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Biomedical subjects

S Baux

Publications and source records attributed to S Baux.

At least 37 records · Page 2Linked to original sources
PubMed1992

[The intermetatarsal transverse ligaments and their connections with the tarsometatarsal articulations].

The authors have performed 20 systematical dissections of the distal part of the foot, conserved in the Toulon's liquor and 3 dissections of fresh cadavers. The last ones have been submitted at different puttings in charge before and after the resection of the intermetatarsal transverse ligament. The intermetatarsal transverse ligament is supple, extensible, but very strong. It constitutes the area of convergence of all the neighbouring fibrous structures and of several tendons of the foot. It connects together the heads of the metatarsus. It renders them jointly liable and its action is reflected above. By its modulating of the convergence of the metatarsus and their necessary associated palmar inclination, by its limitation of their divergence in relation with their dorsal inclination, it modulates and it limits the amplitude of the tarsometatarsal joints. It is helped for that by the little intermetatarsal transverse ligaments, whose the presence has been always confirmed. The metatarsus varus, very frequently associated with the hall valgus, means the escape of the first ray from the effect of the transverse intermetatarsal ligament.

Biomechanical Phenomena↗
PubMed1992

[Extension of the fingers. III. Morphologic and structural study].

The volar fascicles of the interosseous muscles possess two separate components: the proximal and glenoidal one, the distal and aponeurotic other. The armature of the dorsal aponeurosis is constituted the deep, the central and the collateral expansions of the extensor digitorum muscles, and the interosseous muscles, whom are added the lumbrical muscles. The deep expansions are constant and are fixed respectively at the basis of the first phalanx. The central and the collateral expansions constitute equally the central and the collateral, then terminal tendons, which are respectively fixed at the basis of the second and at the third phalanx. The unitive structures: dossiere, triangular and retinacular ligaments are intricate with this of the armature and render jointly the whole. All the concerned fascicles have the mechanical and histological characteristics of the tendon.

Biomechanical Phenomena↗
PubMed1992

[Extension of the fingers. IV. Morphologic and structural study].

The putting in tension of the dorsal aponeurosis of the digits induces its retraction and the nearness of its insertions on the basis of the 3 phalanges. It depends on the extensor digitorum, interosseous and lumbrical muscles. The aponeurosis is not a single driving belt, but set off in itself 3 types of reaction: 1) The gliding on the sides of the pyramid, which constitute the proximal epiphyses of the phalanges. It suppresses the central dorsal-ward tensions. 2) The displacement of the axes of insertion and rotation of retinacular ligaments inducing collateral volar-ward tractions. 3) The modifications of the way of the structures of transmission: at one time the lengthening of the way is induced by the interactions of the fibers; at other times a shortening is suppressed by the extension of the close proximal joint. Analysis of the different fibrous and fascicular interactions and translations.

Biomechanical Phenomena↗
PubMed1992

[Extension of the fingers. V. Anatomic approach to lesions of the extensor apparatus].

The physiopathology of the main deformities of the fingers, induced by the injury of the dorsal aponeurosis of the fingers, is caused by an imbalance of forces: proximally between extrinsic and intrinsic muscles; distally between central and collateral structures. The ulna Claw, caused by the whole paralysis of the intrinsic muscles, can be corrected by an interosseous tenodesis on the basis of the finger. The boutoniere is induced by the exaggeration of the action of the collateral structures with respect to this of the central structures. The swan neck is induced by the exaggeration of action of the central structures with respect to this of the collateral structures. The surgical treatment consist to give back those structures their normal lengthening and way, or else to create new detours or shortenings, allowing to give back the balance. So, any structures, spared by the traumatism, will not injure by the surgeon.

Finger Injuries↗
PubMed1992

[Experimental carpal displacement induced by ligamental lesions].

