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Biomedical subjects

F Moutet

Publications and source records attributed to F Moutet.

53 records · Page 3Linked to original sources
PubMed1990

[Three-dimensional imaging of the carpus].

Since 1987, the authors have developed three-dimensional (3D) imaging of the 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. 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↗
PubMed1989

Metacarpo-phalangeal thumb sprains based on experience with more than 1,000 cases.

The metacarpo-phalangeal thumb sprains are very frequent. They mostly occur during sports (50%), and the ulnar collateral ligament is the structure most frequently ruptured (86%). Surgical repair of all severe lesions and/or bony fragment avulsions has led to 90% of good, and excellent results, when the operation is followed by a proper physical therapy. Criteria for evaluation are considered and so is the management of the old or neglected sprains.

Adolescent↗
PubMed1989

[Shearing splints].

The splint proposed here is designed for patients undergoing extensive tenolysis of the long fingers in zone 5. Based on the anatomy, the principle of this splint is to place the flexor tendons of one finger in a short position and its neighbour in a long position and vice versa. This promotes the formation of "long" adhesions allowing independent movement of each finger.

Equipment Design↗
PubMed1989

[Joint lesions of the first column of thumb].

Lesions involving the thumb from the interphalangeal joint to the trapezo-metacarpal (TM) joint are very frequently the result of sports injuries. The authors discuss the most frequent lesions: 1) Dislocations of the metacarpo-phalangeal (MP) joint of the thumb which can be reduced in almost every case by means of well conducted orthopaedic manoeuvres. 2) Sprains of the MP joint of the thumb, very common lesions the severity of which must not be underestimated and which always require surgical treatment in the serious lesions, regardless of the compartment involved (radial or ulnar). 3) Bennett's fractures or fracture-dislocations of the TM joint; when neglected inadequately treated, these lesions lead to disabling post-traumatic arthritis of the TM joint. A poor result of treatment for any one of these three lesions always compromises opposition of the thumb and/or the strength of pollico-digital grip.

Fractures, Bone↗
PubMed1988

[2 cases of early "siliconitis" (silicone synovitis)].

Two cases of early silicone synovitis, 12 and 18 months after surgery for partial scaphoid implant arthroplasty (Swanson design) are reported. None of the implants had been fixed by Kirschner wire or sutured to the radius or an other carpal bone. Both implants had been immobilized for six weeks. Initially the result in both cases was good. Pain and loss of range of movement gradually increased, and a large erosive osteolytic defect of the radius was seen on the X-ray after 12 months for the first case and 18 months for the second one. Surgical revision consisted of implant removal, synovectomy with a proximal row carpectomy in the first case and a soft tissue interposition arthroplasty for the second one. The histologic examination showed a foreign body reaction with birefringent material in multinucleated giant cells. All reports about this type of silicone implant complication emphasises the role of compression forces and micro-fragmentation of the silicone. Should we continue to perform partial scaphoid implant arthroplasty from whom microparticles are creating a severe foreign body reaction?

Adult↗
PubMed1987

Metacarpal fractures.

We have treated 1,080 fractured metacarpals between January 1972 and December 1982. Supported by ten years of experience and this homogenous series, we explain our choices of treatment. With early mobilization of hand and fingers a constant preoccupation to prevent joint stiffening, two main points stand out: active immediate mobilization, considered not as a dismissal but as a treatment, is managed by a specialized physiotherapist and supervised by the surgeon. We applied it in 32% of our cases. Internal fixation is sometimes tricky and always done with great attention to detail. If so, it enables quick recovery of normal amplitudes of movement through the active mobilization allowed by a stabilized fracture. This is what we did in 47% of our cases, using either plates and/or screws, or fine Kirschner wires following G. Foucher's technique. The other techniques used in 21% of our cases are reviewed along with the complications we came across while treating these fractures. The final data review of this series shows 93.2% god or very good, 4.7% fair and 2% poor results.

Fracture Fixation, Internal↗
PubMed1987

[Principles for the functional assessment of the hand].

In the first part, the authors define the parameters needed for a functional evaluation of the hand. Geometric data are analysed in detail and an equi-angular curve used as a model of digital flexion. Mechanical analysis of the thumb using the same method produces a novel evaluation method for thumb movements. Lastly, the authors consider sensibility evaluation problems and the difficulties of obtaining objective data are emphasized. In the second part, the authors stress the necessity of a physiological and global approach and suggest a global evaluation based on elementary patterns of prehension.

