[Anatomy and physiology of the scaphoid].
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Biomedical subjects
Publications and source records attributed to C Oberlin.
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Twenty-six cases of Zancolli's "lasso" procedure are presented. They were part of a series of 122 operations performed for leprosy in Central Africa. Nineteen cases with a follow-up of more than 6 months were reviewed. Fifteen of these patients had good or very good results. When claw hand deformities are supple, one flexor superficialis tendon may be used for two fingers; when the fingers are partially stiff, one tendon for each finger should be used. The "lasso" procedure is simple and the results are satisfactory, particularly in this series of patients who did not follow any rehabilitation program.
The flag flap, elevated from the dorsal aspect of the proximal phalanx, may be employed as a one-stage procedure to cover a loss of soft tissue on the volar aspect of the adjacent finger, the staff of the flap running over an oblique web-space incision.
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The abductor digit minimi (quinti) transfer is an opposition plasty which is rarely used because of the large armamentarium of other possible transfers. However, it is a very good technic to use in radial side dysplasia in children, especially in the case of four-fingered hands in which it can improve the results of pollicisation. A series of 14 cases with 13 "good" or "very good" results is presented. An anatomical study has defined the distal insertion, distinct from that of the flexor digiti quinti brevis, the vascularisation (Mathes's type II) and the innervation of the muscle. The division of the muscle from the pisiform bone is not recommended because of the risk of pedicular injury.
Defects of the skin of the heel need to be repaired by skin which is both thick and sensitive. A technique of isolation of an island flap from the non-weight-bearing part of the medial side of the sole is described. It is vascularised by the medial plantar artery and innervated by the medial plantar nerve. Lesions of the heel, the medial malleolus and the lower part of the tendo Achilles can be covered by a one-stage surgical procedure without microsurgical suture.
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An immunocompromised 29-year-old man presented with a Ralstonia pickettii osteomyelitis affecting the trapezium bone. The patient underwent two surgical debridement stages, including trapezectomy and long-term drainage. The type of the contaminant organism and the trapezium localization make this observation atypical.
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