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Biomedical subjects

L Sedel

Publications and source records attributed to L Sedel.

At least 127 records · Page 7Linked to original sources
PubMed1983

[Iatrogenic lesions of the spinal accessory nerve. Microsurgical repair].

Iatrogenic lesions of the spinal accessory nerve were explored and repaired in 10 patients. Symptoms included pain, trapezius muscle atrophy, restricted active abduction and drop shoulder; as they developed after cervical lymph node biopsy, diagnosis was usually easy. Depending on the operative findings, microsurgical repair involved suture, neurolysis or grafts. Clinical and electromyographic results are available from 7 patients followed up for 14 months on average: complete recovery was observed in 3 cases and satisfactory but incomplete recovery in 3; there was one failure. Since these lesions often have severe sequelae, exploration and repair are advocated.

Accessory Nerve↗
PubMed1983

[Analysis of the mechanical function of the cruciate ligaments in antero-posterior knee laxity. An in vitro study].

In order to evaluate the contribution of both anterior (ACL) and posterior cruciate ligaments (PCL) in antero-posterior knee laxity, mechanical tests were performed on 31 fresh-cadaver-knees ranging from 20 to 68 years old. The joints flexed at 90 degrees in a mounting apparatus were placed in a testing machine with the tibia fixed in neutral rotation. The load-displacement curves were then analyzed. The results showed that the tensile strength of the ACL decreased greatly with age whereas its stiffness measured during anterior drawer test remained independent of age and sex. Successive resection of the antero-medial (AM) and postero-lateral (PL) bundles of the ACL demonstrated the AM bundle to be the major structure involved in the limitation of tibial displacement in the anterior drawer test. The amount of tibial shift during the anterior drawer test did not reflect the condition of the ACL, while its resection always induced a strong and significant drop in anterior knee stiffness. Dissection of the PCL was always followed by significant posterior tibial displacement during the posterior drawer test of over 10 mm, which did not permit the experimental apparatus to quantify the posterior load displacement relationship.

Adult↗
PubMed1983

Isolated compression of the motor branch of the ulnar nerve.

This paper reports four cases of isolated compression of the deep branch of the ulnar nerve, and reviews the various etiologies (tumor, malformation and microtraumatism). The authors stress the importance of the electric examination, particularly conduction velocity in the palm in localizing the nerve lesion. Surgical exploration in these cases revealed a Giant cell tumor, two synovial cysts, and an abnormal fibrous band stretching between the flexor digiti quinti brevis and the opponents digiti quinti. Postoperative courses were uncomplicated and every patient recuperated quickly and completely. Early surgical exploration in such cases is mandatory.

Adult↗
PubMed1983

[Results of direct surgery of the peroneal nerve in neuritis in Hansen's disease].

Twenty-two patients with common peroneal neuritis from Hansen's disease were treated surgically. Physiopathologic and semiologic features of the affection are discussed, as well as the rules for therapeutic protocols, which should involve both medical and surgical treatment, and the operative technique described. Results on motor function appear to be satisfactory, but are dependent on many factors (duration of the neuritis, importance of the compressive factor, immunopathological form of the disease, quality of medical treatment). The indications for these neurolytic procedures are defined, and are predominantly any hyperalgic deficiency neuritis. The only contraindications are chronic painless palsies where improvement is doubtful because of neural fibrosis.

Adolescent↗
PubMed1983

[Results of the surgical liberation of the ulnar nerve in retro-epitrochlear tunnel syndromes].

Three different techniques have been employed for surgical treatment of 62 ulnar nerves at the elbow region provoking neuropathies. Disorders became worse in 2 out of 11 patients treated by endofascicular neurolysis and this procedure should be abandoned. Overall sensory-motor results of subcutaneous anterior transposition of the nerve, performed in 26 cases, were inferior (78 p. cent good results) to those obtained by neurolysis combined with longitudinal epineurotomy (95 p. cent good results), applied in 25 cases. Almost constant disappearance of subjective symptoms, pain and paresthesia, was observed with the two latter methods. Treatment proposed for the ulnar tunnel syndrome is therefore simple neurolysis combined with longitudinal epineurotomy. Prognostic factors cannot be assessed from this study, the age, time between onset and operation, and the degree of paralysis having no incidence on the postoperative improvement obtained.