Hand↗
PubMed1987

[10 congenital trigger fingers. Apropos of a case report].

Ten congenital triggers fingers have been treated on a 3 years old girl after correction of congenital bilateral club feet. Such a case, without any other congenital malformation seems to be unique in the French literature and only found twice in the English one. This child in spite of a normal growth and good psychomotor development, presents an unusual face, with a mouth a little bit too small, but her karyotype is normal. No trismus and no microstomia were found to enable this case to be classified in a specific syndrome. The right diagnosis may be a non evolutive arthrogryposis of the extremities. Dividing the ten proximal pulleys (A1) let 10 voluminous nodules pass through and allowed full range of motion in nine out of ten fingers. A remaining flexion deformity of the proximal interphalangeal joint needed an anterior arthrolysis, the final result was good.

Abnormalities, Multiple↗
PubMed1986

Reanimation of thumb opposition by the extensor pollicis longus. Report of sixteen cases.

Among some 65 techniques for restoring thumb opposition found in literature, the authors chose the extensor pollicis longus transfer (EPL) onto the abductor pollicis brevis (APB) through the interosseous membrane. This technique described by Duparc et al. in 1971 was codified by Bureau et al. in 1980 using a series of 9 cases. The sufficient force and length of this transfer, associated with its direct course by redirection through the interosseous membrane make it a docile, reliable motor unit as shown by the 16 cases studied. Performed on 11 median-ulnar palsies, 6 isolated median palsies and on one complete avulsion of lateral thenar muscles, only 16 of these 18 transfers could be satisfactorily followed and reviewed from 7 to 35 months later. In our series, 14 of the 16 cases have recovered functional opposition and are using it. After a review of the surgical technique the authors emphasize some practical aspects: dissection of the EPL which may be delicate, resection of the IM which should be adequate, and choice of the reflexion pulley and how to construct it. Results as well as sequelae linked to the choice of the EPL are then analysed.

Adolescent↗
PubMed1984

Controlled postoperative mobilization of sutured extension tendons of the long fingers.

The authors describe a technique of controlled postoperative mobilization of extensor apparatus. They make use of Levame splint in all injuries of extensor-tendons of the last four fingers except for "mallet finger" and "buttonhole". This technique is issued of the so called Kleinert primary suture technic for flexor-tendons and its effectiveness was controlled by electromyography. The Levame splint is used for thirty days and the active flexion is immediately authorized. From 1976 to 1981, 80 cases were treated with this technique and no rupture had happened, and the good results amount to 86%.

Finger Injuries↗
PubMed1984

Value of immediate mobilization in proximal interphalangeal volar plate avulsions.

Volar plate avulsion at the proximal interphalangeal (PIP) joint, either poorly managed or left without treatment, may expose to severe PIP stiffness. The authors systematically employ early mobilization to treat this type of lesion. Rehabilitation is confided to a physical therapist trained in hand rehabilitation and seen weekly or twice a month by the supervising surgeon. In a series of 100 volar plate avulsions demonstrated by X-rays, this kind of easy and adaptable treatment can provide up to 98% of good to very good results. This completely justifies the authors' choice.

Adolescent↗
PubMed1982

Fractures of the fifth metacarpal neck.

The authors reviewed 129 cases of fractures of the neck of the fifth metacarpal. The radiological work-up of this fractures should include an anterio-posterior film with the hand supinated, and an oblique ulnar view with the hand pronated. This fractures can be separated into 4 categories: true cervical fractures; cervico-cephalic fractures; cervico-diaphysary fractures; and epiphyseal separations. In 78 patients an immediate mobilisation was performed. 51 fractures have been treated by multiple medullary pinning because of an unacceptable volar angulation associated with mal-rotation. Good and excellent results were obtained in 86% of cases.

Adult↗
PubMedDate not supplied

Postoperative management of extensor tendon repairs in zones V, VI, and VII.

This paper describes the postoperative management plan for extensor tendon repair in zones V, VI, and VII as conceived by the Grenoble team. This plan includes immediate, postoperative systematic mobilization for all patients with surgical repairs in zones II through VIII. Postoperative mobilization in zones V and VI is performed under the protection of a Levame-type, dorsal steel leaf-blade spring. Depending on lesion location, proximal or distal to juncturae tendinum, Frère's three-finger rule applies. In zone VII, differential tendon gliding between the wrist and finger extensors and surrounding tissue is accomplished with a Tom splint, which gives individual extension assistance to each digit and the wrist while limiting flexion.

Biomechanical Phenomena↗