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Biomedical subjects

F Moutet

Publications and source records attributed to F Moutet.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Fractures and luxations of the thumb].

The integrity of the first carpometacarpal column determines the mobility of the thumb in space and thus opposition, a fundamental function of the human hand. Fractures and dislocations of this architecture can jeopardize its function. Joint lesions lead to instability or incongruity and subsequent post-traumatic stiffening arthrosis. Diaphyseal fractures can put out of axis or lead to abnormal rotation which impair the flexion and overall function of the thumb. Great attention should therefore be given to the anatomical reconstruction of these lesions. Open, unstable joint or periosteal fractures should be surgically reduced and a rigid fixation should be used. Dislocations require emergency treatment and in case of postreduction instability should be immobilized.

Emergencies↗
PubMed1994

[A comparative study of the "Levame" type extension splint and the "Low Profile" type extension splint: impact on therapeutic indications].

The most widely used dynamic extension systems, both to straighten the digital flexion retractions as well as to ensure directed mobilization after surgical repair of extensor tendons, are the so-called "Levame" and "Low Profile" splints. This study analysed the application of forces for these two types of extension splints, the directional constraints which they impose and freedom of joint movement which they allow in order to more clearly define the type of motorization to be used as a function of the most frequent indications.

Equipment Design↗
PubMed1994

[Restoration of opposition using the extensor pollicis longus. Apropos of 8 cases reviewed after 11 years].

Moutet and coll. had studied in 1986 a series of 16 cases of restoration of thumb opposition by extensor pollicis longus transfer onto abductor pollicis brevis through the inter osseous membrane. Eleven years follow-up revision of 8 of those 16 patients was performed by the authors. Indication of transfer was traumatic median nerve isolated palsy or associated to ulnar nerve palsy. Objective and subjective analysed parameters allowed to check the evolution of the transfer and to justify its indications. No transfer retraction has been noted in long term follow-up. The side effects of its removal (thumb retropulsion and MP extension defects) have minimum functional consequences. The opposition has been restored at the time of thenarians recovery and as well, each time the palsy was going on. In the cases where the thenarians recovered, the transfer became an antepulsion supply. The authors suggest to perform an opposition transfer, each time it is technically possible, in severe median nerve lesions, at the time of emergency operation.

Adolescent↗
PubMed1994

[The evaluation of the Artem grip in its function assessment].

The aim of our study is to assess the Artem pincers efficiency, which is both a new grip strength instrument and a hand reeducation instrument. It is original through its pleasant good looking and it offers many different programs of use. This study was carried out involving 60 healthy subjects. We compared the Artem system with two other measurement instruments of reference (Jamar for grip strength and Pinch-Gauge for pinch strength). With this Artem system we also studied two other originals tests: 1) Evolution of hand and finger strength within 15 seconds. 2) Tiredness test. Our measurements demonstrated good high correlation and high reliability between reference instruments and Artem system dealing with strength measurements. We can't conclude about the two original program's statistics, but it would probably be interesting to compare these with a group of patients in course of reeducation.

Adult↗
PubMed1994

[A new titanium-carbon finger joint implant. Apropos of 15 initial cases].

Arthroplasty of the MP and PIP joint remains a therapeutic challenge for the hand surgeon. The poor results of the currently available implants are due to their mechanical conception (non strained) or their material (silicone causing instability, ruptures and silicone synovitis). The authors present the preliminary results of a new digital articular implant (IAD). It is a strained implant with a rigid hinge allowing 105 degrees of range of movement (0 degree to 105 degrees). Three sizes are available and very soon four. The intramedullary stems are in titanium alloy (TA6V) and the gliding surfaces in pyrolytic carbon. This association allows solidity, endurance, excellent gliding and no wear debris. 15 implants were evaluated (13 PIP and 2 MP joints) with a follow-up from 4 to 1 year. A painless range of motion were restored in 11 cases and 4 articulations were only lightly painful during motion requiring strength and at the end of the movement. The gain of the range of movement was 50 degrees always in a useful sector. The grasp was 60% better in post than in pre operative conditions. No infection was found. It is only the beginning of this implant but the indications seem to be good for all the articular destructions of the digital joints what ever was the aetiology (traumatic, infection or rheumatoid arthritis).

Adult↗
PubMed1994

[A proposal for a functional evaluation record for the hand].

Proposition of a new evaluation method included an analytic cotation, a functional cotation, and a cosmetic cotation. Use is speeded by the suppression of all kind of measure instrument and facilited by pictures. Application to the corporal damage evaluation.

Disability Evaluation↗
PubMed1994

[Use of an implanted electrode for rehabilitation after tenolysis of the flexor tendons].

The electric stimulation is widely used in flexor tenolysis rehabilitation by the authors. Since 1983 implantable electrodes were used during the operative procedure. Actually they gave better access to the deep muscles (Flexor Profundus of the index), better specificity, less dysesthesia of the skin. Further more they allowed to tests the quality of the tenolysis without wrist incision. This procedure gave 76% of good or very good results over 25 finders in 20 patients. The results were especially good for the index finger which is usually unable to be stimulated by the surface electrodes and for the fingers badly damaged. In this type of situation prognostic was getting better (70% of good and very good results).

Adolescent↗
PubMed1993

[Subcutaneous rupture of long finger flexor pulleys in rock climbers. 12 case reports].

