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Biomedical subjects

C Oberlin

Publications and source records attributed to C Oberlin.

At least 73 records · Page 4Linked to original sources
PubMed1992

Three-dimensional reconstruction of the carpus and its vasculature: an anatomic study.

Three-dimensional reconstructions of the carpus have been assembled from tomographic data of anatomic specimens after vascular injection with resin polymer of a density similar to that of bone. We have been able to produce three-dimensional reconstruction of the relationship between carpal bones and their vasculature. Fine tomographic slicing, on the order of 1 mm, has yielded sharp definition of bone structure, particularly of the entry points of nutrient vessels. The use of a very fluid synthetic resin has made possible the definition of vessels of fine caliber. A computerized program of three-dimensional reconstruction was used to obtain a series of views spaced at 10 to 20 degrees at predetermined right-angled axes. This has provided a precise matching of vessels with their corresponding points of bony penetration. This new method of imaging has enabled us to describe the entire vasculature of the bones of the carpus. The technique enjoys a number of advantages over conventional methods of study of carpal vasculature. In practice, the various known methods of arteriographic and digital angiographic examination do not have the same high definition and are unable to eliminate the effect of superimposition of views. In addition, the dissections are difficult and are likely to produce significant artifact. Corrosion techniques are elegant, but they are time-consuming, delicate procedures if selective isolation of bone and vasculature is required.

Arteries↗
PubMed1992

[Total paralysis of the brachial plexus caused by supra-clavicular lesions].

From 1983 to 1987, 50 adult patients who suffered total palsy of brachial plexus were operated on. The average follow up was 39 months. They suffered severe supra-clavicular lesions of all the roots. All the roots damaged in the scalenic area were grafted, the avulsed ones were not. One root was grafted in 23 patients, two roots in 9 patients, three roots in 5 patients, four roots in 1 patient. No root was grafted in 12 patients. An active flexion of the elbow (over M3+, M4) was recovered in 39 patients (76 per cent). An active adduction of the shoulder (m. pectoralis major) was recovered in 24 patients (48 per cent), and an active abduction (supraspinatus or deltoid) in 13 patients (26 per cent). Twenty seven patients had severe pain before surgery. After grafting, pain decreased in 17 (62 per cent. At follow-up, 31 of the 50 patients had no pain or mild pain. These results justify for the authors nerve repair in total palsy of brachial plexus by supra-clavicular lesions.

Adolescent↗
PubMed1992

[High-resolution MRI of the carpal tunnel. Anatomical correlations].

This anatomical study of the carpal tunnel compares magnetic resonance imaging sections and adult and fetal anatomical sections. The MRI studies were carried out in 12 normal controls. The use of an experimental high resolution module allows achieving as high a degree of spatial resolution as 0.13 mm2. The comparison of MR images with anatomical sections allows a very accurate analysis of the contents of the carpal tunnel, especially of the median nerve, of the flexor tendons and of the flexor retinaculum.

Adult↗
PubMed1991

[Digital flap autografts for pulp coverage in distal amputations of the fingers. 68 flaps].

Sixty-one patients underwent 68 digital pulp amputations involving the distal phalanx (Zone 2 and 3). 46 unipedicular Vankataswami-Subramanian island flaps (VS flap) and 22 bipedicular Moberg-O'Brien flaps (MOB flap) were performed. All distal thumb amputations were treated by MOB flap, whereas all lateral finger distal amputations of the long digits were treated by VS flap. Both flaps were used for the other types of amputation. Four digits developed complications and needed a delayed regularisation. The mean follow-up for the 46 flaps was two years. Pulp reconstruction was satisfactory in all flaps. Sensation was normal or slightly decreased in 66%. Nail dystrophy was considered to be poor in 56% and was attributed to initial trauma and the distal phalanx shortening. 20 degrees of extension deficit was found in 8 patients. We obtained 61 excellent and good results justifying our indications: MOB flap for all types of distal amputation of thumb in zone 2 and 3, VS flap for lateral distal amputations of the long fingers. In transverse amputation of the long fingers, MOB flaps seem to give better results than VS flaps.

