Chirurgie de la main
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Chirurgie de la main · Feb 2013
Case Reports[Intra-articular distal radial fracture with lunate fossa rotated, about 4 cases: interest of surgical procedure by volar medial approach].
Intra-articular distal radial fractures in young subjects occur in severe trauma. Articular reduction needs to be anatomical. We report four cases with the particularity of having a 90° or 180° rotated lunate fossa. Our goal is to bring out the positive aspects of surgical procedure by volar medial approach and to assess long-term functionnal and radiological results. ⋯ Imaging with simple radiographs is not sufficient and needs to be complemented with CT scan. Our approach allows for direct access to the fragment of the lunate fossa and easier visualization of the distal radioulnar, compared to Henry's approach, thereby avoiding excessive traction of the median nerve. TYPE D'ÉTUDE: Niveau IV.
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Chirurgie de la main · Dec 2012
Comparative StudyLigament reconstruction and tendon interposition arthroplasty of the trapeziometacarpal joint with the use of the full thickness of the flexor carpi radialis tendon.
We analyzed the outcomes of the ligament reconstruction and tendon interposition arthroplasty of the trapeziometacarpal joint with use of the full thickness of the flexor carpi radialis. We reviewed 19 patients, with 23 thumbs at mean follow-up of 59 ± 15 months. According to Dell classification, 11 thumbs were grade 2, and 12 thumbs were grade 3. ⋯ Mobility of the thumbs was improved; 19 thumbs could touch the base of the fifth finger, and five thumbs could touch the crease of the proximal interphalangeal joint. We compared the operated side with the healthy one in 15 patients, the grip strengths were 82% of the contralateral side, tip pinch strengths 78%, and lateral pinch strengths as 75%. According to our series, this surgical technique relieves pain and provides stability and mobility of the thumb.
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Chirurgie de la main · Dec 2012
[Surgical treatment by percutaneous pinning of articular fractures of the base of the fifth metacarpal (descriptive study of 20 cases)].
The aim of this study is to show the benefits of surgical treatment of intra articular fractures of the base of the fifth metacarpal by intermetacarpal double pinning. ⋯ Intermetacarpal double pinning is a technique of choice in surgical treatment of intra-articular fractures of the base of the fifth metacarpal. It ensures good closed reduction and a satisfactory functional result.
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Necrotizing soft tissue infections and necrotizing fasciitis are life-threatening infections affecting the hypodermis, muscular fascia, and dermis secondarily. Mortality is high, with an average of 30%. ⋯ Adjunctive therapies may have a role, but their effectiveness remains unproven. A review of the literature allows us to highlight this multidisciplinary management.
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Chirurgie de la main · Dec 2012
Case Reports[Anterior dislocation of the elbow joint without peri-articular fracture in an adult].
In view of the comparative frequency of posterior dislocations of the elbow, it is rather remarkable that anterior dislocations of that joint should be among the rarest of injuries [1]. Our case is one of the first cases of anterior dislocation of the elbow without any periarticular fracture or pre-existing deformities around the elbow [2].