Search PubMed⌕ Search

Biomedical subjects

C Oberlin

Publications and source records attributed to C Oberlin.

At least 55 records · Page 3Linked to original sources
PubMed1997

Distal insertions of abductor pollicis longus muscle and arthritis of the first carpometacarpal joint in 104 dissections.

The different types of distal insertions of the tendons of the abductor pollicis longus muscle (APL) were studied in 104 cadaveric hands, and the appearance of the rhizarthrosis in the level of the basal joint of the thumb, as well, in a try to detect possible anatomical relationships. From the anatomical point of view, it was evident that the insertions of the APL muscle are usually multiple (95%), that the insertion to the base of the first metacarpal is constantly present, accompanied in 70% of the cases with an insertion to the trapezium. Finally, the accessory tendon to the thenar eminence was proved to be extremely frequent (42%). Rhizarthrosis has been found in 97% of the dissections. The lateral compartment of the joint surface appeared to be the most frequently affected with arthritis (71%) and probably the starting point of the lesion. But no correlation has been recorded between severe arthritis and any type of distal insertion of abductor pollicis longus muscle. Early tenotomy of some tendons, in order to prevent arthritis of the first CMC joint, cannot be recommended from this study.

Arthritis↗
PubMed1996

[New metacarpal osteotomy: metacarpal cervicocapital shortening osteotomy of the rheumatoid hand].

Volar dislocation of the four long fingers is a common situation in rheumatoid hands. Surgical reduction is rather difficult because of soft tissue retraction, especially interosseous muscles, and requires large releases. The authors propose the use of Weil's osteotomy, initially described in foot surgery. This is an oblique cervico-capital osteotomy which shortens the metacarpal bone, fixed by two screws. This makes soft tissue release less extensive and facilitates relocation of the extensor tendon. Two cases are reported.

Aged↗
PubMed1996

[Reconstruction of the loss of bone substance of the forearm by cubitalization of the radius (one bone forearm). Apropos of 6 cases].

Extensive forearm bone loss, whatever its etiology, presents a difficult reconstruction problem. This is mainly the case in the presence of lesions of the interosseous membrane associated with the radio-ulnar joint. When preservation of forearm rotation is not possible, cubitalization of the radius and reconstruction of the forearm by creation of a "one bone forearm" seems to be an excellent salvage technique both functionally and cosmetically. Our experience concerns six clinical cases; two of these cases are original and give the authors the opportunity to describe a new reconstructive technique of the distal humerus and elbow by vascularized transfer of the radius onto the radial artery (with a cutaneo-osseous transfer in one case). The etiology of the bone defect included severe trauma in three cases, and a Volkman's syndrome complicated by osteomyelitis in one case. Two cases represent an original technique of reconstruction of the distal humerus by a vascularised transfer of the radius onto the radial artery. Forearm reconstruction is performed by cubitalization of the radius. The etiology was traumatic in one case and neoplastic in another, and a cutaneo-osseous transfer was performed in the latter case. In this difficult problem of bone reconstruction, a favorable functional and cosmetic result was obtained in our series.

Adult↗
PubMed1996

Median nerve suture in the distal part of the forearm. MRI evaluation.

The aim of the study was to assess MR images of median nerve suture in the distal part of the forearm on fresh cadavers and injured patients. The median nerve was dissected in the distal one-third of the forearm in four fresh cadaveric specimens, divided and repaired in three of them in two cases with 3/0 nylon (one with well-apposed edges and the other with a lateral gap) and, in the third specimen, with 9/0 nylon with well apposed edges. The course of the median nerve was then studied on MR imaging in different planes and the quality of the nerve repair was evaluated. A good correlation was found between the MR images and the type of nerve suture. These findings were applied in management of two clinical cases in whom reexploration and revision of the median nerve repair was carried out.

Adult↗
PubMed1996

Incidence and distribution of scaphotrapezotrapezoidal arthritis in 73 fresh cadaveric wrists.

The STT joint was examined in 73 fresh cadaveric specimens (25 male and 48 female with an average age of 84 years) with a view to study the incidence and characteristics of degenerative changes in this joint. The articular degeneration was graded from 0 to 3 according to increasing loss of cartilage and the location of the changes was noted. At the same time, the presence and extent of concomitant trapezio-metacarpal arthritis was noted. 61 of the 73 hands (83.3%) were found to present STT arthritis. Degeneration of the trapezoid articular surface was:- more frequent: 53 hands (72.6%) as compared to 48 (65.7%),-of greater severity: 40 cases (55%) of grades 2/3 as compared to 25 (34%), than that of the trapezium. Concomitant or isolated arthritis in the trapezometacarpal joint (90.4%) was present in 66 of the 73 hands (79%) examined with grade 3 changes in 13 cases. The apparent predominance of degeneration in the scapho trapezoidal articulation could, perhaps, lead us to assume that this might be the site of origin of STT arthritis. It could also explain the persistence of symptoms following prosthetic replacement of the trapezium.

