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Biomedical subjects

G Foucher

Publications and source records attributed to G Foucher.

At least 145 records · Page 8Linked to original sources
PubMed1990

[Local intravenous treatment of algodystrophy of the hand: buflomedil versus guanethidine, long term follow-up].

This report compares the results obtained after treatment of reflex sympathetic dystrophies (algodystrophies) of the hand by pharmacological segmental blocks with buflomedil (51 cases) versus guanethidine (30 cases). The results were similar for all the different stages of algodystrophies treated: 65% satisfactory to excellent results with buflomedil, versus 63% with guanethidine. The sooner the algodystrophy is treated after its onset, the better the results. On TPBS, when the technique is effective, both hemovelocity and blood pool return to normal, along with the improvement in the patient's condition. Early and delayed bone fixations evolve independently of the treatment. These techniques should always be associated with active, mild physiotherapy, and in some cases with dynamic splints in order to prevent the development of functional sequelae in the form or capsulo-aponeurotic retraction.

Adult↗
PubMed1990

Transfer of a composite island homodigital distal interphalangeal joint to replace the proximal interphalangeal joint. Technique and case report.

The authors present an original technique of PIP joint reconstruction by an homo-digital island compound DIP joint transfer. The transfer consists of joint, capsule, volar plate, and ligaments. The distal joint is fused and the islanded joint interposed at the PIP level. In our clinical case, a flexion of 80 degrees was obtained with an extension lack of 15 degrees. This salvage procedure can be useful in selected well motivated patients. It provides rapid bone healing, good lateral stability, potential for growth in children, long term preservation of cartilage and acceptable range of motion.

Adult↗
PubMed1990

Free vascularized toe-joint transfer in hand reconstruction: a series of 25 patients.

Twenty-eight vascularized toe-joint transfers performed on 25 patients were reviewed. A number of different techniques were used: proximal interphalangeal joint or metacarpophalangeal joint reconstruction, one-stage double joint transfer, and interphalangeal thumb or trapezometacarpal joint replacement. Using these types of vascularized joint transfer allows one-stage composite transfer (including skin, bone, and extensor tendon) and provides rapid bone healing, potential growth in the young, good long-term cartilage preservation, normal lateral stability in pinch, and limited but useful range of motion (mainly at the proximal interphalangeal level).

Adolescent↗
PubMed1990

[The lower radio-ulnar joint in malunion of the lower end of the radius: therapeutic implications].

Malunion of the lower extremity of the radius is frequently accompanied by a lesion of the inferior radio-ulnar joint marked by inversion of the inferior radio-ulnar index. Surgical treatment must always take this parameter into account and should attempt to correct it. The authors' preference in the treatment of malunion consists of Duparc osteotomy, in which the size of the graft is calculated in order to restore the inferior radio-ulnar index. If the correction is insufficient or in the case of moderate malunion, the authors propose the Kapandji-Sauvé operation which allows better preservation of the wrist stability.

Adult↗
PubMed1990

[Ambulatory surgery of the hand].

After performing ambulatory surgery in hospital, then in a private clinic, without specifically distinguishing this activity, we have created an independent Hand Surgery Center in 1980. This unit was recognized by the Social Security, with whom we have signed an agreement. This 20-year experience of ambulatory surgery has enabled us to outline its advantages and disadvantages, both for the patient and for the medical staff and the health care system. Savings on medical costs cannot be the aim of this practice, which is justified only if the patient's comfort is improved while at the same time guaranteeing the quality of care. It will only be developed harmoniously if precise "specifications" are drawn up to avoid errors and mistakes that may lead to an unjustified summary "execution". We have continued the figure-based study of which we had presented the preliminary results to the Academy of Surgery as early as 1984.

Ambulatory Surgical Procedures↗
PubMed1990

[Radiographic views in hand surgery].

Numerous radiographic views are available for visualisation of the squeleton of the hand. After an analysis of the literature, the authors selected those approaches which are simple and yield the best results.

Carpal Bones↗
PubMed1990

[Reconstruction after traumatic destruction of the finger joints].

Miniaturized osteosynthesis still is the best solution for articular injuries, but in case of destruction the indications will depend on several patient-linked factors (age, handedness, profession...) and on the loss of substance. In case of limited loss of substance, Swanson's prosthesis provided an average mobility of 48 degrees at the MP level and 34 degrees at the PIP level. In case of extensive osteoarticular loss, only island or free vascularized articular transfer allow avoiding arthrodesis. The transfers provided mobility exceeding 45 degrees at the MP level and 42 degrees at the PIP level, therefore better values than with free articular toe transfers (35 degrees for the MP joints and 23 degrees for the PIP joints).

