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C Oberlin

Publications and source records attributed to C Oberlin.

At least 37 records · Page 2Linked to original sources
PubMed1999

The beta enolase subunit displays three different patterns of microheterogeneity in human striated muscle.

In higher vertebrates, the glycolytic enzyme enolase (2-phospho-D-glycerate hydrolyase; EC 4.2.1.11) is active as a dimeric protein formed from three subunits--alpha: ubiquitous, beta: muscle specific, and gamma: neuron specific--encoded by different genes. In the present study, we have shown that an antiserum previously produced against the mouse beta beta enolase is also a specific reagent for the muscle specific human enolase. Using this antiserum to study human muscles, we demonstrated novel patterns of the beta subunit microheterogeneity which are distinctive from those observed previously in rodents and which appear to be independent of age, gender and muscular activity. Two variants of the beta subunit differing by their size have been detected: one heavy form of 46 kDa (beta H) and one light form of 45 kDa (beta L). Muscle biopsies expressed either beta H or beta L or beta H + beta L, and all muscles of an individual expressed the same variants. The products of in vitro translation of RNA prepared from human muscle displayed beta subunit variants identical to those of the protein present in the biopsy. Therefore the differences observed between individuals reveal a difference already present at the level of the RNA transcripts. These observations suggest the existence of an yet undescribed polymorphism of the human beta enolase gene which could affect the coding sequence. Comparative immunocytochemical and histochemical analyses of biopsies demonstrated that the beta subunit was expressed in all fast fibres (type II), but not in slow fibres (type I). No difference was observed in the intensity of beta enolase immunolabelling between the various types (IIA, IIAB, IIB) of fast fibres. No significant difference in fibre type composition and histological appearance was visible between muscles presenting either one of the three patterns of microheterogeneity.

Adult↗
PubMed1999

Opponensplasty.

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

[Partial arthrodeses of the wrist: experimental studies].

The partial arthrodeses of the wrist joint are well known as a method of treatment of several articular pathologies. Although there exists controversies about the final range of motions. In the goal to compare the state of the ligaments to the final range of motions we realised some of the most popular intracarpal arthrodeses in an anatomical laboratory. For our study we used 10 fresh cadaver specimens with the mean age of 88 years (84-95). The arthrodeses were realised with Kirschner wires. Biggest range of motion (more than 70%) was obtained after scapho-lunatum, scapho-capitatum and luno-triquetrum arthrodeses, while after luno-capitatum, scapho-luno-capitatum and triquetro-hamato-luno-caitatum it was the poorest--less than 50% of the initial state. We found a correlation between the state of the ligaments and the final results--in specimens with tears of the ligaments the results were closer to the perfect-ones from the clinical series. In our opinion the measurement of radial and ulnar deviation in clinical practice is not exact and should not be considered in the elaboration of scientific databases.

Aged↗
PubMed1999

[Anatomic study and review of the literature on the Martin Gruber anastomosis].

We dissected 72 upper limbs of fresh cadavers and found 17 cases of the Martin-Gruber anastomosis. The incidence was 23.6%. They can be classified into 5 types. Type I (n = 5, 29.4%): Communication between the anterior interosseous and the ulnar nerves. Type II (n = 3, 17.6%): Communication between the median and the ulnar nerves. Type III (n = 3, 17.6%): Communication between the muscular branches of the flexor digitorum profundus muscle (FDP). Type IV (n = 3, 17.6%): Communication between the anterior interosseous and the ulnar nerves, the muscular branches of the flexor digitorum profundus muscle (FDP) originated from the connection. Type V (n = 3, 17.6%): The anastomotic branch originated from the median nerve and joined the ulnar at two different points as well as connecting with the ulnar branch of the FDP. Through histologic examination, we found the number and size of nerve fascicles which every connection contained to be very different. In one case of type II only one single nerve fascicle was found. We propose the hypothesis that the different amounts of nerve fascicles innervate different amounts of intrinsic hand musculature. The communication which contained one single nerve fascicle only innervate the first dorsal interosseous muscle (FDI).

Aged↗
PubMed1999

[Anterior transbrachial approach of the coronoid apophysis].

Fractures of the coronoid process of the ulna can cause elbow instability. Treatment of these fractures, sometimes surgical, raises a problem of the incision. The incisions described to date do not provide specific exposure, or require sometimes dangerous nerve and vascular dissections. The authors propose a strictly brachial midline anterior incision. The biceps tendon is retracted laterally and the brachialis muscle is then dissociated longitudinally providing direct exposure of the coronoid process, with no risk of nerve lesions, and allowing direct screwing of the fracture.

