Biomedical subjects

C Mathoulin

Publications and source records attributed to C Mathoulin.

At least 19 recordsLinked to original sources

PubMed2005

[Vascularized bone graft in carpal bone reconstruction].

We report our experience of vascularized bone graft harvested from the volar aspect of the distal radius for carpal bone reconstruction. Thirty cadaveric dissections showed in all cases the volar carpal artery which born from the radial artery. Between 1994 to 2001, we treated 87 scaphoid non-unions with an average follow-up of 41 months (range 6 to 65 months). Union was obtained in 80 patients (92%) with an average delay of 8.6 weeks (range 6 to 24). Between 1994 to 2000 we treated 22 patients with a Kienbock's disease. A radius shortening was always added to the revascularization of lunate by this vascularized bone graft. Preoperative and postoperative MRI was systematically done. The average follow-up was 55 months (range 24 to 92 months). MRI showed healing with good revascularization in 16 cases (74%). Lesions of lunate were stabilized in five cases and we had one failure with secondary palliative procedure. This simple but meticulous technique needs only one approach and allows a sufficient revascularisation.

Adolescent↗

PubMed2005

[Not Available].

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Journal Article↗

PubMed2005

[Not Available].

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Journal Article↗

PubMed2004

Arthroscopic resection of wrist ganglia.

The arthroscopic resection of synovial cysts of the wrist is a simple technique which is comfortable for the patient. We report on a series of 96 patients with dorsal synovial cysts (75 women, 21 men). All patients had undergone preliminary treatment which had been unsuccessful. We operated on 32 patients with a volar cyst (27 women, five men). All the patients were operated on as outpatients under local regional anaesthesia. For the dorsal cysts, after having precisely located the cyst, it is then resected after having inserted a shaver directly through the wall of the cyst starting with the capsule. For the volar cysts the arthroscope was inserted through a 3-4 portal and the shaver was inserted through a 1-2 radiocarpal portal. In all cases, there was no immobilisation and a range of motion was started the same day. For the dorsal cysts, our average follow-up was 34 months (range 12-46 months). There were no complications. We had four recurrences. For the palmar cysts, our average follow-up was 26 months (range 12-39 months). There have been no recurrences to date.

Adolescent↗

PubMed2003

Vascular anatomy of the palmar surfaces of the distal radius and ulna: its relevance to pedicled bone grafts at the distal palmar forearm.

The potential for harvesting vascularized bone grafts from the palmar surface of the distal radius has been studied in 40 arms of fresh cadavers which had previously been injected with coloured latex solution. It was found that vascularized grafts can be pedicled on the radial part of the palmar carpal arterial arch. If a longer pedicle is required, the bone graft can be pedicled on the anterior branch of the anterior interosseous artery with retrograde flow occurring from the palmar carpal arch.

Bone Transplantation↗

PubMed2003

[Skin complications of stonefish envenomation in 6 travellers returning from the Indo-Pacific maritime region].

Stonefish (Synanceja verrucosa) sting has been known for a long time to be a medical hazard. It is a common cause of severe marine envenomation. Immediate complications (collapsus, pulmonary oedema) have been described extensively. Late complications (oedema, tissue necrosis) have not been studied in details although they are common and a cause of invalidity and pain. We have observed six travellers with complications of stonefish sting over a 10 year-period in our department. All the patients were coming back from the Indo-Pacific maritime region. They presented with cutaneous abcess (in one) or necrotic complications (foot ulcers in two, cellulitis in three) associated with painfull oedema in two and lymphangitis in three. Surgery has been performed in four patients, two of them undergoing many operations. Two had long term sequelae. Such complications could be avoided. Appropriate initial treatment (i.e., neutralization of the venom by hot water, disinfection, antivenom and antibioprophylaxis) seems to be able to reduce late complications. Antivenom is indicated in severe systemic manifestations which are life threatening and in case of crucial pains. Prevention is the most important part of therapy and relies on appropriate information of the travellers.