Aged↗
PubMed1995

Surgical correction of pseudo-ainhum in Vohwinkel syndrome.

Vohwinkel syndrome or hereditary mutilating keratodermatitis is a rare condition producing palmoplantar hyperkeratosis and constricting rings of the fingers and toes which can progress to compromise neurovascular function and mobility. Medical treatment with oral retinol derivatives is recommended when its use is not contra-indicated. This paper describes surgical correction of the constricting rings on both hands in a 33-year-old woman affected by this condition.

Adult↗
PubMed1995

The by-pass extensor tendon transfer. A salvage technique for loss of substance of the extensor apparatus in long fingers.

A salvage technique for the treatment of substance loss of the extensor apparatus with some special features is presented. It uses the extensor indicis muscle prolonged with a tendon graft. The tendon is directly attached to the middle phalanx. After surgery, the wrist is immobilized in extension, allowing immediate active mobilization of the PIP joint. The results in five patients are satisfactory.

Adolescent↗
PubMed1995

[Fibro-osseous pseudo-tumor of the fingers. A little known entity. A case of an 11 year-old girl].

The authors report a case of fibro-osseous pseudo-tumour affecting a long finger. This is a rare tumour difficult to diagnose. Complete excision of the tumour was delayed till two years after its appearance as it's true nature had not been recognised at the time of the initial histopathologic examination. It is a benign tumour with a good prognosis as it does not undergo malignant degeneration and does not recur locally if excision has been complete. Errors in interpretation of the histopathologic picture have, in the past, led to unwarranted amputations of the involved fingers.

Child↗
PubMed1995

The posterolateral malleolar flap of the ankle: a distally based sural neurocutaneous flap--report of 14 cases.

The posterolateral malleolar flap is a fasciocutaneous flap designed on the principles of distally based neurocutaneous flaps. It is based distally at the level of the lateral retromalleolar gutter. Elevation of the flap involves the proximal sectioning of the sural nerve, which contributes to its vascularization by reversed flow. This is a very reliable flap, even in patients with distal arterial insufficiency. For this reason, it has emerged, in our experience, as the method of choice in the treatment of heel necrosis. Fourteen cases are reported, of which six were elderly patients.

Adult↗
PubMed1994

Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases.

Four patients with C5-C6 root avulsion after brachial plexus injury were treated with a transfer of part of a normal functioning nerve in the arm to the motor nerve of the biceps. Ten percent of the bulk of the ulnar nerve was harvested for a suture directly to the motor nerve of the biceps with no significant impairment of hand function.

Adolescent↗
PubMed1994

[The spinal accessory nerve (n. accessorius) I: anatomical study].

INTRODUCTION: In order to increase knowledge of the spinal accessory nerve concerning its situation, trajectory and terminal branches and also the connections with the cervical plexus, the authors report an anatomical study based on 11 dissections of the trapezius muscle mode of innervation and the connections between the accessory nerve, the sternocleidomastoid and trapezius muscles. DISCUSSION: The accessory nerve is a muscular nerve and supplies the main innervation to the trapezius muscle especially for the superior and middle sections. There is a clear participation of the cervical plexus either through the trapezius muscle by nerve anastomosis behind the trapezius or directly especially in the distal portion. CONCLUSION: This anatomical study allows a better understanding of the clinical aspects and the indications of nerve repairs.

Aged↗
PubMed1994

[Traumatic lesions of the spinal accessory nerve. II: clinical study and results of a series of 25 cases].