Adult↗
PubMed1998

Histomorphometry of the ulnar nerve and of its branches.

A morphometric study has shown that 10% of the fibers of the ulnar nerve should suffice to reinnervate the biceps muscle in brachial plexus palsies. The aim of this study was to evaluate, by a morphometric study using computerized microanalysis, the cross-sectional surface areas of the different collateral and terminal branches of the ulnar nerve. This was expressed in terms of percentage of the cross-sectional surface area of the main trunk of the ulnar nerve. The study revealed that the branch to the flexor digitorum profundus bellies to the ring and little fingers formed 9.5% of the cross-sectional area of the ulnar nerve. Thus use of these fascicles destined for the flexor digitorum profundus, identified by intra-operative nerve stimulation, at the level of the arm would be sufficient for neurotisation of the nerve to the biceps. This has been confirmed by the initial clinical results in patients operated upon using this technique.

Aged↗
PubMed1998

The posterior interosseous nerve and the radial tunnel syndrome: an anatomical study.

Twenty anatomical specimens were carefully studied in order to establish a possible connection between the posterior interosseous nerve and the radial tunnel syndrome. Our results show that the posterior interosseous nerve distal to the supinator muscle may be compressed by various structures. These include the distal border of the supinator muscle, the ramifications of the anterior and posterior interosseous vessels, and the septum between the extensor carpi ulnaris and the extensor digitorum minimi. The posterior interosseous nerve is also stressed during passive supination (elongation and rotation), and during passive pronation (compression). This suggests that the interosseous nerve distal to the supinator muscle should be explored in radial tunnel compression syndromes.

Aged↗
PubMed1998

Tendon transfers to restore elbow flexion after traumatic paralysis of the brachial plexus in adults.

Loss of elbow flexion after traumatic brachial palsy produces significant functional and cosmetic problems. Although a direct approach to the neurological lesion with an attempt to reinnervate the biceps has given some encouraging results, these can be incomplete and for this reason tendon transfers still have an important role. We report the results of our series of 60 patients (54 men and 6 women) who have undergone tendon transfer between 1984 and 1994. The transfers were performed during or after nerve surgery, and we used the muscles arising from the medial epicondyle, the pectoralis minor and the triceps. Our results were judged on any improvement in shoulder stability and in the power of lateral rotation, together with the power and range of active and passive flexion of the elbow. Good results were achieved in 74% of the patients in our study, with more than 120 degrees of elbow flexion and an ability to support at least 1 kg with the elbow flexed to 90 degrees.

Adult↗
PubMed1998

Contribution of magnetic resonance imaging for the diagnosis of median nerve lesion after endoscopic carpal tunnel release.

Deterioration of pre-existing signs or appearance of a nerve deficit raise difficult problems during the complicated course following endoscopic carpal tunnel release. One possible explanation is transient aggravation of nerve compression by passage of the endoscopy material, but these signs may also be due to incomplete section of the flexor retinaculum or an iatrogenic nerve lesion. Each case raises the problem of surgical revision. The authors report three cases of open revision in which MRI allowed a very precise preoperative diagnosis of the lesions and all of the MR findings were confirmed during surgical revision. In the first case, MRI showed section of the most radial branches of the median nerve (collateral nerves of the thumb, index finger and radial collateral nerve of the middle finger). The proximal origin of the nerve of the 3rd web space, above the retinaculum, an anatomical variant, was also identified. Section of 2/3 of the nerve of the 3rd web space, proximal to the superficial palmar arch, was observed in the second case. Simple thickening of the nerve of the 3rd web space, without disruption after opening of the perineurium, was observed in the third case. MRI therefore appears to be an examination allowing early and precise definition of indications for surgical revision in this new iatrogenic disease.

Carpal Tunnel Syndrome↗
PubMed1998

Extensor digiti minimi tendon "rerouting" transfer in permanent abduction of the little finger.

Permanent abduction of the little finger is a bothersome deformity which usually occurs in the context of sequelae of ulnar nerve palsy (Wartenberg's sign), but also in rheumatoid arthritis. The authors report an original technique for correction of this deformity. The extensor digiti minimi tendon is sectioned at its distal insertion and transferred in the wrist through the extensor retinaculum. The "rerouted" tendon is finally resutured distally on the radial aspect of the interosseous muscle. Side-to-side suture of the transferred tendon to the extensor digitorum tendon of the little finger further reinforces the solidity of the procedure. The distal insertion of the extensor digiti minimi tendon is consequently radialized. Its new direction eliminates the abduction component, and the tendon then behaves as an active adductor of the little finger. Five cases (2 cases of ulnar nerve palsy, 3 cases of rheumatoid arthritis) are reported with a mean follow-up of 19 months. All patients have complete active adduction of the little finger in extension, with a persistent capacity for abduction. The other correction techniques published in the literature are discussed.