Adult↗

PubMed2001

[Interest in wrist arthroscopy for treatment of articular fractures of the distal radius: report of 27 cases].

We report our results of treatment of intra articular distal radius fracture assisted by wrist arthroscopy. Twenty six patients (15 men and 11 women) were treated using this technique. All the patients were operated on under regional anaesthesia, the elbow flexed to 90 degrees, and in-line traction applied using "Japanese" fingers traps (4 to 6 kgs). After articular cleansing, reduction under arthroscopic and fluoroscopic control was carried out using K-wires. All fractures were intra articular and in four cases of fractures with four fragments, it was necessary to combine a volar plate with the K-wires. There were 21 associated ligament injuries (seven TFCC tears, four lunotriquetral ligament injuries and ten scapholunate injuries of which four necessitated pinning). Our average follow-up time was 16 months (6-26 months). There was absence of pain in 23 cases and the results were good for wrist motion and strength. We did not experienced any severe secondary displacement. Eighteen excellent, seven good results and one average result were obtained. The quality of these functional and anatomical results seems to be directly linked to the quality of reduction obtained under arthroscopy and the quality of internal fixation carried out under traction.

Adult↗

PubMed2000

Pedicled hypothenar fat flap for median nerve coverage in recalcitrant carpal tunnel syndrome.

We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included. We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12-80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%). The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic environment of the median nerve and relieves pain.

Adipose Tissue↗

PubMed2000

[Vascularized bone grafts in children. Specifics and indications].

The authors report on the vascularized bone grafts used in children. Some of them are the same as those used in adults, like the fibula free flap. Others are growth plate transfers as the proximal fibular epiphysis, the iliac crest or the lateral scapular crest. Finally, other transfers are periosteal vascularized grafts. The indications and results are discussed concerning the congenital pseudarthrosis of the tibia (43 cases treated by the first author), the congenital pseudarthrosis of the forearm, the tumors of the limb and the post-traumatic defects. The specific indications in children are the microsurgical growth plate transfers, especially the epiphyseal growth fibula for the upper limb and the iliac crest for the lower limb.

Bone Transplantation↗

PubMed1999

Arthroplasty of the proximal interphalangeal joint using the Sutter implant for traumatic joint destruction.

We report the functional results in a series of 21 Sutter arthroplasties for post-traumatic arthritis with an average follow-up of more than 2 years. The dorsal approach was used in every case. Pain was always present preoperatively and mobility was reduced to an average range of motion of 15 degrees. Postoperatively, pain was absent in 18 cases. The average active range of motion was 55 degrees. There were two fractures of implants. Although the follow-up is limited, the Sutter arthroplasty has given results that are similar to, or better than, those reported for other techniques.

Adolescent↗

PubMed1998

Further experience with the index metacarpal vascularized bone graft.

We report our experience in the use of a vascularized bone graft harvested from the head of the index metacarpal to treat scaphoid nonunion after failure of other techniques. Only 15 patients were treated between 1988 and 1994, showing the scarcity of indications for the operation. Union was obtained in 14 cases but the functional results were acceptable in ten cases only. This was due to previously unnoticed degenerative lesions.

Adult↗

PubMed1998

Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion.

We report the use of a bone graft harvested from the palmar and ulnar aspect of the distal radius and vascularized by the palmar carpal artery for the treatment of scaphoid nonunion in 17 patients, ten of whom had already had unsuccessful surgery. Union was obtained in all cases at an average of 60 days (range, 45-90 days). The average follow-up was 16 months (range, 12-36 months). There were no failures.

Adolescent↗

PubMed1994

[Limits and insufficiencies of the treatments of recent double-break articular fractures of the lower fourth of the radius].

The authors present a series of 39 intra-articular fractures of the distal part of the radius classified as Frykman VII and VIII. Clinical results showed 77% of good and very good results. Radiographs showed 71% of reduced articular surfaces but only 37% of radiuses were considered to be anatomical. The authors emphasize the high rate of secondary displacement due to the epiphyseal comminution, and the importance of pre-operative radiographs obtained under traction, allowing good analysis of the fracture and evaluation of the comminution.

