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Biomedical subjects

J M Thomine

Publications and source records attributed to J M Thomine.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Secondary locked nailing of the leg after external fixation. 25 cases].

Twenty-five tibial shaft fractures were treated by primary Hoffman external fixation and secondary locked nailing with reaming. The indications were: aseptic non union (12 cases) and the original plan of treatment (13 cases) (early delayed nailing). The septic risk factors were the initial opening of the fracture site (19 sites) and, in all cases, the pin-tracts with, in 5 cases, an intolerance to pins marked by a drainage or an osteolysis. Union was achieved in the 25 cases in an average time of 3.3 months. The restoration of alignment was anatomic in 19 cases. The risk of infection was confirmed with the onset of 4 deep infections which occurred each time when risk factors existed: prolonged bone exposure and intolerance to pins. Infection was treated by a selected antibiotherapy with the nail kept in place and union was obtained primarily: secondary removal of the nail was necessary in 2 cases to obtain drying up. The risk of infection after secondary nailing has thus been confirmed but its frequency and severity didn't appear excessive when compared to the advantages of locked intramedullary nailing.

Bacterial Infections↗
PubMed1991

[Changes in the pronosupination caused by resection of the radius head and prosthetic replacement. Anatomical study of 20 cases].

To improve the contribution of the radio ulnaris superior joint to the unrolling of pronation supination motion, we have set an anatomical and functional study with 20 cadaveric forearms. The first part concerned measures of the radial head diameters, which confirm its constant ovality, nevertheless unsufficient to create a "cam effect" likely to permit the passage of tuberositas radii over the ulna. The second part was supposed to evaluate the modifications of the pronation supination amplitude with fixed ulna, following radial head resection and prosthetic replacement. This study permitted to obtain relatively equivalent graphs in these circumstances; the prosthetic group realises the most important average range of motion, and graphics with the most approximating isocentrical arc of circles aspect. As a conclusion, no experimental argument seemed sufficient for us, to make a better choice between radial head resection and prosthetic replacement.

Aged↗
PubMed1991

[Correlation between microhardness and X-ray transparency of the proximal portion of the human femur].

In order to be able to evaluate the mechanical properties of cortical and sub-cortical bone from a radiologic acquisition, the authors have researched a link between the X-rays transparency of bone and its hardness. A device for measuring hardness has been developed which allows an almost punctual evaluation of the mechanic value of bone. This value has been compared with X-rays transparency of the studied point. The link found between these two variables on 80 measures was strong, with signification less than 0.001.

Biomechanical Phenomena↗
PubMed1990

[Vital prognosis in fractures of the proximal femur. Study in 506 patients of 60 years of age and over].

Five hundred and six patients aged 60 years or over admitted to hospital between 1977 and 1982 for a fracture of the upper end of the femur were the subject of a retrospective study to determine their mortality. Those with multiple injuries or affected by a pathological fracture were excluded. The median age of the population was 80 years, with a clear female predominance. Ageing appeared to be the main risk factor in fracture of the upper end of the femur. Surgical treatment was early, at a median of two days, and weightbearing was possible on the fifth day for half of the patients. The mean time in the surgical department was 15 days, followed by transfer to a nursing home or to a rehabilitation unit for two-thirds of the patients; 7.9 p. cent of patients died during their stay in the surgical department. The actuarial survival rate at one year was 64.7 p. cent and at five years was 35.3 per cent. Compared with the corresponding general population, a fracture of the upper end of the femur is accompanied by a persistently higher mortality for at least two years after the accident, more marked in relative values in men and in younger subjects. A multifactorial study of the prognostic factors using Cox's model showed that the mortality rose with age at the time of the fracture but was lower when the patient had previously been able to go out of the house and was of the female sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Rare benign bone tumors and dystrophy in the hand. Review of literature and report of four cases.

In 1986, the Groupe d'Etude des Tumeurs osseuses (Bone Tumors Studying Group), organised a multicentric study of benign bone tumors and dystrophies localised in the hand. The result was very poor, because only five cases were found. Adding these cases to those already published in the literature, we report: 58 aneurysmal cyst, 12 chondromyxoid fibroma, 9 chondroblastoma, 6 bone cyst, 5 monostotic fibrous dysplasia. The total of 90 cases seems to confirm that the hand is a very unusual localisation for these tumors. These concerned equally metacarpal and phalanx for 37 each, but the carpus was concerned in only 7. Diagnosis was regularly missed before operation, and chondroma was usually suggested; the reason is probably that these tumors lost their usual characters in this particular localisation, except in two cases of fibrous dysplasia. In most cases curettage and cancellous graft seems sufficient to ascertain histology and cure the lesion.

Adult↗
PubMed1988

[The tibio-calcaneus external fixator in the treatment of fractures of the lower tibia].

Twenty-seven patients with complex fractures of the lower end of the tibia were treated by an external Hoffman fixator between 1977 and 1981. Its use was inspired by the presence of skin lesions and by the anatomical type of fracture when it was felt that other methods of treatment would be ineffective or hazardous. In favour of the method was the absence of iatrogenic infection and anatomical results that were superior to those of conservative treatment. Against it, there was a longer time for union, with eight delayed unions and three non-unions and the fact that it was impossible to correct joint impaction which was present in 14 out of 28 cases.

