].
Scaphoid fractures are sometimes difficult to diagnose and even more difficult to fix. Recent progress such as miniaturization of osteosynthesis material, adoption of the percutaneous route, and widening of the indications to include undisplaced fractures has still not abolished complications. In this context, computer assisted surgery (CAS) may be useful and deserves further study. ⋯ Its limits are of a geometrical nature "two images available in two planes", data processing "non-specific software dedicated", instrumental "instrument calibration, micromobility of the immobilisation device" and live surgery "no current validation on a fractured scaphoid". Meantime, the development of a percutaneous scaphoid osteosynthesis procedure by CAS can only bring advantages: reduction in the learning curve, widening of the indications, comfort in the technique, reduction in the errors of ostesynthesis and, reduction in the exposure to x-rays. In the current state of knowledge, the method would only be applicable to undisplaced fractures.