Search PubMed⌕ Search

Biomedical subjects

G Foucher

Publications and source records attributed to G Foucher.

At least 127 records · Page 7Linked to original sources
PubMed1991

Indications and results of skin flaps in painful digital neuroma.

Of the many procedures for treating painful neuromas, resection and proximal translocation are the most usual techniques, but these can decrease distal sensibility increasing deafferentation pain. In cases of intricate pain (nociception plus deafferentation), certain types of flaps allow the treatment of both components of the pain. We have used 30 such flaps in 28 patients: local flaps (exchange, advancement or lasso island flaps) and distant flaps (free "custom-made" toe flaps). The results of the different techniques provides 86.6% excellent or good results.

Adult↗
PubMed1991

[Neuritis and neuroma of the sensory branches of the radial nerve. Apropos of 44 cases].

The authors present a series of 44 cases of sensory disorders in the radial nerve territory. Eighteen cases of pure painful neuromata gave, excellent results according to Herndon criteria in 11 cases with various techniques. Wartenberg neuritis (22 cases) was found to respond favorably to conservative treatment in the majority of cases (19 cases). A legal problem can arise from association with De Quervain disease if the condition has not been recognized before surgical release of the first compartment. Finally 9 cases are presented with intricate pathology of neuroma plus neuritis. Treatment addressing both conditions provided good results.

Adult↗
PubMed1991

[Local and regional anesthesia of the upper limb in emergency hand surgery].

The very conditions of the emergency led the authors to define the indications for the various modalities of local and regional anaesthesia: intravenous regional anaesthesia, nerve trunk blocks, plexus blocks, interdigital block and local infiltration. The parallel development of anaesthetic drugs with variable systemic toxicity and a duration of action inversely proportional to the toxicity now allows precise adaptation of the anaesthesia to the type of lesion, the patient's general condition, the practical conditions of the emergency and the surgical technique selected, provided the anaesthetist is fully aware of the traps to be avoided, which can only be based on a long practice of local and regional anaesthesia in elective surgery.

Anesthesia, Conduction↗
PubMed1991

Custom-made free vascularized compound toe transfer for traumatic dorsal loss of the thumb.

Dorsal compound traumatic thumb loss can be reconstructed in selected young and well-motivated patients with a custom-made partial great toe transfer. The transfer, including the nail complex and vascularized piece of bone, can be fashioned by longitudinally cutting the distal phalanx to approach the appearance of the opposite thumb and to allow for more normal nail appearance. Ten patients illustrate this technique and emphasize its reconstructive potential as well as cosmetic acceptance.

Adolescent↗
PubMed1991

[Escalator flap in the treatment of claw nail].

Nail horn deformity can be corrected by a proximal withdrawal of the nail complex on the distal remaining skeleton. The main problem is the flap coverage and we have combined an "in bloc" O'Brien island flap with the withdrawal of the nail. This "escalator" technique allowed a good correction with a satisfactory palmar skin cover and a decreased "wave" of the dorsal skin.

Amputation, Traumatic↗
PubMed1991

[Repair of the flexor digitorum profundus and the flexor pollicis longus by the "rope down" technique. Results in a series of 77 cases].

UNLABELLED: Seventy-seven flexor tendon lesions in zone I have been reinserted by the "rope down" technique using the Jennings barb-wire. They included 20 cases of repair of FPL. The patients were reviewed with an average follow-up of 4 years (minimum 3 months, maximum 10 years). By means of this technique, immediate active mobilisation was possible in 70 of the 77 cases. Mobility of the MCPJ and the PIPJ was maintained in all but one case. At DIPJ level active flexion was recovered at an average of 42.8 degrees with an average extension deficit of 5.5 degrees. This corresponds to a 1.3% (D1) and 2% (D2-D5) handicap as assessed by the International Federation of Hand Surgery. Complications were recorded in 12 of the 77 cases. Two cases required a secondary tenolysis. The factors which influence on the result were analysed. This analysis demonstrates the frequency with which the association of other lesions worsens an outcome which, traditionally, is otherwise good. The average time off work was 6.9 weeks (minimum 0, maximum 6 months). IN CONCLUSION: this simple, rapid technique achieves secure reinsertion allowing immediate active mobilisation. The use of barb-wire demands meticulous surgical technique and close post-operative surveillance. These requirements indicate why this method does not readily lend itself to the management of these lesions in infants.

