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Biomedical subjects

F Schernberg

Publications and source records attributed to F Schernberg.

35 records · Page 2Linked to original sources
PubMed1983

Isolated traumatic dorsal dislocation of the distal radio-ulnar joint. Report of seven cases.

The authors report seven cases of isolated dorsal dislocations of the distal radio-ulnar joint. Four were recent dislocations and three were old, chronic dislocations. Acute dislocations were treated surgically. An anatomic study on human cadavers enabled us to define the injuries responsible for radio-ulnar dislocations. An electromyographic study of the extensor carpi ulnaris confirmed its role as a dynamic stabilizer of the ulnar head. Two of the three old dislocations were revised after an attempt at ligamentous reconstruction. These patients benefitted from a resection of the ulnar head. The third patient one underwent a Sauve-Kapandji procedure. Cadaver studies underline the fact that ligamentous reconstruction procedures are actually tenodeses.

Acute Disease↗
PubMed1983

Thirty cases of duplication of the thumb. Operative results.

Thirty cases of duplication of the thumb have been seen during a period of 8 years. Twenty-four children underwent surgery for a total of 25 operations, and these are reviewed after a follow-up of at least a year. Wassel's type IV was the most frequent type, occurring in 14 cases. There were 23 primary operations, and 2 reoperations for frontal deviation, which were secondary to operations done elsewhere. The average age at the time of operation was 16 months, the mean follow-up is 4 years (1 to 8 years). The results are analyzed according to Wassel's criteria. Regardless of the location of the duplication, function is unaffected, the structure of the thumb is good, and the parents are satisfied. However, examination revealed some loss of mobility in 10 cases, shortening of the thumb in 5 cases, instability of the collateral ligament in 3 cases and axis deviation in 10 cases. Six of these were clinodactyly at the IP, 1 a clinodactyly at the MP and 3 Z-shaped deformities at the IP and MP. The two reoperations were done to correct a significant loss of alignment, and in each the result was upgraded from "poor" to "fair". It seems that the end results are determined at the original operation which should be done before the 18th month. The thumb with the least function, usually on the radial side, is resected and the remaining component reconstructured. This includes centralization of the insertions of the extrinsic muscles, and reinsertion of the thenar muscles. Immobilization by pinning is usually done due to the need for an osteotomy during the surgery for realignment of the axis of the thumb. It must, however, always be remembered that this surgery is cosmetic rather than functional.

Age Factors↗
PubMed1983

[Dynamic radiologic examination of the wrist].

Several possible lesions of ligaments may be diagnosed using dynamic radiographs in radial or ulnar deviation, with stressing in torsion, traction, or radial, ulnar, anterior or posterior displacement. The initial position is strictly defined in the front and sagittal planes. The shapes of the bones, their relationship and the joint lines are observed. The authors have made a complete study of the normal wrist and describe some pathological conditions including dislocations, disjunctions between the scaphoid and lunate, mid-carpal sprains and radio-carpal sprains. Descriptions are given as to how to obtain standard radiographs in a painful wrist. Five views are necessary, four in the frontal plane, (radial and ulnar angulation, radial and ulnar displacement) and one in the sagittal plane.

Adult↗
PubMed1982

Dislocations of the proximal interphalangeal joints of the long fingers. Anatomo-clinical study and therapeutic results.

The authors report an anatomo-clinic study on dislocations of the PIP joint in order to point out the lesions and the adequate treatment. This study is composed of two parts: first an anatomoclinical study of 29 dislocations all of which were operated on principle after a clinical and radiographic examination. The second part is a complementary anatomical study of 20 cadaveric joints based on an analysis of the different stabilizing structures of the joint. The study showed that, in order to get a dislocation of the PIP joint, it is necessary that two stabilizing formations be damaged. There is a major lesion and a minor one. The major lesion is characteristic of the type of the dislocation. Anterior dislocations were very rare in this study. The major lesion is a rupture or desinsertion of the central slip of the extensor tendon and the minor lesion is a tear in the collateral ligament. The treatment must be surgical because of the major lesion of the extensor apparatus. Quite different from the anterior lesions are the posterior and the lateral dislocations. They are more frequent. Although they have some similarities, they are, in fact, very different from an anatomoclinical and a therapeutic point of view. In posterior dislocations the major lesion is a rupture of the volar plate. The minor lesion is a partial desinsertion of the collateral ligament. These dislocations are stable after reduction. According to the authors, the best treatment is orthopedic, with a partial immobilization preventing the last degrees of extension. The major lesion in lateral dislocations is a rupture or avulsion of the collateral ligament and the minor lesion is a partial tear of the volar plate. After reduction they are unstable, and thus justify, according to the authors, an operative treatment, especially as they are often associated with cartilaginous lesions.

