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Biomedical subjects

L Doursounian

Publications and source records attributed to L Doursounian.

30 records · Page 2Linked to original sources
PubMed1989

Dynamics of the junction between the medulla and the cervical spinal cord: an in vivo study in the sagittal plane by magnetic resonance imaging.

Sagittal sections of the brain-stem made by MRI reveal differences in the angle formed by the medulla and the cord. In order to study the normal mobility of this region of the CNS during flexion and extension of the head, sagittal MRI studies were made in the sagittal plane in 18 young volunteers. The volunteers were in dorsal decubitus with the cervical spine first flexed and then extended, with the movement localized to the cranio-cervical junction as far as possible. T1-weighted sequences were used, with body coils in 16 cases and surface coils in two. Measurements were related to global cranio-cervical range of movement, movement at the cranio-cervical junction and spino-medullary movement. Variations in the depth of the free space in front of the medulla, pons and spinal cord during movement were also noted. We also checked for downward shift of the lower part of the 4th ventricle and modification of the shape of the ventricle during flexion-extension. The global range of cranio-cervical movement was between 31 and 100 degrees (average 63 degrees). The range between the cranium and C1C2 was 4 to 39 degrees (average 19 degrees) and the spino-medullary range was from 1 to 32 degrees (average 14 degrees). During flexion, the free space narrowed in front of the pons 11 times, in front of the medulla 14 times and in front of the cervical cord 11 times. There was a downward shift of the lower part of the 4th ventricle during flexion in 4 cases but no change in shape was noted. Though this study is open to criticism from several aspects, it may be concluded that variations of the spino-medullary angle in the sagittal plane during flexion-extension do occur, that they are closely correlated with movements at the cranio-cervical junction, moves forward during flexion.

Adult↗
PubMed1989

[Pain in the trochanteric region caused by tunnel compression of the lateral cutaneous perforating branch of the ilio-hypogastric nerve. Indications for neurolysis].

After consideration of anatomical and clinical studies, the authors describe a new tunnel syndrome involving the lateral cutaneous branch of the iliohypogastric nerve as it emerges above the iliac crest. Irritation of the strangulated nerve produces pain over the lateral aspect of the hip. In 7 cases where local infiltration failed, neurolysis was carried out and produced excellent results in 5 patients, thus confirming the pathophysiology of this syndrome.

Female↗
PubMed1987

[Extra-coracoid axillary approach to the gleno-humeral joint].

The authors advocate an elective approach to the lower part of the humeral (shoulder) joint by an original axillary route. This route is external to the short head of the biceps brachii muscle which is retracted together with the neurovascular bundle. The articular capsule is opened through the space between the subscapular and latissimus dorsi muscles. The skin incision is cosmetic. No muscle is cut, and in surgery for anterior instability of the shoulder the crucial area is automatically exposed. This technique, however, requires two assistants and may be arduous in very muscular subjects. In addition, the visibility of the rest of the humeral joint is limited. With a few precautions, the neighbouring vessels and nerves are well protected.

Axilla↗
PubMed1987

[Surgery of severe vertebral kyphosis in ankylosing spondylitis].

12 cases of spinal osteotomy in patients with ankylosing spondylarthritis are reported. It concerns 3 cases of cervical osteotomy and 9 cases of lumbar osteotomy with severe kyphotic deformity. The techniques and the operated cases are analyzed. The indications of this surgery, which is not devoid of neurological risks, are rare. It is only justified in severe deformities in order to restore a normal visual field for the patient.

Adult↗
PubMed1986

Preliminary note on biometric data relating to the human coraco-acromial arch.

A biometric study based on 20 human scapulae made it possible to specify the variations in the gap of the coraco-acromial arch in relation to its depth and height. A graphic representation in rectangular coordinates, then in spatial representation in relation to the three planes of reference, leads to the following findings: the bony variations in the arch occur essentially: at the coracoid apophysis, and two types of arch can be distinguished depending on the predominance of bony or of ligamentous components.

Acromion↗
PubMed1984

Treatment of slipped upper femoral epiphysis: 80 cases operated on over 10 years (1968-1978).

Guidelines are proposed for the treatment of slipped upper femoral epiphysis based on the analysis of 80 cases. Treatment is strictly surgical, but the procedure to be employed depends on the degree of displacement. Major operations are reserved for maximum tilting of the epiphysis: Dunn's operation when the growth plate is still open, trochanteric osteotomy once it has closed. Complications of treatment are epiphyseal necrosis and stiffness.

Adolescent↗
PubMedDate not supplied

Total shoulder replacement by magnetic arthroplasty.

Permanent magnets offer a novel solution to the problem of shoulder implant instability when the rotator cuff has been destroyed. We report a case of their use in a 66-year-old patient with a large proximal humerol breast cancer metastasis. Humerol resection was below the deltoid insertion. The polyacetal device had samarium-cobalt magnets in the humeral head. The glenoid component (the keeper in the magnetic circuit) was made of titanium nitride-coated F17 stainless steel. The system's breakaway force was ca. 40 N. At 24 months the shoulder was free of pain and stable, with an active range of movement of 30 degrees flexion, 45 degrees external rotation, and internal rotation to T8. The patient could perform household tasks and drive an automatic car. Radiography showed no implant loosening or upward humeral head dislocation. Subsequently, the patient's condition deteriorated; at 33 months she was bedridden, and radiography showed dislocation of the humeral component.

Arthroplasty, Replacement↗
PubMedDate not supplied

A new internal fixation technique for fractures of the proximal humerus--the Bilboquet device: a report on 26 cases.

We describe a novel internal fixation device and report on 26 patients (mean age, 70 years) whose proximal humeral fractures were managed with this technique. The 2-part titanium implant consists of a circular staple impacted into the humeral head cancellous bone and a spigoted diaphyseal stem that inserts into the staple "cup." Of the 26 cases reviewed, 16 had 3-part fractures and 10 had 4-part fractures. Mean follow-up was 25.9 months. In the 16 3-part fractures, the mean active forward elevation was 114 degrees and the results were as follows: excellent, 7; good, 5; fair, 3; poor, 1. In the 10 4-part fracture patients, the mean active forward elevation was 101 degrees and the results were as follows: excellent, 2; good, 4; fair, 3; poor, 1. There were 5 cases of avascular necrosis and 1 case of tuberosity nonunion. Only 2 cases needed conversion to hemiarthroplasty. The new technique should simplify the surgery of these fractures and reduce the need for arthroplasty.

Adult↗