Chirurgie de la main
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Chirurgie de la main · Dec 2012
[Complete wrist denervation: a retrospective study of 27 cases with a mean follow-up period of 77 months].
Complete wrist denervation is a palliative operation, which yields still controversial outcomes. The aim of our study is to assess the late outcomes of complete wrist denervation. ⋯ Complete wrist denervation is an intervention with few complications indicated in chronic wrist pain of any aetiology.
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Chirurgie de la main · Sep 2012
Case Reports[Unusual rupture of a flexor profundus tendon in a rock climber].
Injuries of the flexor pulleys are common in rock climbers. Ruptures of the flexor profundus tendons are less common and take place almost exclusively in zone I at the level of the distal phalangeal insertion of the tendon. ⋯ Tendon repair by direct suture followed by early active mobilization led to a satisfactory result. To the best of our knowledge, this is the first description of this type of injury in a rock climber.
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Chirurgie de la main · Jun 2012
Case Reports[Freon gas frostbite: an unusual burn evolving in two stages].
Freon gas is a halogenated derivative widely used in refrigeration and air conditioning. It is maintained at a temperature below -41°C and its contact with skin may cause very serious burns. This is usually an accident at work and the burns affect the hands of patients first. ⋯ Few cases of this injury are reported and no treatment protocol is established at this time. We present two cases of frostbite by freon gas, initially evaluated at a stage of superficial burns and evolved spontaneously in a few days to full thickness burns necessitating surgical treatment by excision and skin grafting. This evolution in two phases has never been described and could help to better understand the pathophysiology of this frostbite and the possibilities of management.
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Crush injuries of the hand have a bad prognosis. The development of a compartment syndrome in crush injuries is feared but rare, and usually affects the radial interosseous muscle compartment due to certain anatomic features. The usual clinical presentation is an edematous hand held in a slightly intrinsic position with severe pain resistant to level 111 analgesia. ⋯ The aim of this work is to resolve differences in compartmental pressure measurements that may cause misdiagnosis and surgical error. The dermofasciectomy is the only treatment that stops muscle ischemia and avoids perpetuation of the viscious circle of irreversible damage. Functional prognosis is compromised in compartment syndrome and the dermofasciectomy cannot be delayed under any circumstance.
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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.