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Biomedical subjects

P Vichard

Publications and source records attributed to P Vichard.

At least 73 records · Page 4Linked to original sources
PubMed1989

[The immediate management of fractures of the femoral trochanter using a plate with a support. Experimental basis, technic, results, indications].

Early full weight bearing in femoral trochanteric fractures is an important problem. It seems to us to be imperative because the very old aged population (about 80 year old average) concerned by that type of fractures. That attitude reduces hospitalisation and rehabilitation time. The authors propose an original 95 degrees angular-plate rendered by a stay. A complete experimental study proved that material able to support the immediate weight bearing. A clinical application on 207 cases confirmed the experimental hypothesis.

Aged↗
PubMed1989

[Open fracture of the leg with major cutaneous lesions. Imperative character of immediate closure and following possibilities of internal stabilization of the skeleton. Apropos of a continuous series of 20 cases].

The advantages of immediate wound closure in case of open leg wounds, as opposed to delayed repair or the use of greasy dressings, need no longer be proven. Indeed, modern plastic surgery technics have become quite ingenuous, reliable and applicable to most severe skin, lesions (type III as per Cauchoix-Duparc and so--called potential type III). These facts have been confirmed by a study of 20 cases including both types. Moreover, more and more often, immediate wound repair allows for external fixation replacement, typically by osteosynthesis, which is more advantageous from the viewpoint of fracture consolidation. Complications (namely infection rates) have not increased, which is an encouragement for the continued application of this method, which constitutes a departure from usual indications.

Adult↗
PubMed1989

[Socioeconomic value of early weight-bearing after fracture of the greater trochanter:--the role of osteosynthesis using an angled support plate].

Early full-weight bearing in patients undergoing surgery for femoral trochanteric fractures does not decrease the rate of mortality. However, such full-weight bearing is of great psychological value for the patients as well as the nursing staff to whom immediate care seems thus more ambitious. Moreover, such an attitude reduces post-operative hospitalisation and an eventual convalescence period to a minimum. This full-weight bearing is allowed by different techniques which are here outlined and discussed. The authors propose a 95 degree angular plate which avoids acetabular protrusion during weight bearing before bone healing. Addition of a stay renders this plate more resistant than the 130 degree one which, moreover, migrates toward the hip joint during weight bearing. An experimental study has proved that this material allows early weight bearing without risk of rupture. Clinical applications have confirmed such a view.

Aged↗
PubMed1989

[Entrapment of the median nerve after dislocation of the elbow].

Entrapment of the median nerve as a complication of a dislocation of the elbow has rarely been reported. The prognosis is worse in case of delayed diagnosis. Exploration surgery is indicated when neurological signs remain following reduction of a dislocation of the elbow.

Child↗
PubMed1989

[Anatomoclinical forms of fractures of the sternum. Role and methods of osteosynthesis of unstable fractures].

In general, fractures of the sternum are of little interest. This is unfair since unstable fractures may be the cause of paradoxical respiration and hence respiratory distress. Fractures often result from automobile accidents and occur in passengers wearing seat belts. In these circumstances, the seat belt in fact replaces the steering wheel as the causative agent. With reference to several cases this variety of injury is studied from the anatomo-pathological, clinical and therapeutic viewpoints. Osteosynthesis using a plate and screws limited to the sternum or including neighbouring rib fractures would appear to be the method of choice. Surgical fixation of the fracture site, the methods of which are discussed, is of value for both isolated lesions of the thoracic cage, and also in the context of single stage surgery in certain patients with multiple trauma.

Accidents, Traffic↗
PubMed1988

Recent simple flexor tendon injuries in zone I, II, III of Verdan. Results of tendon repairs concerning 115 fingers in 99 patients.