Rock climbing generates a new type of microtraumatic, stress pathology involving all of the osteoarticular chain of the upper limb. The hand is the site of specific lesions: pulley ruptures (A2) are the most frequent. 12 top-level climbers (7a and above) were reviewed out of a series of 23 cases. In 7 cases, the ring finger was affected and in 5 cases the middle finger was affected. All cases were treated by rest and protection of the A22 pulley with an external rigid ring. Progressive return of climbing was allowed after the 45th day. The effects on the level of performance, residual pain and its consequences, and on associated lesions of the upper limb were investigated. 8/12 patients regained at least their previous level of performance and 6/12 no longer experienced any pain. 5/12 patients experienced minor pain which did not affect their level of performance. One patient had to stop top-level climbing because of persistent pain. Protection of the pulley, possibly combined with syndactylisation and complete rest, not only from sports activities, for at least 45 days are the best way of ensuring a satisfactory functional result in these particularly demanding subjects. Physiotherapy and non-steroidal anti-inflammatory treatment can also be combined.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

[Synthetic ligament reconstruction of the thumb metacarpophalangeal joint. 21 cases].

Since 1984, the authors have performed ligamentoplasties of the metacarpophalangeal (MP) joint of the thumb with Dacron mesh. A series of 21 cases is reviewed and tested clinically with a mean follow-up of 34 months. The MP joint remained stable. Loss of flexion of the MP joint was 30% of the healthy side. The mobility of the interphalangeal joint remained normal. Opposition ranged between 8 and 10/10 for 20 of the 21 patients. The mean overall reduction in strength was 30% on the dominant side and 20% of the non-dominant side. Apart from two failures by arthrodesis, all patients were very satisfied with their operation.

Adolescent↗
PubMed1993

[Protected early mobilization using Levame's device after primary repair of the extensor tendons of the hand. Apropos of a series of 88 cases].

Seventy patients with 88 lesions of the hand extensor apparatus were treated by primary repair followed by post-operative mobilisation with a dynamic steel blade splint (Levame). Results were good or very good in 97.7% of cases and moderate in 2.3% of cases for this series of simple lesions from zones 3 to 6. Prognostic factors influencing final result and wrist position during splint are discussed, the authors leave the wrist free for lesions in zone 3 and 4. Early mobilisation is the best treatment for tendinous lesions and a review of the literature confirms the validity of the author's choice. In spite of its biomechanical deficiencies, this simple technique may be used for non-disciplined patients and by non-specialized physiotherapists. For simple lesions of extensor tendons, the Levame splint may be considered as a real dynamic protective splint.

Adolescent↗
PubMed1993

[Congenital cutaneous aplasia. Apropos of 3 new cases located in the vertex].

Aplasia cutis congenita is a rare malformation characterized by absence of skin. We report three new cases, localized on the vertex with one appearing as a familial form and requiring an emergent surgical repair with a favorable outcome. After a review of the literature, the authors discuss nosological aspects and etiological problems which are still not resolved. It seems that vascular differentiation of the skin could play an associated role. As regards of treatment, different attitudes are possible and are exposed, with a preference for surgery which is the method of choice for the authors.

Abnormalities, Multiple↗
PubMed1991

[Urgent nature and severity of lesions due to high pressure injections in the hand].

High pressure injections in the hand and fingers are relatively rare accidents, but are responsible for serious lesions. Only extremely urgent treatment can minimise the aesthetic and functional sequelae. This treatment must include debridement of the portal of entry, exposure of all the contused and devitalised tissues and broad spectrum antibiotics. The postoperative course must include long and patient rehabilitation for these lesions which actually correspond to severe contusion of the hand and fingers associated with a high risk of septic dissemination. The authors describe these lesions based on a series of 20 consecutive cases.

Amputation, Surgical↗
PubMed1991

[Role of neurolysis of the posterior tibial nerve in plantar perforating diseases of diabetic origin].

Perforating ulcers of the foot in diabetics constitute a difficult therapeutic problem. In a series of 17 cases, the authors stress the value of tibial nerve neurolysis associated with periarterial sympathectomy which results in cure of the 15 patients treated within 30 days. Although no electromyographic improvement was observed, perfusion studies and oxymetry demonstrated an improved local vascular situation which promoted healing.

Adult↗
PubMed1990

[Three-dimensional imaging of the carpus].

Since 1987, the authors have developed three-dimensional (3D) imaging of carpus. This reconstruction based on 30 CT scans of the carpus is a new approach to imaging and allows spatial visualisation of the complex shapes of the carpal skeleton from all angles and views. The development of this technique should lead to a better understanding of the intimate physiology of the carpus and should allow the development of a real simulator of the wrist for precise planning of surgical procedures (osteotomy, intracarpal arthrodeses, etc.). It also helps to elucidate complex pathological images which are not always easy to interpret on CT scans.

Carpal Bones↗
PubMed1990

[Three-dimensional imaging in plastic surgery. Application to the carpal bones and skull].

Since 1987, the authors have developed three-dimensional (3D) imaging of the carpus. This new application of imaging allows spatial visualization of the complex shapes of the carpal skeleton from all angles and from all illuminations. The development of this technique should lead to a better understanding of the intimate physiology of the carpus, allowing the construction of a model of the wrist enabling precise planning of operative procedures. It also helps to elucidate complex pathological images which are sometimes difficult to interpret on computed tomography scans. In parallel, the same process has been developed for the skull. It is particularly useful in cranio-facial surgery, especially in congenital deformities. Progress in this technique should allow surgical simulation on a video screen in the very near future.

Carpal Bones↗