Adolescent↗
PubMed1998

[Traumatic lesions of the deep branch of the radial nerve].

PURPOSE OF THE STUDY: We report a retrospective study of 21 patients treated for an injury of the deep branch of the radial nerve. The aim of this study was to precise the indication and to evaluate the results of nerve surgery and tendon transfer. MATERIAL: 21 patients, mean age 32, with complete divided lesion of the nerve due to open injury were included. 5 cases with fresh discision of the deep branch of the radial nerve were treated in emergency by suture repair. 16 cases were old lesions. 6 of them had initially severe associated lesions involving skin, forearm muscles or radius. In this case, the treatment of the nerve lesion was delayed after the treatment of the associated lesions. 10 were simple lesions of the nerve who were initially misknowned (6 cases) or caused by a surgical procedure at the proximal forearm (4 cases). METHODS: 4 patients had tendon transfers, due to a very old lesion for one of them and a severe muscle involvement for the 3 others. Twelve nerve graft repairs were performed. Their were 8 troncular grafts and 4 fascicular grafts because the lesion was in the posterior forearm at the level of the terminating branches of the nerve. They required a mean length of 5.8 cm and an average of 3 to 4 cables for nerve graft. RESULTS: The mean follow up was 25 months. Results were appreciated on the recovery of 5 functions (supination, fingers extension, thumb abduction, thumb retropulsion, wrist postero-ulnar extension). Primitive nerve repairs had full recovery in all cases. Tendon transfers had good results. The 12 nerve grafts had 2 excellent results, 8 good results, 1 fair and 1 poor result. These 2 last cases required secondary tendon transfers. DISCUSSION: Traumatic lesions of the deep branch of the radial nerve are often misknowned and often iatrogenic. Nerve surgery provides better functional results than tendon transfers. Nerve grafts in delayed nerve repairs are possible even if the lesion is distal. They give excellent or good functional recovery in most cases after a delay of 7 months. Tendon transfers are indicated if nerve surgery fails or in case of large forearm muscle defect, old patient, and when the delay after the injury is superior to 12 months.

Adult↗
PubMed1998

[C5-C6 and C5-C6-C7 traumatic paralysis of the brachial plexus of the adult caused by supraclavicular lesions].

PURPOSE OF THE STUDY: In C5-C6 and C5-C6-C7 brachial plexus palsies, prognoses was based on the recovery of a useful shoulder and elbow in order to control a normal or partially impaired hand. Treatment was an integrated procedure combining direct nerve surgery and muscle transfers. MATERIAL: Our study was performed on 27 cases of C5-C6 plexus palsy and 43 cases of C5-C6-C7 plexus palsy operated between 1984 and 1994, with an average delay between trauma and surgery of 8 months. METHODS: Elbow flexion was obtained by nerve surgery on the anterior part of the primary trunk or directly on the musculo-cutaneous nerve and after muscle transfer. Nerve surgery on supra-scapular nerve, on posterior part of primary trunk or directly on axillary nerve was also performed. RESULTS: The results were analyzed separately for shoulder and elbow flexion and globally. In C5-C6 palsies, elbow flexion was a goal which has been reached in 100 per cent of cases. Only 56 per cent of cases obtained a stable shoulder with active external rotation. In C5-C6-C7 palsies, elbow flexion was reached in 86 per cent of cases and stable shoulder with active external rotation only in 26 per cent. Reinnervation of the elbow flexors was reached by direct nerve surgery in 60 per cent of C5-C6 and 52 per cent of C5-C6-C7. Active external rotation was reached by spinal-suprascapularis nerve neurotization in 60 per cent of C5-C6 and 54 per cent of C5-C6-C7. DISCUSSION: No significant difference after nerve surgery for elbow flexion was found between C5-C6 and C5-C6-C7 plexus palsies. Failures of nerve surgery will undergo muscle transfer. When C7 is damaged, less muscles are transferable and results are less good. For shoulder, best results were obtained after spinal suprascapularis nerve neurotization with direct suture. In case of failure, a derotation osteotomy was performed. If shoulder was still unstable, transposition of the coracoacromial ligament to the humerus was also performed. CONCLUSION: In C5-C6 palsies, elbow flexion is a goal which must be reached in 100 per cent of cases. Prognosis depends of shoulder function. In C5-C6-C7 palsies, results are less good. 6 patients did not recover elbow flexion, no active mobility of the shoulder was observed in 63 per cent of them. The results obtained for elbow flexion are satisfactory if the program does not separate nerve surgery and muscle transfers.

