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J P Brutus

Publications and source records attributed to J P Brutus.

12 recordsLinked to original sources
PubMed2006

Bone density comparison of selected carpal and tarsal bones: validation for their use in compression fracture fixation studies of scaphoid screws.

INTRODUCTION: To determine if trabecular, total and cortical bone densities of the capitate, navicular, cuboid, and first cuneiform were equivalent to those of the scaphoid, such that these bones could be used in place of the scaphoid in evaluating new headless scaphoid compression screws. METHODS: Fifty scaphoids, capitates, naviculars, cuboids, and first cuneiforms were harvested from fresh frozen cadavers. The trabecular, total and cortical bone densities were measured using pQCT technology and statistically compared. RESULTS: A paired t comparison between paired scaphoids and capitates showed no difference between the trabecular bone densities. However, their total bone and cortical densities were found to be different. An independent measures ANOVA comparison of the five bones, showed no significant difference in mean trabecular density between the capitates, naviculars and first cuneiforms when compared to the scaphoids. However, the mean total and cortical densities of the first cuneiforms were less than the scaphoids and the mean trabecular, total and cortical bone densities of the cuboids were all less than the scaphoids. DISCUSSION: Compression fracture fixation studies of headless compression screws could be conducted using the capitate, navicular, and first cuneiform as models of the scaphoid when the supply of scaphoids is limited.

Aged↗
PubMed2005

Septic monoarthritis of the first carpo-metacarpal joint caused by Mycobacterium kansasii.

A case of septic carpal monoarthritis due to Mycobacterium kansasii developing 16 months after accidental inoculation in a healthy laboratory technician is reported. No predisposing factor such as immunosuppression, preexisting degenerative, inflammatory arthritis or cortisone injection was present. Treatment with antituberculous oral medication alone resulted in resolution of the disease. Synovectomy was unnecessary. Ten years after the initial causative event, the patient remains free of symptoms.

Adult↗
PubMed2004

Could this unusual scaphoid fracture occurring in a badminton player be a stress fracture?

An unusual fracture of the scaphoid occurred in an otherwise healthy young badminton player, caused by a violent movement of extension/flexion of the wrist while performing a smash. There was no direct blow or fall on the wrist, nor history of wrist pain prior to the fracture. No underlying pathology was identified. Conservative treatment failed and surgical stabilization was required to achieve bone union. The diagnosis of stress fracture was suggested. The characteristics of these uncommon fractures are reviewed.

Adult↗
PubMed2004

[Short term results of total carpometacarpal joint replacement surgery using the ARPE implant for primary ostearthritis of the thumb].

INTRODUCTION: We have reviewed the short-term results of the ARPE arthroplasty of the first carpometacarpal joint for osteoarthritis of the thumb. MATERIAL AND METHODS: One hundred and eighteen patients have been operated on in our department between June 1999 and June 2003, by the same surgeon. Sixty-three of these patients had been followed for a minimum of six months and were included in this retrospective study. We have evaluated functional results as pain, key-pinch, mobility and patient satisfaction. The occurrence of complications was investigated. RESULTS: The results of this procedure were found to be excellent for pain, mobility and strength. Recovery was judged fast and patient satisfaction was high. The most frequent complication was implant luxation in six cases. Implant loosening was seen in three. DISCUSSION: Functional results of this type of arthroplasty are excellent. We consider it to be superior to trapeziectomy for recovery (rehabilitation is unnecessary) and strength. Most common complications have a relatively simple surgical solution. Trapeziectomy remains possible thanks to a minimal shortening of the metacarpal bone. CONCLUSION: The ARPE arthroplasty can be considered as a good surgical option for treatment of thumb osteoarthritis. A longer follow up is necessary to predict the long-term behaviour of the prosthesis.

Adult↗
PubMed2002

Single injection digital block: comparison between three techniques.

INTRODUCTION: Regional anesthesia of a single finger is commonly achieved by the traditional ring block. The major drawback of this technique is the need for at least two painful injections in the digit. Single injection techniques have been described. A comparison of their results could help health professionals select the most appropriate technique. MATERIAL AND METHODS: A prospective randomized study was designed to compare three techniques in term of patient tolerance, distribution of anesthesia and efficiency: the modified transthecal digital block, the subcutaneous digital block and a combination of the two. Digits were randomized in three groups (n = 30). Blocks were performed by a single investigator. A visual analogic scale was used to evaluate pain associated with the injection. Prick-testing was used to evaluate anesthesia at the volar and dorsal aspects of the phalanxes. Statistical analysis of the results was performed. RESULTS: All techniques allowed surgery to be performed without complementary injection most of the time (25/30). The dorsum of the proximal phalanx, however, was unpredictably included in the anesthetized territory. The highest rate of full digital block was achieved with the combined technique. DISCUSSION: The least invasive of equally effective techniques should be considered as the first choice. The subcutaneous single injection digital block is safe, efficient and easy to perform. It allows treatment of all conditions on the volar aspect of the finger and on the dorsal aspect of the distal and middle phalanxes. For surgery on the dorsal aspect of the proximal phalanx, a supplementary dorsal block should be used.

Anesthesia, Conduction↗
PubMed2002

Percutaneous Herbert screw fixation for fractures of the scaphoid: review of 30 cases.