Ligamentous lesions were created experimentally in 40 fresh cadaver wrists. The precise localization of traumatic rupture of the ligaments and the subsequent carpal imbalance were defined by the comparison between the experimental results and the clinical displacements. The displacements may be permanent, sequential or induced by external forces. Lesions of capsular ligaments cause the displacement. There are 3 functional units; the distal scaphoid complex; the palmar ligaments which form a "belt", consisting of the lateral external ligament, the radiocarpal ligaments an the radiate ligament; the medial ligaments, which also form a "belt" consisting of the palmar triquetral ligaments on each side of the triquetrum. The sprains are caused by a lesion of a functional unit. The lateral sprain is characterized by a lesion of the distal scaphoid complex. The scaphoid moves into a horizontal position, causing a dorsal deviation of the lunate and a scapholunate diastasis. The central sprain is induced by a rupture of the palmar "belt", causing an anteroposterior radiocarpal or mediocarpal drawer movement. The medial sprain is induced by the rupture, of different extents, of the medial ligaments. On examination, there is either a click or a palmar deviation of the lunate, sometimes with a lunotriquetral diastasis. The dislocations of the wrist are caused by lesion of several ligamentous units.

Biomechanical Phenomena↗
PubMed1992

[The carpal synovial sheaths and their vascularization].

The synovial sheaths of the flexor digitorum of 70 pieces of fresh cadavers have been studied on the whole of their length as far as the basis of the fingers: 20 have been injected with a latex or a physiologic solution, after the ablation of the palmar aponeurosis and of the superficial palmar arch. The arteries of the 50 other pieces have been injected with coloured latex solution from humeral artery. The proximal limit of the superficial sheaths is located 5 centimetres above the radiocarpal articular line and this of the deep sheaths 7 centimetres. In the metacarpal area, the superficialis central sheath presents peritendinous expansions, which realise an uninterrupted connection with each digital sheath. It is the aponeurotic and vascular extrinsic compressions, which simulate the interruption of these expansions. The proximal synovial arteries have a muscular origin. The antibrachial collateral arteries, 3 pairs in number, arise from the radial and the ulnar arteries. The distal synovial arteries come from the palmar arches and from their branches: superficial branches for the superficial sheaths and deep branches for the deep sheaths. There is many anastomoses between the different synovial arteries. Two are particularly developed and connect the proximal arteries to the palmar arches: the superficial longitudinal anastomotic artery; which runs close along the medial edge of the median nerve; the deep longitudinal anastomotic artery, which gives the nutritious branches for the tendons of the flexor digitorum. This disposition allows to create two synovial flaps of gliding and vascular help, centred on the anastomotic longitudinal arteries, pediculated on the volar archs and distal-ward rotated.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1992

[Finger extension. I. History. State of knowledge].

Recapitulation of the principal stages concerning the descriptive and the functional anatomy of the extensor apparatus of the ulnar digits. They can be written in the following frame: The Gálien's theories of the exclusive role of the extensor digitorum muscles prevail during more as a millenium. The indispensable conjoined action of the interosseus muscles through the collateral tendon is demonstrated by Duchene in 1867. The role of antagonistic muscles is clearly showed by Bouvier in 1851 on the level of the metacarpo-phalangeal joints and by Valentin and Tubiana in 1962 on the level of the proximal interphalangeal joints. The role of the oblique retinacular ligament on the extension of the third phalanx is specified in 1956 by Landsmeer.

Anatomy↗
PubMed1992

[Finger extension. II. Materials and methods].

The study of the extensor apparatus through different methods concerns 200 fingers, the most of fresh cadavers. The dissection through direct observation or with surgical microscope of the dorsal aponeurosis of 30 fingers has been completed by an histological study of 10 fingers. The mechanic properties of each dorsal aponeurotic structure has been tested by extensometry on 12 fingers. The functional study of the role and of the transmission of the different motor components concerns 128 fingers. It has been completed by experimental sections of each aponeurotic structure concerning 20 fingers.

Finger Injuries↗
PubMed1992

[Salvage ligament repair following failure of arthrodesis of the lunate-triquetrum-hamate joint for internal instability of the joint. Apropos of a case report].

A case of posttraumatic carpal dislocation in volar inclination of the intermediary segment (VISI), treated by a lunate-triquetrum-hamate arthrodesis (LTH) is presented. This operation leaves the rupture of the radio-triquetrum dorsal ligament; rather the entire carpus rotates in supination postoperatively. This repair of the radio-triquetrum dorsal ligament permits realignment and stabilization of the carpus and results in resolution of pain.