Adolescent↗
PubMed1982

[Results of great nerve trunk grafts].

The authors describe the results of 60 cases of trunk repairs, carried out by the same surgeon, and with a follow-up period of 18 months or more. The grafts were autologous and in most cases the donor was the saphenous nerve. The grafts were placed under microscope. The recipient sites were the median nerve (19 cases), the ulnar nerve (16 cases), the radial nerve (10 cases), the sciatic nerve (8 cases), the musculo-cutaneous nerve (6 cases) and the spinal nerves (1 case). After a description of the technique used, the results are analyzed in accordance with the classical criteria of Highet and Holmes, to which has been added the notion of harmony of movement. The overall evaluation has been carried out in accordance with the following scale: two-point discrimination less than 15 mm + M4 or M5 + harmony = very good; two-point discrimination impossible to interpret, protective sensitivity S2 + M4 or M5 + harmony - good; crude protective sensitivity (S1) + M3 or less X average. Of the 60 cases, 21 ranks as very good and 22 as good, together giving an aggregate 72% of the total, with 12 cases ranking as mediocre and 5 failures. The incidence on these results of the following factors in then considered: the patient's age, the nerve damaged, the level of the injury in a given nerve, the time intervening between the initial lesion and the repair, the length of the nerve injury, the number of fascicles, the quality of the tissues and the surgeon's experience. It would seem that the best chances of success involve: a patient aged under 30, a short intervening period (less than 6 months between accident and repair), an injury less than 5 cms long, the maximum number of fascicles, good quality tissues and an experienced surgeon.

Adolescent↗
PubMed1982

Ulnar neuritis in Hansen's disease results of fifty neurolyses in the arm and elbow.

Fifty cases of ulnar nerve neuritis in Hansen disease are reported. The authors analyse the type of lesion, the clinical feature, the treatment, and the results of neurolysis. Many points are emphasized: the requirement to an association antileprosy, chemotherapy and corticotherapy with a careful neurolysis; pain and paresthesia were relieved immediately after neurolysis, recovery within two years after neurolysis; the amount of recovery was directly related to the extent and stage of involvement of the nerve; and thus the sooner procedure give the best result.

Adolescent↗
PubMed1982

The results of surgical repair of brachial plexus injuries.

Between October 1972 and December 1980, 139 post-traumatic brachial plexus palsies were operated upon by the same surgeon. The results of 63 are reported with a follow up of at least three years for the 32 complete palsies and two years for the 31 partial palsies. The protocol for examination and surgical repair is described. Major repairs were performed in 48, including suture, interfascicular grafting and nerve transfer. The remaining 15 had a neurolysis. The results are given for each type of lesion and for each kind of repair. Two series of complete palsies, one treated operatively, the other conservatively, are compared. It is concluded that surgical repair gives good results in partial palsies and in some complete palsies. Nerve transfer or graft gives some improvement but the usefulness of the limb remains disappointing.

Adolescent↗
PubMed1981

[Acceleration of repair of non-unions by electromagnetic fields (author's transl)].

This work deals with the results obtained by four French orthopaedic departments using the electromagnetic field stimulation for non union treatment. This is the method established by A. Bassett. 37 cases are studied, the results are known for 35 of them with 6 failures and 29 successes. The failures can be explained for four of them by a bad application of the device. Concerning the 29 successful cases, the role of the stimulation is discussed. Discarding those who have been treated a short time after a surgical procedure, those who have been immobilized more than 6 months and those where the non union could have been a delayed union, it remains 14 successful cases apparently undisputable. For them the role of the electromagnetic field stimulation seems real.

Adolescent↗
PubMed1980

Comparison of the effects of intramedullary nailing or plating on the mechanical properties of fracture callus.

Twelve metatarsal sheep bones were osteotomized and fixed either with an intramedullary nail or with a standard plate without compression. The mechanical properties of the callus were assessed three months post-operatively using a bending test. Ultimate bending strength, tangential stress, energy to tailure, stiffness and moment of inertia were measured or computed with the recorded data. It was concluded that the nailing technique improved callus properties more than plating. For the 12 weeks of consolidation, the mechanical properties of the callus at this stage have been ascribed to the degree of mineralization.

Animals↗