INTRODUCTION: Trapezius muscle paralysis after accessory nerve injury was mostly seen after a so called minor surgery of the neck: 17 lesions among 25 appeared after the excision of a cervical cyst or a small benign tumor. This notion should be remembered because the prevention of this paralysis is easy. MATERIAL AND METHODS: In the established lesion, the repair is to be done as soon as possible. The authors report a retrospective study of 25 cases of traumatic accessory nerve injury, followed from 1983 and 1992. A nerve repair was done in 15 cases. It consisted in an average 5 centimeters graft in 10 cases, an intramuscular neurotization in 4 cases, a direct suture in 1 case, and a neurolysis in 6 cases. A palliative treatment was suggested in 4 cases. RESULTS: The mean follow up was 15 months (range 6 to 57 months) and 22 operated cases had more than a 1 year follow up. We observed 10 good results for 10 grafts, 1 good result after 1 direct suture; the 4 neurotisations has 3 good results and 1 average result; the 6 neurolysis had 1 very good, 4 good and 1 poor results and in one case there was no possibility of repair. DISCUSSION AND CONCLUSION: The authors underline the good results after nerve repair following a lesion near from the paralysed muscle and also the need for prevention.

Adolescent↗
PubMed1994

The anatomy of the palmar scaphotriquetral ligament.

The palmar ligaments of the wrist were dissected in 15 adult cadaver wrists and demonstrated by MRI in three. Ten fetal wrists (10 to 19 weeks' gestation) were studied in histological sections. The palmar scaphotriquetral ligament was found in them all. Its attachment to the triquetrum is substantial but that to the scaphoid is thin and fan-shaped, its fibres interdigitating with those of the radioscaphocapitate ligament. The contribution of the ligament to carpal stability has yet to be studied, but it may help to support the head of the capitate when the wrist is dorsiflexed.

Adult↗
PubMed1993

[GUEPAR total trapeziometacarpal prosthesis in the treatment of arthritis of the thumb. 36 case reports].

The authors review a series of 36 total GUEPAR trapezometacarpal arthroplasties, performed between 1981 and 1990 in 32 patients, with a Dell stage III or IV carpometacarpal arthritis of the thumb (primary arthritis = 34 cases; secondary arthritis: 2 cases, 1 case of chondrocalcinosis, 1 case of osteochondromatosis). Scaphotrapezial arthritis present in 7 cases is not a contraindication to total arthroplasty. The mean follow-up period was 3 and a half years, with a range of 1 to 9 years. Functional results were considered to be good in 89%, without limitation of activity. X-ray study shows: 1) A radioclinical concordence in 64% of cases with good clinical and X-ray results, stable in the long term. 2) A radioclinical discordance in 22% of cases with good functional result but mobilisation of metacarpal stem. 3) Failure in 5 cases (14%) with unsealing and trapezial fracture. This radioclinical study yields two failure factors: preoperative destruction of trapezium in all the failures and these cases are now a contraindication to the prosthesis and inadaptation between stem arthroplasty and metacarpal cavity. This study supports total arthroplasty in trapezometacarpal arthritis of the thumb: III or IV Dell's stage, with preserved trapezium configuration.

Adult↗
PubMed1993

Partial replantation after traumatic proximal lower limb amputation: a one-stage reconstruction with free osteocutaneous transfer from the amputated limb.

A case of immediate stump reconstruction following proximal leg amputation below the knee is reported. Additional length and sensation are conferred to the stump by free autotransplantation of a composite flap taken from the unsalvageable amputated leg. This flap provided 13 cm of vascularized tibia invested in the skin of the foot. This operative procedure facilitated the fitting of a prosthesis and preserved knee function despite an initial very proximal amputation.

Adult↗
PubMed1993

[Traumatic lesions of the trunk of the femoral nerve and its terminal branches. Apropos of 52 cases].

Fifty-two cases of nerves injuries involving the sciatic nerve or one of its two main branches (tibialis or peroneal nerve), between the sciatic notch and the knee, were treated by nerve grafts or nerve sutures. 26 cases were injured in the thigh. They were treated by 11 nerve sutures followed by good results in isolated lesions, and 15 nerve grafts. In 9 cases nerve loss was short and fascicular graft was possible. Clear cut injuries had satisfactory results. In 6 cases, nerve loss was extensive (> 10 cm), especially after sciatic nerve disruption following femoral bone fracture. There was not enough nerve graft available to repair the entire sciatic nerve. Tibialis nerve repair was chosen to restore plantar sensitivity. A vascular nerve graft of peroneal nerve could restore plantar sensitivity in all cases. 26 cases were injured around the knee and involved the peroneal nerve. In 12 cases the lesion was clear cut, treated in 10 cases with a short fascicular nerve graft, and in 2 cases by a suture. In most of the cases, results were good, better than that those obtained after tibialis posterior transfer. 14 cases had peroneal nerve disruption after a severe lateral sprain of the knee. Nerve damages were extensive and results were poor. Tendon transfer had to be done quite often.

Adolescent↗