Biomedical subjects
Publications and source records attributed to S Baux.
Review of the literature of chondrocalcinosis and rheumatologic osteoarticular causes of the carpal tunnel syndrome. Presentation of one observation of chondrocalcinosis of the wrist with presence of a pseudotumor, developed in the carpal tunnel and having induced a carpal tunnel syndrome, at first subacute, then particularly painful by direct irritation of the median nerve.
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In the light of a physiopathological study of severe medial strain of the metacarpophalangeal joint of the thumb in 20 cadaver hands, the authors propose a correlation between anatomical and clinical findings and a classification derived from it: Stage I: rupture of one fascicle of the collateral ligament. Passive valgus mobility of less than 15 degrees. The ruptured ends of the ligament remain in contact. Stage II: rupture of both fascicles of the ligament. Passive valgus and supination mobility of the metacarpophalangeal joint of 20 to 40 degrees. Interposition of the dorsal digital expansion between the ruptured ends of the ligament. Abnormal movements can be corrected by applying tension to the dorsal digital expansion. Stage III: rupture of both fascicles of the collateral ligament and the dorsal digital expansion. Tension from the thenar muscles causes abnormal movement and produces a fixed flexion of the metacarpophalangeal joint with hyperextension of the interphalangeal joint (Z-shaped thumb). From this the authors determine the operative indications and suggest a palliative ligamentoplasty to restore the anatomy as much as possible.
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A bone graft, taken from the medial part of the radial epiphysis can be pedicled on the radial branch of the volar carpal arch, freed back to its origin. The graft can be transferred into the proximal row of the carpus to fill up a loss of bony substance or to provide vascularised bone. This permits the treatment of chronic pseud-arthrosis of the scaphoid where a Matti-Russe operation has failed. In the first three cases operated upon, favourable results have been obtained.
Contractures of the elbow after burn injury are frequent and are often connected with other contractions. Surgical correction must take into consideration the topography, the likelihood of possible heterotopic ossification and the condition of the surrounding skin. A study of 66 contractures allowed us to reach the following conclusions: Linear contractures surrounded by normal skin require IC-type local flaps. Widespread contractures can be treated with thoracic flaps if healthy skin remains or else with the 'backwards flap'. Surgery on existing associated heterotopic ossification must be in two stages starting with the cutaneous step.
Early excision-graft of burned hands seems to have totally superseded the conventional method of progressive detorsion often with late grafting. Does this treatment merit acceptance under these conditions? Do the theoretical advantages of aggressive methods counter-balance the primary difficulty of diagnosing the initial depth of burn? Are these fewer difficulties and risks in early excision-graft than in the slower methods? Can we ascribe the failure of conventional method to a poor technical realisation? Following a short summary of the principles of the two methods, we attempt to answer these questions by a retrospective study comparing identical series of patients. We have begun a prospective randomized trial and present the preliminary results here.
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The displacement of the proximal and distal fragments of fractures of the carpal scaphoid have been studied in fresh cadavers. In 10 subjects, a comparison has been made between a below-elbow plaster, a moulded plaster gauntlet and an above-elbow plaster. The most satisfactory immobilisation has been obtained with a moulded plaster gauntlet incorporating the proximal phalanx of the thumb and leaving the elbow free.
Repairing the cervico-mandibular angle following neck burns is a major problem. Several artistic landmarks show its aesthetic importance. From a functional point of view, the authors show the positive consequences of rebuilding using the results from 101 patients with neck burns. In principle, the treatment involves maximal use of healthy skin, and the separate reconstruction of the horizontal and vertical parts of the neck.
Modality of appearance in fetal life. Racial (certain) and congenital (probable) predisposing factors. X-ray discovery of radioscapholunate fusion after minor sprain of the wrist in a young 22 year old woman otherwise without past history. Functional study of the wrist. Analysis of six similar observations reported to date.
The supracondylar process in an osseous spur located above the medial condyle of the humerus. It may be responsible for compression of the median, as well as the ulnar, nerves. Diagnostic must be directed in this direction whenever a deficit is found in the nerve distribution territory of one of these nerves.
Although very rare, fractures of the lesser multiangular (trapezoid) bone may be suspected clinically and demonstrated radiographically by special projections.
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