Adolescent↗
PubMed1991

[Digital varices. 12 cases].

Twelve cases of varix of the fingers are reviewed. The mean age was 41 years with a female predominance (75%). A palmar site was predominant (92%) and the ring finger was most frequently involved (50%). No recurrence was observed after a mean follow up of 6 years.

Adult↗
PubMed1991

["Shark tooth" in the excision of so-called giant cell circumdigital tumors of the tendon sheaths. Results apropos of a series of 74 patients].

The authors propose an easily extended incision around the finger for giant cell tumors of the tendon sheath: two distally based triangles, one palmar, one dorsal, joining at the midlateral line. A V-Y plasty allows further enlargement and decreases the excess of skin bulkiness. Used in circumferentially extensive tumors, a decreased recurrence rate (4%) was noted compared to the classical approach (15%).

Adolescent↗
PubMed1991

[Compound vascularized island joint transfer in hand surgery. Apropos of a series of 16 cases].

Sixteen compound island joint transfers performed in 14 patients were reviewed with a mean follow up of 37.6 months. 15 were harvested from a non conservable "finger bank" and one as an homodigital islanded DIP to PIP transfer. The "donor" joint was an MP joint (7 cases), a PIP joint (5 cases) and DIP joint (4 cases). The reconstructed joint was the MP joint (10 cases) or the PIP joint (6 cases). If we exclude one failure (arthrodesis), the average range of flexion was 45 degrees for MPJ and 42 degrees for PIPJ. In selected cases with good patient motivation, available "donor" finger and intact flexor tendon in recipient digit, this technique provided a one stage composite reconstruction, a good lateral stability in pinch with possibility of growth in children and long term preservation of the articular cartilage.

Adult↗
PubMed1991

[Partial toe transfers. Functional results: apropos of 26 cases].

We present our results from a series of 26 partial toe transfers (11 pulp transfers and 15 composite tissue transfers) performed in posttraumatic reconstruction of the thumb (22 cases) and fingers II to V (4 cases). There was one failure due to arterial thrombosis. The results for sensitivity were satisfactory after pulp transfer (Weber-average of 9 mm), less satisfactory after composite transfer. Recovery of mobility and strength usually were satisfactory. Problems with the donor foot were mainly slow healing and poor tolerance to cold; the latter was experienced by 1/3 of the patients although functional deficits were rare. Partial toe transfer is used at present for distal reconstruction of the thumb, and leaves the metacarpophalangeal joint intact. There are basically two techniques: "tailored" transfers from the big toe for amputations of the distal phalanx of the thumb, and wrap-around flap of Morrison for amputations proximal to the proximal phalanx.

Adolescent↗
PubMed1991

[Treatment of severe callus of the metacarpus and phalanges. Indications and results apropos of a series of 38 patients].

Severe deformities of metacarpals and phalanges, whether isolated or associated with soft tissues lesions impair the hand function and are to be corrected. The authors initial proposal was the fixation after corrective osteotomy by wiring which have been proved to be suitable in the treatment of recent fractures. This technique was used in 25 cases out of 38 treated malunions with 21 satisfactory results. 4 poor results were related to associated lesions of the soft tissues more than to the osteotomy itself. The other 13 malunions were treated by several techniques arthrodeses, callus resections, dynamic splintage, osteotomies with satisfactory results.

Bony Callus↗
PubMed1991

[Hand surgery].

Explore the source record for details and available documents.

Emergencies↗
PubMed1990

Syndactyly: can web creep be avoided?

Syndactyly is one of the most common congenital hand deformities but there still remains a high incidence of contractures and web creep after attempts at surgical correction using many assorted techniques. Little attention has been paid to the potential junctional scar in the aetiology of web creep. To remedy this, a technique is described which involves a dorsal flap and two palmar laterally-based flaps. This method not only breaks up the palmar junctional scar but also completely reconstructs the web, not just the floor. The procedure can be used in all varieties of syndactyly and has reduced the incidence of creep in a series of 49 webs.

Adolescent↗