Adult↗
PubMed1978

[Non-articular fractures of the proximal tibia (author's transl)].

The authors have made a detailed study of the bony architecture of the upper tibial metaphysis and epiphysis. They describe a number of types of extra-articular fracture of the upper end of the tibia according to their mechanical etiology (direct injury or strain). Forty five such fractures are reviewed. Forty percent of the fractures were compound and vascular complications occurred in three cases. Two patients died from embolism and one required early amputation. Twenty seven patients were treated conservatively and eighteen surgically. After an analysis of the results, the authors note that bonyunion is particularly slow in this type of fracture. They conclude that surgical treatment gives better results, especially with the use of epiphyseal plates.

Casts, Surgical↗
PubMed1977

[Synovectomy in the treatment of acute arthritis caused by Micrococcus pyogenes].

In addition to antibiotic therapy associated with immobilization in a plaster cast, effective in the majority of cases of acute arthritis caused by St. pyogenes and resection-arthrodesis which is necessary in the stage of osteoarthritis, synovectomy occupies an intermediate position. During a period--possibly not a short one--when the lesions are still purely synovial and do not regress under medical treatment, their ablation permits recovery from the infection with restoration of the functional activity of the joint. The experience is based on 26 observations (19 knees, 3 hips, 2 shoulders, 1 thumb, 1 metacarpo-phalangeal lesion). In 2/3 of cases these arthritides were iatrogenic (13 after cortisone infiltration, 4 postoperative, 1 haematogenic from i.v. catheterization). Synovectomy should be complete; haemostasis must be rigorous; an aspiration drain is left in place for 5 or 6 days; additional immobilization in plaster is not obligatory; antibiotic treatment is continued until the BSR has returned to normal. As regards control of the infection, this was obtained in 19 of 26 operations. As regards function, in 10 of these cases the results were very good, in 7 good (slight persistent restriction of movement), in only 2 cases the results were unsatisfactory. The factors that appear to affect the results are on the one hand rigorous technique and on the other sufficiently early operation before the lesions have become too fully established. However, a study of arthritides after cortisone infiltration of previously affected joints has shown that even relatively late operation can lead to satisfactory results (9 of 13).

Acute Disease↗
PubMedDate not supplied

[Recent scaphoid fractures (within the first three weeks)].

Scaphoid fractures are the most common carpal fracture, accounting for 70 a 80% of all fractures of the wrist. The diagnosis of acute fracture of the scaphoid still continues to be missed despite an increasing improvement of imaging techniques. In fact, these fractures are mainly neglected because of minimal early symptoms or quick resolution of initial symptoms. X-ray analysis of acute fractures is rather difficult because of the irregular shape of the scaphoid and its overlapping with other structures. In case of doubtfull or negative initial radiographic views, a technetium 99 bone scan or MR imaging should be consisidered. These fractures occuring in the young and most active members of our society represents a population that doesn't have the patience for traditionnal immobilisation in cast. Thus patients with undisplaced fractures for whom early return to work or sport is a primary concern, percutaneous repair with cannulated screw fixation using fluoroscopy and even aided with arthroscopy represents an increasing option. Nevertheless, in thoses cases, cast immobilisation should always be first considered. If percutaneous internal fixation is the first choice in proximal pole fractures or fractures seen with a delay, in the other cases, it can only be advocated if internal fixation will provide a stable reduction. There is little controversy for the treatment of displaced unstable scaphoid fractures. Open repair and internal fixation with a screw represents the golden standard. Complex displaced or dislocated fractures are often comminuted and associated with bony defect. Accurate reduction may need to perform a bone graft. The ligamentous injuries should also be carefully repaired . Evidence of associated cartilagenous lesions must be asessed with precision, as they always jeopardize the end result.

Biomechanical Phenomena↗