Adult↗

PubMed1993

Congenital pseudarthrosis of the forearm: treatment of six cases with vascularized fibular graft and a review of the literature.

Six cases of pseudarthrosis of the forearm are reported. One involved only the radius, one the ulna alone, and four both forearm bones. There was associated neurofibromatosis in five cases. All the cases were treated by wide resection and free vascularized fibular graft. In two cases, a single-bone forearm was created. In all cases, good results were achieved, with moderate forearm shortening. The literature suggests electrical stimulation, corticoperiosteal graft, osteotomy of the involved bone, and free vascularized bone grafting as treatment alternatives. Vascularized free bone grafting appears to be more successful than other treatments. The use of microsurgical sutures permits this treatment in young patients.

Adolescent↗

PubMed1993

[Free transfer of the vascularized fibula in pseudarthrosis and femoral bone loss].

The authors report their experience of femoral reconstruction by free fibular graft transfer. Twenty eight patients were operated on between 1977 and 1988. The average follow-up was 7 years and 3 months. The etiology of most of the cases was a post traumatic lesion (70 per cent). Loss of substance was found in 19 cases. 60 per cent of these were septic. The approach was usually posterior and vessels from the sciatic nerve were used. Union was obtained in 89 per cent of the cases. In 65 per cent of the cases union occurred in less than 1 year. In 1 out of 4 cases graft thickening was necessary and achieved by secondary bone grafts. The comparison of this technique with standard treatments evidenced a definite superiority of vascularized bone grafts in cases of septic pseudarthrosis and significant losses of bone.

Adolescent↗

PubMed1992

[Description of a vascularized bone graft taken from the head of the 2nd metacarpal bone].

The authors describe a new vascularised bone graft from the distal part of the second metacarpal. They report an anatomic study on 20 cadavers which demonstrates the existence of two dorsal first web arteries (superficial and deep). The existence of free anastomosis between the two arteries is demonstrated. The vascularisation of the bone graft relies upon the deep first web artery which lies against the lateral aspect of the bone. The operative procedure is described and the authors stress the necessity to transfer the vascularized bone graft with a large soft tissue pedicle.

Arteries↗

PubMed1991

[Presentation of a new homodigital, countercurrent sensitive island flap].

The authors present new sensitive homodigital island flap which can be used to cover large finger pulp defects when classical techniques cannot be applied. An anatomical study consisting of the meticulous dissection of the branches and anastomoses of the digital arteries formed the basis for this new flap. The precise but safe surgical technique is described with the presentation of the first five clinical cases. The authors consider the following advantages of this flap: unrestricted coverage of large pulp defects, the flap is innervated after repair of the transposed digital nerve, tension is avoided allowing immediate mobilization. They also consider the disadvantages related to the necessary section of the digital nerve and artery. However the authors consider that the benefits outweight the disadvantages when compared with conventional techniques.

Adult↗

PubMed1991

[Reconstruction of loss of bony substance in limbs by free vascularized fibula transplant].

The authors present their experience of bone-loss reconstruction by a free vasculized fibular transfer. 62 cases were operated, with an average follow-up of 6 years (between 24 to 13 years). Studied were 15 upper limbs (10 humerus, 3 ulna, 2 radius), 28 femurs and 19 tibias. We found a male predominance: 46 cases and the average age was 33 years old. The etiology was often due to trauma: serious road traffic accidents (37 cases). 44 cases were septic and the average bone-loss was of 10 cm (between 4 cm to 30). The most frequent complications were due to fractures of the graft (10 cases) and stiffness (15 cases). Consolidation rate was of 87%: 8 were failures (3 upper limbs: 20% at femur level, 10% at tibia level). The average consolidation rate of the septic cases was of 81%, and the non-septic cases over 97.5%. It seems to be a good technique and in particular for septic cases using a basic orthopedic technique and microsurgical suture.

Bone Transplantation↗