In this study, the authors analyze 197 recent injuries of the flexor tendons of fingers in zones I, II and III of Verdan, without complex cutaneous lesions, associated with an injury of one or both digital nerves, but leaving safe at least one digital artery. Tendon repair is either followed by strict immobilization or by Kleinert's method of immobilization. Results concerning 115 reviewed injuries evaluated according to Kleinert's criteriae, show a net superiority of Kleinert's technique compared to strict immobilization. Global results are analysed according to the age, the finger injured and the presence of a work accident. Lesions treated by Kleinert's technique have been analyzed according to the zone of injury, the tendon injured in zone II and the existence or not of an injured digital nerve. After Kleinert's method, factors affecting the prognosis are lesions in zone II, injury of both tendons, lesions of the fifth finger, the responsibility of a "work accident". The authors conclude as to the correct time for repair, the tendons to be repaired and the type of injuries to be immobilized. They also emphasize the progress brought to the surgery of flexor tendons by Kleinert's method.

Adolescent↗
PubMed1988

Fractures of the proximal end of the radius associated with other traumatic lesions of the upper limb. A report of seventy-three cases.

Closed isolated fractures of the radial head should be considered and managed in a different way from those associated with other traumatic lesions of the upper extremity. The recommended treatment for the radial head is early motion, with or without internal fixation or arthroplasty. For this to be achieved, surgical fixation of most of the associated fractures, and surgical repair of serious damage to capsular and ligamentous structures, should be performed. Indications are proposed, according to the results of a series of 73 cases which are compared with our series of 168 observations on isolated radial head fractures.

Arm Injuries↗
PubMed1987

[Melorheostosis. Apropos of a localization in the hand].

The authors describe a case of melorheostosis localised in the hand. Melorheostosis is an unusual affection. The first signs appear in some cases at birth, but the disease is often diagnosed during the fourth decade. Clinical symptoms are pain, ankylosis, the deformation provoked by the lesion of soft tissues and especially limitation of motion. Radiographs permit the diagnosis: opacities parallel to the diaphysis with a "monomelic" topography. The natural history of the condition is characterized by the possibility of extension of the disease. Operative treatment is rarely indicated.

Ankylosis↗
PubMed1987

Treatment of isolated fractures of the proximal end of the radius in adults. Remarks concerning 168 cases.

The review of a series of 168 cases of isolated fractures of the upper end of the radius in adults allows the authors to note the advantage of functional therapy. The early physical therapy contributed to obtain an important rate of good results with the different types of Mason's classification. An osteosynthesis, when performed, must permit the early mobilisation of the elbow in order to avoid stiffness. Such a short experience does not allow the authors to conclude in favor of the necessity for the emergency use of a radial prosthesis instead of an isolated resection.

Adolescent↗
PubMed1987

[Injury rupture of flexors of the index finger complicating subcutaneous dislocations of the semilunar bone].

A case is reported here of an unusual case of rupture of the flexor tendons of the index finger in the carpal tunnel complicating a subcutaneous displacement of a lunate bone. This was combined with a carpal tunnel syndrome with hypoaesthesia. The treatment, taking account of the age of the patient and the relative tolerance to the dislocation, consisted of a simple resection of the lunate to free the medial nerve together with a partial graft of the flexor digitorum profundus.

Finger Injuries↗
PubMed1986

[Carpal tunnel syndrome in childhood. Apropos of a familial and idiopathic case].

The authors report an uncommon' case of carpal tunnel syndrome in a ten year old girl. Symptoms are typical with noctural paresthesias. The nerve conductor studies show a important compression with thenar atrophy. In consideration of the importance of nocturnal pain and amyotrophy an operation was decided. At operation, the median nerve is found constricted under tickened transverse carpal ligament. At the wrist, the volume of nerve is normal, there are not anomalous muscles or inflammatory tenosynovitis. In fact, the appearance of median nerve is identical to the cases of carpal tunnel syndrome in adult. After surgery symptomsare abolished. The mother of the young girl, 37 year old, also present a bilateral carpal tunnel syndrome with onset at the age of 10 years. There is a important thenar atrophy. At operation, the nerve is very constricted with a tickened transverse carpal ligament; no other anomaly is noted. A study of literature complete these observations.

Adult↗