Adult↗
PubMed1991

[Necrotizing fasciitis of the upper limb. 12 cases].

Twelve cases of necrotizing fasciitis or streptococcal cellulitis of the upper limb are reported. Four cases presented with a low grade aggressive for and one case was chronic. Seven fulminating cases resulted in two deaths. These different presentations are in fact different stages of the same disease which is a group A beta-hemolytic streptococcal necrotizing infection of the subcutaneous tissue. It is a medical emergency in which surgery is the main treatment. In cases seen early, surgery helps by making an early diagnosis by showing the typical appearance of the subcutaneous tissue and by isolating organisms in wound culture. In fulminant cases, only extensive surgical debridement can control infection. Delayed or incomplete radical excision may lead to disseminated infection. Infection spreading beyond one upper limb worsens the vital prognosis.

Adult↗
PubMed1990

[Anatomy of the articular nerves of the wrist. Implications for wrist denervation techniques].

The knowledge of the anatomy of the wrist articular nerves is at the base of the denervation technique. After a dissection of 12 adult wrists, we specify the situation and the relation of these nerves at the level where they are accessible to a surgical approach. The 10 articular branches of Wilhelm are described successively. The posterior interosseous is the most voluminous and most constant. Some branches need a specific surgical approach: anterior and posterior interosseous nerve, lateral cutaneous nerve, articular branch of the first web. Other nerves are cut blindly after skin undermining (perforating branches from cutaneous nerves). Some branches appear inaccessible to a cautious surgery because they are closely tight to other motor branches (deep branches of the cubital nerve). Finally some branches described by Wilhelm were not found in our dissections: branches of the median palmar cutaneous nerve, and direct branch of the cubital nerve.

Classification↗
PubMed1988

Fractures and non unions of the proximal pole of the carpal scaphoid bone. Internal fixation by a proximal to distal screw.

We report a new proximal to distal screw fixation technique for proximal pole fractures and non unions of the carpal scaphoid (type I of the Schernberg, Elzein and Gerard classification). Seven cases of non union with a live proximal polar fragment were operated from 1984 to 1986 with 4 excellent and 2 fair results and one failure. Three recent displaced fractures were also treated this way, with 3 excellent results. This useful technique is worth knowing and deserves a place in the treatment of scaphoid fractures, especially type I proximal pole fractures which represent a challenging problem, and are in no way comparable to other locations.

Bone Screws↗
PubMed1988

Opponensplasty through translocation of the flexor pollicis longus. Technique and indications.

Eleven cases of opponensplasty by translocation of the flexor pollicis longus are reported. Some technical points ought to be outlined: this translocation is mostly performed through a fused IP joint; the level of the reflection of the translocated tendon should necessarily be the neck of the first metacarpal bone. Nine cases were reviewed with eight very good results. There are very few indications for this technique: total palsy of thenar muscles with stiff IP flexion deformity of the thumb, whenever a fusion is indicated. Particular cases of high-level palsy of the upper limb, when no other transfer can possibly be used.

Arthrodesis↗
PubMed1988

[Covering losses of cutaneous substance of the leg and foot using skin flaps. Apropos of 76 cases].

Between 1983 and 1987, 76 flap grafts were performed in the leg and foot. In general, 3 types of flap were used: --51 ipsilateral flaps, the majority of which were musculo-cutaneous flaps from the medial head of gastrocnemius (17 cases). --17 cross-leg flaps from the opposite limb, the majority of which were medial fascio-cutaneous flaps (13 cases). --8 free flaps, making use of microsurgical techniques. The indications for cross-leg flaps and free flaps have become more limited in favour of local regional pedicle flaps. The lower part of the leg and amputation stumps in the foot are easily covered by distal leg pedicle flaps and amputation stumps of the upper third of the leg can be covered by a flap of fascia lata with a distal pedicle based on the superolateral branches of the peri-articular plexus of the knee.

Cicatrix↗