Arthrodesis↗
PubMed1992

[Experimental carpal displacement induced by bony lesions].

Bony lesions were created experimentally in 48 fresh cadaver wrists. They consisted of radial and scaphoid resections along the extent of the proximal carpal row, representative of clinically-induced (usually traumatic) lesions. The displacements obtained experimentally to mirror each clinical situation modify the physiologic equilibrium established between the trans-osseous forces and the ligaments. The comparison between the experimentally-induced lesions and clinical displacements shows the etiology of the clinical conditions which indicates the proper treatment.

Carpal Bones↗
PubMed1990

Properties of the fibrous structures of the wrist.

Every fibrous structure of ten wrists of fresh cadavers has been the object of an elastometric study. The opposite wrists have been studied surgically and then histologically with the optical microscope. Comparison between the two shows a close relationship between the mechanical features and the morphology of the bundles, which proved also to be perfectly measurable. It also displays the great differences between ligaments and tendons. Histological study of the tendons and ligaments of four other wrists subjected to manoeuvres of axial loading, rupture and bending, reinforces these statements. The therapeutic consequences are considered.

Biomechanical Phenomena↗
PubMed1990

[Reduction mammoplasty with a J-shaped scar (the Jean-Sauveur Elbaz technic). Review of 125 cases].

Public hospital experience of reduction mammaplasties using L scars of J.S. Elbaz technique. The authors review their public hospital experience of reduction mammaplasties using the L technique described by J.S. Elbaz. This technique minimizes scaring because there is non medial horizontal branch. After describing the technique, they analyze the immediate and long-term results. Immediate postoperative course is uneventful: there were no cases of cutaneous or areolar necrosis. The following points are emphasized: residual mammary volume, shape, stability of contour, course of the scar, areolar sensitivity and appearance. The overall results are good. This technique has the same advantages as more recent mammaplasty procedures (vascular safety, easily adaptable reduction, good long-term results), for minimal scarring which is an indisputable psychological and aesthetic advantage. Nevertheless, problems arise in cases of very severe hypertrophy, for which secondary procedures are frequently necessary.

Adolescent↗
PubMed1990

[Cutaneous expansion in burns sequelae].

This technique of skin expansion with inflatable balloons has rapidly become generally used since Neuman's and Radovan's work. It offers new prospects for the treatment of the sequellae of burns as it allows increasing the surfaces of the remaining unaffected skin and using them to cover the excision of scar lesions by local or remote flaps. Experience with more than 500 implanted balloons is assessed, demonstrating very satisfactory general results in spite of a still too high number of complications, which increasingly refined techniques aim at reducing.

Burns↗
PubMed1989

Burns in the elderly.

This report describes the treatment and prognosis of 37 burned patients over 70 years of age.

Aged↗
PubMed1989

The nutrient flap: a new concept of the role of the flap and application to the salvage of arteriosclerotic lower limbs.

The nutrient flap is a new concept of the role of the flap. It has three functions: (1) it provides supplementary blood flow to ischemic zones, (2) it assists venous drainage in regions of venous insufficiency, and (3) it induces the formation of a capillary network. Its skin covering role is only accessory. We have applied this principle to osteitis, pseudoarthrosis, and arteriosclerosis. The nutrient flap constitutes a new type of treatment for stage IV arteriosclerosis of the lower limbs when classical revascularization techniques cannot be performed and when high amputation is indicated. Four clinical cases and the surgical techniques used are described. The flap, usually raised from the latissimus dorsi, is anastomosed to the popliteal artery by means of an inverted saphenous vein graft. It is applied to the distal extremity of the limb after excision of the necrotic tissues. The nutrient flap preserves weight-bearing by maintaining the heel.

Aged↗
PubMed1988

Boutonniere deformity in Dupuytren's disease.

The boutonnière deformity in Dupuytren's disease has been found to be due to fibrous contraction of the transverse retinacular ligament which anteriorly displaces the fibres of the extensor apparatus. Complete ablation of this ligament and liberation of the extensor apparatus allows easy extension of the finger when operating on severe cases of Dupuytren's contracture.

Dupuytren Contracture↗