Chirurgie de la main
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Chirurgie de la main · Feb 2011
Case Reports[Pseudoaneurysm of the superficial palmar arch, following endoscopic carpal tunnel release. A case report].
Pseudo-aneurysm of the superficial palmar arch following carpal tunnel release is exceptional and thus poorly reported. We present one observation, recorded on more than 1300 hands treated by endoscopic release using the "Chow" technique by a single surgeon. Ultra-sonography could be used in an attempt to locate the superficial palmar arch and thus prevent vascular damage at surgery.
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Trigger finger is an entity seen commonly by hand surgeons. It is produced by a size mismatch between the flexor tendon and the A1 pulley, which causes pain, clicking, catching, and loss of motion of the affected finger. ⋯ Treatment modalities in trigger finger include splinting, corticosteroid injection and/or surgery. Indication depends on the clinical form of trigger finger.
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Chirurgie de la main · Feb 2011
Locking plates for fixation of extra-articular fractures of the first metacarpal base: a series of 15 cases.
Extra-articular fractures of the first metacarpal base may lead to retraction of the first web and weakness of the pinch. Conventional surgery (K-wire or non-locking plates) needs six weeks of immobilization. Our goal was to achieve the reduction of such fractures using locking mini-plates to allow early mobilization. ⋯ Our results seem to indicate that locking T-plates do not provide sufficient strength to allow early mobilization. The direct cost of locking plates is high but this must be weighed against the reduced indirect costs when calculating the cost effectiveness of this type of management. Double-row locking plates offer a valuable therapeutic alternative since they allow stable fixation and early mobilization of the thumb, which may outweigh their high cost.
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Chirurgie de la main · Feb 2011
Case Reports[Fracture of the distal radius associated with an articular comminutive fracture of the distal ulna: treatment in emergency by osteosynthesis of the radius by volar locking plate for the radius and a resection of the distal end of the ulna: report of one case].
The authors present a case of a distal radius fracture associated with a comminutive fracture of the ulna head, treated by volar locking plate for the radius fracture and ulnar head resection. We obtain an early good objective and subjective functional result, whereas this type of fracture is classically associated with bad results in the series published with other treatments. This result needs to be confirmed by a more exhaustive series.
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Chirurgie de la main · Dec 2010
Comparative Study Clinical TrialThe Canaletto®™ implant for reconstructing transverse carpal ligament in carpal tunnel surgery. Surgical technique and cohort prospective study about 400 Canaletto cases versus 400 cases with open carpal tunnel surgery.
The techniques used for carpal tunnel release are open surgery, endoscopy and retinaculum repair. Postoperative outcome, however, is often altered by pain, weakness, insufficient sensory or motor recovery and recurrences. We propose, since March 2001, a new surgical technique based on the reconstruction of the flexor retinaculum using the Canaletto®™ implant. ⋯ Mean duration of sick leave decreased from 5 weeks in the group without Canaletto to 3 weeks in the Canaletto group. Such mechanical and biological properties made this implant becoming part of our surgical armamentum; we use it in about 25% of our surgical procedures for carpal tunnel syndromes. There is some limitations regarding the results of this study due to: (1) a potential selection bias between the two cohorts related to Canaletto indication, and (2) one of the authors is also the designer of the implant (the other one has no conflict of interest).