INTRODUCTION: The purpose of this study was to evaluate the results of percutaneous fixation of undisplaced or minimally displaced fractures of the scaphoid using the first generation Herbert screw in terms of union, functional results and scaphoid mobility. METHODS: 30 of the 50 patients operated on in our department between 1995 and 2000 were available for evaluation by an independent observer. Wrist mobility, grip strength and key pinch were measured. Scaphoid mobility was evaluated by measuring radioscaphoid angles in flexed and extended positions on dynamic X-rays. RESULTS: The union rate was comparable to that achieved by non-operative management (90%). Resumption of professional activities was possible long before bony union because immobilization was short. Grip strength, wrist and scaphoid mobilities were comparable to the controlateral sides except for scaphoid flexion. Persistent symptoms were found in 30% of the patients despite union of their fracture. DISCUSSION: Our results demonstrate that percutaneous stabilization of undisplaced or minimally displaced fractures of the scaphoid preserves the mobility of the wrist and minimally alters the normal dynamics of the carpus. The duration of work inability is short.

Adult↗
PubMed2001

Atypical mycobacterial infections of the hand: report of eight cases and literature review.

INTRODUCTION: Atypical mycobacteria are an uncommon cause of hand infections in immunocompetent patients. Diagnosis is often delayed, with consequent increased morbidity. Better awareness would allow earlier diagnosis and treatment. MATERIAL AND METHODS: Eight patients with atypical mycobacterial hand infections treated in our department over a 21 year period have been retrospectively identified. Their charts have been searched for the general characteristics of these infections, treatment and outcome. Our findings have been compared to the data collected from a literature review. RESULTS: These pathogens have caused soft tissue infections in otherwise healthy patients. Clinical signs were those of chronic finger or wrist synovitis or skin granulomas. Carpal tunnel syndrome was a common finding. Diagnosis relied on surgical biopsy. Germ identification required specific incubation temperature and media. Antibiotics and synovectomy have been the mainstay of therapy. DISCUSSION: In a patient with achronic, relapsing, superficial or deep skin infection or tenosynovitis, aquatic and farm exposures are important anamnestic keys to diagnosis. Extensive synovectomy is both diagnostic and therapeutic. Specific cultures should be ordered without delay. Oral pharmacotherapy should be initiated upon clinical suspicion.

Adult↗
PubMed2001

Arthrographic and CT arthrographic findings in dorsal peripheral detachment of the triangular fibrocartilaginous complex.

Arthrography and CT arthrogram were evaluated in the diagnosis of dorsal peripheral detachment of the triangular fibrocartilaginous complex (TFCC) in the wrist. The imaging findings and medical records of 19 patients, who underwent surgical repair of a dorsal peripheral detachment of the TFCC, were retrospectively studied. Diagnoses were based on the results of the arthrography and CT arthrogram as well as on the clinical examination. The arthrographic features assessed included abnormal filling of the tendon sheath of the extensor carpi ulnaris (ECU) and irregular contrast extravasate in the dorsal ulnar and peristyloid region. The findings on arthrography and CT arthrography were correlated with the arthroscopic results. In conclusion, the arthrographic signs seem to be reliable findings in the diagnosis of dorsal detachment of the TFCC.

Adult↗
PubMed1998

Lateral canthotomy: a simple and safe procedure for orbital haemorrhage secondary to endoscopic sinus surgery.

Two cases of orbital complications secondary to functional endoscopic sinus surgery are presented. One case was complicated in the immediate post-operative period with an orbital haematoma, which required urgent decompression using lateral canthotomy. The second case had presented an acute orbital haemorrhage during functional endoscopic sinus surgery, which required the same surgical procedure. These cases demonstrate that lateral canthotomy constitutes a safe and fast surgical procedure to decrease the intraorbital pressure.

Adult↗
PubMedDate not supplied

Atypical cause of forearm skin ulceration in a leukaemic child: mucormycosis. A case report.

Primary cutaneous mucormycosis is an uncommon, deep and aggressive fungal infection occurring mainly in immunosuppressed or diabetic patients. Rapid diagnosis and therapy are necessary to prevent a fatal outcome. An eight-year-old leukaemic child presented with a dark necrotic ulcer on the volar-ulnar aspect of the left forehand. The lesion had developed over seven days, beginning as a vasculo-haemorrhagic erythematous plaque. There was no known history of trauma to the area, but skin necrosis from external compression caused by an intravenous line could not be completely ruled out. The lesion rapidly progressed to a 5 x 8 cm painful necrotic ulcer with an erythematous border. Treatment with ichthyol dressing and intra-venous antibiotherapy failed to improve the condition. Wide debridement was performed and specimens were sent for microbiology and pathology examinations. Microscopic examination demonstrated broad, irregularly walled, non-septate fungal hyphae that were consistent with Mucor. Amphotericin B was administrated intravenously (1 mg/kg/day) and hydrogel and hydrophile adhesive polyurethane foam dressings were applied. After 12 days, the soft tissue defect was covered with a split-thickness skin graft, harvested from the lateral aspect of the thigh. Diagnosis of this infection is based on complete histopathological and microbiological studies. Awareness, and a high index of suspicion are required because of the potential fulminant and fatal course.

Amphotericin B↗