Adult↗
PubMed1989

Homodigital neurovascular island flaps for digital pulp loss.

Terminal amputations with loss of the distal pulp are common injuries. This report analyses 64 consecutive cases of advanced or exchanged homodigital neurovascular island flaps operated on by one surgeon between 1981-1986. The surgical technique, indications, contra-indications and five year results are evaluated. Overall, these flaps provide reliable vascularity as well as normal sensibility at the distal end of the finger where high quality perception is required.

Adolescent↗
PubMed1989

Histologic structure of the palmar digital nerves of the hand and its application to nerve grafting.

The digital nerves from 20 adult hands were studied histologically. The number of fascicles increases from the proximal to the distal portion of the finger. The number of myelin fibers was nearly the same in the nerves of the thumb and the index, long, and ring fingers. The mean diameter of the fascicles was of the order of 210 micrometer. Because there were many variations in the number of fascicles in the same nerve of different subjects, there was no attempt made at classification.

Aged↗
PubMed1989

Primary repair of extensor tendons with assisted post-operative mobilisation. A series of 48 cases.

Forty-eight patients with lesions of the extensor apparatus of the hand were treated by primary repair with assisted post operative mobilisation by means of a dynamic extension, low profile splint. They were divided into three groups: 25 simple wounds of the extensor tendons of the fingers; 14 simple wounds of the extensor tendon of the thumb; 9 complex lesions. The mobility of the tendinous suture and the callus displacement were monitored by means of metallic markers implanted at operation. Functional electromyographic study during physiotherapy permitted refinement of the technique of reeducation by a limitation of the range of flexion of the proximal interphalangeal articulations. The results are divided into 4 categories: excellent 33 (60%), good 9 (16.4%), average 4 (7.3%), bad 9 (16.4%). No complications (infection, loosening of suture, reflex sympathetic dystrophy) were detected in this short preliminary series. The proposed technique produced improvement of only minor significance in comparison with traditional methods, when applied to uncomplicated wounds. Significantly improved results were obtained in the group of patients with complex lesions.

Adult↗
PubMed1989

[Radiographic effects in surgery of the hand].

Numerous radiographic views are available for visualisation of the skeleton of the hand. After an analysis of the literature, the authors selected those approaches which are simple and yield the best results.

Carpal Bones↗
PubMed1989

[The socio-economic costs of finger replantation. Apropos of 40 replantations of the thumb].

Microsurgical techniques are becoming increasingly important in the emergency treatment of hand trauma and in secondary reconstructive surgery. In the light of the current concern with financial feasibility, we thought it important to determine whether this surgery, sometimes wrongly described as being luxury surgery, is economically feasible. The cost of 40 reimplantations and revascularisations of the thumb treated in the context of work accidents was studied. Although the short-term cost of reimplantation is higher than that of amputation, in the long-term, a successful reimplantation constitutes a definite economy for society and justifies this type of specialist surgery.

Amputation, Traumatic↗
PubMed1989

[A denervation technic of the wrist].

Denervation provides palliation of painful advanced secondary arthrosis of the wrist. The operative technique involves formal division of named nerve branches as the posterior interosseous nerve and sub-cutaneous undermining to sever numerous twigs of sensory nerves.

Denervation↗
PubMed1989

[Computerized study of the functional results of a 2nd toe transfer in finger mutilation].

In a series of 157 transfer cases, 73 were carried out in 58 patients using the second toe. 55 transfer operations were performed on the long toes versus 18 on the big toe. Indications are discussed on the basis of an original classification of amputations. Among tested parameters, sensitivity and mobility statistically correlated with 17 factors. Of statistical import were age, sensitivity to cold, duration of ischemia, partial exclusion of fine pinch. Significant mobility factors were industrial accident, the surgeon's experience, the number of nutrient arteries, the reconstruction level, and the amputation score.

Adolescent↗
PubMed1989

Tendon transfers for treatment of the paralyzed hand following brachial plexus injury.

The correction of functional deficits of the hand after a brachial plexus lesion is difficult; treatment should be provided by a well-knit team of surgeons and therapists. The patient should be fully aware of the limitations of surgical treatment before surgery, and should be entrusted to the care of a physical therapist during the critical period of nerve regeneration after initial surgical treatment to ensure optimal results. This article presents therapeutic possibilities and discusses specific problems of tendon transfers in brachial plexus palsy.

Brachial Plexus↗