Adolescent↗
PubMed1997

Anatomical and biomechanical studies of the pathogenesis of trapeziometacarpal degenerative arthritis.

An anatomical and biomechanical study of the stabilizing ligaments of the thumb trapeziometacarpal joint was conducted on 32 hand specimens. Five main ligamentous structures could be identified. The mechanical properties (in particular, strength) of the five ligaments using a strain-rate failure test were determined and evaluated quantitatively. The maximum tensile strength of each ligament was correlated with the condition of the trapeziometacarpal articular cartilage. In studying the anterior oblique ligament, maximum strength decreased from Grade 0 to Grade 1 by 51%. With the first intermetacarpal ligament, the drop from Grade 1 to Grade 2 was 53%. With the posterior oblique ligament, the decrease was closely related to the grade of the deterioration of the trapeziometacarpal articular surface. These three ligaments also significantly decreased in strength with age. Our results may suggest that the anterior oblique ligament, intermetacarpal ligament and posterior oblique ligament play a large role in stabilizing the trapeziometacarpal joint and that the decrease in their strength is related to the pathogenesis of trapeziometacarpal osteoarthritis.

Aged↗
PubMed1997

[Bilateral SLAC (scapholunate advanced collapse) wrist: an unusual entity. Apropos of a 7000-year-old prehistoric case].

SLAC (Scapho-Lunate Advanced Collapse) wrist is the most common form of osteoarthritis of the wrist. The main aetiology is ligamentous rotary subluxation of the scaphoid. The authors report on a case of bilateral SLAC wrist, identified on a prehistoric skeleton derived from the Hassi-el-Abiod site in the malian Sahara (Dutour, 1989). The paleopathological study consisted of macroscopic examination and radiological examination. Radiocarbon dating situated this human occupation to 7 thousand years ago. The diseases observed included bilateral radiocarpal lesions in an adult male individual. The degree of preservation of the carpal skeleton was 90%. Lesions were bilateral, but predominantly affected the right side. The radial styloid processes presented a lateral osteophytic cuff, giving a tapered "pen-nib" appearance. The scaphoid has a normal shape, but presented posterior and lateral osteophytes. The scaphoid surfaces of the two distal extremities of the radius and the corresponding parts of the scaphoid showed characteristic polishing. X-rays showed a band of condensation corresponding to the ivory region on the articular surfaces. In this case, the bilateral nature and the absence of any obvious macrotraumatic aetiology suggest that the only aetiology was progressive and bilateral ligamentous distension, due to repeated microtrauma analogous to that observed in sports disease (volley-ball) or in occupational diseases (jackhammer). The manufacture of stone tools (carved or polished) can be incriminated in the pathogenesis of these lesions. These lesions are therefore useful markers of repeated microtraumatic activities or "activity markers". The is the first paleopathological description and the oldest known case of bilateral SLAC wrist.

Carpal Bones↗
PubMed1997

[Ulnar nerve fascicle transfer onto to the biceps muscle nerve in C5-C6 or C5-C6-C7 avulsions of the brachial plexus. Eighteen cases].

The authors report 18 cases of transfer of several ulnar nerve fascicles onto the biceps muscle nerve, performed between 1990 and 1997. The patients were between the ages of 17 and 41 years, and presented C5-C6 paralysis in 8 cases and C5-C6-C7 paralysis in 10 cases. The operation was tempted between 4 months and 6 years (m = 17 months) after the initial accident. In the 8 cases of C5-C6 paralysis reviewed, 7 patients recovered elbow flexion and only one required an additional Steindler transfer. In the 9 cases of C5-C6-C7 paralysis reviewed, 4 patients recovered elbow flexion after nerve surgery alone, while 4 patients only obtained elbow flexion after a complementary Steindler transfer. Two of these 4 patients were operated very late (27 and 75 months). Finally, a single 40-year-old patient, operated 28 months after the accident, was considered to be a complete failure. Overall, ulnar biceps nerve transfer appears to be indicated in C5-C6 avulsion, during the months following the initial accident. Flexion against gravity is then regularly obtained in less than 6 months, without any objective or subjective sequelae of the hand.

Adolescent↗