Adolescent↗
PubMed1987

The natural history of scaphoid non-union. A review of fifty-two cases.

Fifty-two cases of scaphoid non-union requiring Matti-Russe operation are studied. 46% of patients did not receive any treatment after the initial trauma. 32 patients had suffered a single trauma with continuous painful symptoms. In 20 patients, the non-union was only decompensated after a second trauma. Eight of the 32 cases presented with DISI, which is always accompanied by displacement of the fracture by at least 1 mm. Comparison of the present study with that of G.R. Mack and L.K. Ruby confirmed several points: arthrosis is inevitable after a variable delay (10 years for the most optimistic). DISI probably carries a poor prognosis, but a significant correlation with arthrosis could not be demonstrated before 10 years.

Adolescent↗
PubMed1986

[Primary suturing of zone II flexor tendons (103 digits). Results and Kleinert's limitations].

One hundred and sixty-two instances of traumatic division of the flexor tendons in zone 2 occurring in 103 injured digits were studied in 88 patients with at least 6 months follow-up. Motion and sensibility studies as well as trophic evaluation were available for all patients. Sixty-eight patients underwent repair according to Kleinert's technique. Overall results in these cases showed a 58% rate of "satisfactory" results versus 34% when classic techniques had been employed (35 cases). Kleinert's technique afforded the highest percentage of "good" results (75%) when tendon division was isolated whereas the rate of "good" results dropped to 23% when the injury went through to the floor of the digital tunnel. Complications included joint stiffness due to adhesions (19%) mainly related to the magnitude of the initial trauma, fixed flexion deformities (15%) and secondary rupture of the tendon (7%). Excision of the superficial flexor tendon was invariably associated with a poor results. Secondary treatment of these lesions was disappointing. While we agree that Kleinert's operative technique be used whenever feasible, semipassive mobilization as indicated by Kleinert, should however be reserved for isolated lesions in cooperative patients treated in centers where closely supervised rehabilitation is available. Immobilization of the interphalangeal joints in flexion together with their separate passive mobilization according to the method of Duran and Strickland, may reduce the number of complications observed with Kleinert's technique in the following circumstances; severe lesions (groups 3 A, 3 B), inadequate healing, an uncooperative patient. It is of paramount importance to look for and repair concomitant nerve injuries. Inadequate nerve management alone in these circumstances can account for up to 25% of overall functional failures. When bilateral vascular lesions are present, it is essential that vascular repair of the digital arteries be performed at once. Unilateral arterial insult does not seem to significantly affect results in terms of active motility.

Evaluation Studies as Topic↗
PubMed1986

[Results of the Insall operation (plasty of the anterior cruciate ligament by transfer of the fascia lata with bone block) in the treatment of chronic anterior instability of the knee. Analysis of 30 cases with at least 1 year of follow-up].

The authors have performed the Insall procedure on 30 knees since 1981. The results are analysed with a minimum of one year follow-up. The procedure, which is an active transfer of the iliotibial tract to the tibial plateau is based on the action of the proprioceptive structure of the muscles of the thigh. It produced a decrease of 50 p. 100 in the anterior drawer sign, the Lackman test disappeared in two thirds of the cases and the pivot-shift test disappeared in four knees out of five. Twenty-two patients engaged in some kind of sport before their accident; 17 were able to practice their sport at the same level after the operation. The results as evaluated by the CLAS system were good in 23, fair in five and poor in two. The indications are discussed and the results compared with those obtained after other procedures. This procedure should be performed on patients suffering disabling instability in daily life with a marked anterior drawer sign, but who are not high level athletes. The technical details are given. The transfer should be sufficiently massive, solid and well vascularised. The lateral stability of the knee should not be impaired by the procedure.

Chronic Disease↗
PubMed1985

Biometrical study of flexion of the long fingers joints in prehension.

The angles of flexion of the three digital joints were measured in 112 hands while grasping test cylinders the diameter of which ranged from 8 to 90 mm. Based on the average of several measurements, the angles of overall and joint-by-joint flexion were determined for each cylinder size. Studied finger by finger, it was shown the each digit has its individual pattern of flexion, the angles of flexion of each joint being different for each finger. Flexion is prevalent in the proximal interphalangeal joint of the index while it is prevalent in the metacarpophalangeal joint of the little finger. When the standard deviation values were calculated, they showed that the individual variations were relatively small in cylindrical grasps. This is the opposite of what was observed in two of the pinches between the thumb and the other fingers. In these cases, the values of the angles of flexion were remarkably dispersed according to the individuals, especially in the proximal interphalangeal joint.

Adolescent↗
PubMed1983

Functional brace in the treatment of diaphyseal fractures of the proximal phalanges of the last four fingers.

The authors describe a system of functional brace for the treatment of displaced fractures of the proximal phalanx of the fingers. Using four digit syndactylization this technique allows simultaneous stabilisation of the fracture and early active mobilization of the proximal interphalangeal joint, where stiffness is known as the principal impairment after such fractures. Among 14 cases treated by this method, fracture healing has been obtained in all cases with only one significant malunion. No severe stiffness has been observed and active motion at the PIP joint has been in a useful sector of 25 degrees and 75 degrees at least in all cases.

Adult↗