Search PubMed⌕ Search

Biomedical subjects

F Iselin

Publications and source records attributed to F Iselin.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Surgical indications in the treatment of spastic hand].

Spasticity is the loss of tonus control of some muscles. It is caused by cerebral disorders occurring mostly in children. Their I.Q. and compartmental response to the environment must be considered in evaluating the surgical possibilities. These depends on the types of spasticity which have been classified by Zancolli. Surgical possibilities are not many but should usually improve function. They range from hyponeurotisations to muscle-slide operations or tendons lengthening. Tendon transfers may be useful to rebalance the thumb. Results are evaluated on finger motion, thumb and wrist position, but only in a purely functional standpoint.

Adolescent↗
PubMed1984

[Painful stumps after digital amputations].

Two etiologic groups of painful digital amputation stumps may be seen, each calling for a different type of treatment. One-fourth of painful amputation stumps are due to excessive nociperception and their management usually consists of local treatment. The other three-fourths are due to thalamic sensitive deafferentation and call for neurosurgical treatment if discriminative sensitivity has not been reestablished in the painful zone. Intermittent thalamic stimulation is our choice and has led to recovery in 25 out of 26 patients who have been submitted to this type of treatment.

Amputation Stumps↗
PubMed1984

The transfer of the abductor digiti quinti: palliative treatment for paralysis of the superficial thenar muscles.

Described by Huber in 1921, the transfer of the abductor digiti quinti constitutes an elegant solution to paralysis of thumb opposition. Interest in this operation was renewed and defended by Littler and more recently by Manske and McCarroll. The technique is simple and we do not believe that it is necessary to detach the muscle from its proximal insertion, thus preserving the force of the transfer. The advantages are as follows: elective reconstitution of antepulsion of the thumb column, which supposes that the adductors and the flexors are intact. A small operative field with limited routes of approach reducing scarring to a minimum. The cosmetic advantage is evident with reconstitution of the thenar contour. The functional loss is minor and in our opinion the abductor digiti quinti appears to be less inexpendable than the flexor digitorum sublimis or the extensor pollicis. The limitations of the operation are the absence of functional deep thenar muscles and adductors as well as, of course, the absence of a healthy abductor digiti quinti as in associated ulnar palsy. The results in 8 operations lead us to think that, when possible, the transfer of the abductor digiti quinti is a particularly interesting solution to paralysis in women and children, but probably insufficient in manual hard labor workers, at least in those who need strong abduction of their thumb.

Humans↗
PubMed1984

Cosmetic amputation of the long finger with carpal osteotomy.

Amputations of the third digital ray leave a central gap which can usually be closed by shifting either the second or the fourth digital rays medially. This however calls for an osteotomy with it usual hazards. To avoid metacarpal osteotomy, we have completed the amputation of the long finger in six cases with a central carpal osteotomy through the capitate. This enables the second and fourth rays to be moved intact medially and to close the gap, thus providing a cosmetic three fingered hand.

Amputation, Surgical↗
PubMed1984

Resection arthroplasty with Swanson's implant for posttraumatic stiffness of proximal interphalangeal joints.

Proximal interphalangeal joint resection arthroplasty with Swanson's implant should be considered as a simplified new hinge joint with a simplified shorter but isometric extensor system which will work if the flexor system is intact. The procedure is indicated in cases of severe, ill-tolerated, fixed joint contractures. Functional improvement with restoration of some range of motion can be expected. Patients should be aware that they will not regain a complete range of motion at the PIP joint, there will be limited involvement of the distal interphalangeal joint, and there may be some discomfort in cold weather. The procedure is not recommended for patients with a high risk of postoperative dystrophy, on workmen's compensation, or unable to understand the goals and limitations of a joint resection arthroplasty.

Arthroplasty↗
PubMed1983

Skin problems in the treatment of the finger "en crochet".

The study of 33 fixed flexion contractures of the finger shows that after tenolysis or teno-arthrolysis a skin gap appears when the finger is extended. Only 10 cases out of 33 had previous cutaneous involvement. The necessary skin plasties have been 14 heterodigital flaps and 19 local dorsal-lateral flaps. Results are comparable in both series and the surface of the skin defect has no influence on the choice of the type of flap. Therefore, whenever possible, a local flap is preferred to a distal flap.

Cicatrix↗
PubMed1983

Fixed post-traumatic flexion-contractures of digits. Review of thirty-three cases.

A fixed post-traumatic flexion contracture of a finger is usually secondary to multiple previous operations. We have observed that a former flexor tendon laceration is not constant and is missing in 18% of our cases. The flexor tendons are, nevertheless, always involved in the contracture. A volar skin contracture was present in all cases, but only in half of them was noted a retraction of the volar components of the PIP joint. This articular involvement has no statistical correlation with the time elapsed from the onset of the contracture. We have reviewed 33 cases of post-traumatic flexions contractures of the digits all secondary to volar trauma. In every case there was at least a flexor tendon adhesion and skin contracture. They have all been submitted to both objective and statistical analysis. Results have been evaluated by comparison between the normal functional range of motion for each digit and the actual post-operative active range of motion. On the basis of our study we conclude that the age of the patient is an important prognostic factor. We obtained 75% satisfactory results in patients younger than 27 years, but only 22% in the older group. Good results are more easily obtained in radial (65%) than ulnar digits (31%). While the authors rated 39% of the results bad, half of the patients in this group were satisfied with the result. A volar PIP joint release has been necessary in half of the cases with no significant secondary joint stiffness. A skin flap is necessary to cover the cutaneous defect secondary to the release. There is no statistically significant advantage to cross finger flaps. Therefore we feel that local flaps are indicated except in the cases where local scar tissues would not make it, feasible. The prognosis is independent of the number of previous operations and of associated nerve lesions. Therefore amputation is not the only solution for a multi-operated finger fixed in flexion.

Adolescent↗
PubMed1982

Treatment of old introclable lesions of the extensors of the middle finger by resection arthroplasty with implant.

Traumatic boutonniere deformity may become fixed and cannot be reduced when the joint cartilage become altered. We propose a resection arthroplasty with a Swanson's silicone implant as a valuable solution for this problem as it simplifies the joint and the extensor apparatus. We use a transverse approach through the extensor tendon which enables to restore a good balance between bone and tendon and seems to avoid some adhesions. Results of 17 operations with a minimum follow up of 12 months show that 40 degrees of motion have been recovered in an angle sector which corrects the deformity. The final evaluation is good if compared to the severity of the initial status.

Adolescent↗
PubMed1977

A simplified technique for treating mallet fingers: tenodermodesis.

Tenodermodesis is a useful surgical procedure in cases of mallet fingers where conservative treatment has failed. The results have been satisfactory in 22 of 26 patients. These results all have been achieved within 60 days and with no more than 35 days of permanent splinting of the distal part of the digit. The final range of motion depends on the patient and on the patient's age; this procedure should not be proposed for elderly patients. The operation is not performed until 3 months after the initial trauma and until formal request from a patient who cannot tolerate this small disability. We recommend local anesthesia for this procedure. Thus with a small incision, without hospitalization, and with minimal splinting and immobilization, this procedure provides a simple treatment for a minor lesion, a principle which never should be forgotten.

Adult↗