RESUMEN
Conflicting data in the literature justify this review about the flexor retinaculum (FR). Reconstruction of the FR following carpal tunnel open release has been recommended in order to limit the drawbacks of open carpal tunnel release; these drawbacks have been reported in wide series of results published between 1956 and 1988. This paper includes a review of the literature, a survey of the practice of the members of the French society for surgery of the hand (GEM), a self-evaluation of grip strength as well as a summary of indications.
Asunto(s)
Síndrome del Túnel Carpiano/cirugía , Ligamentos/cirugía , Humanos , Procedimientos Ortopédicos/métodos , Encuestas y CuestionariosRESUMEN
We describe a new procedure of trapeziometacarpal ligamentoplasty. This ligamentoplasty is both passive and active. The operation is performed in three stages: (1) Transfert of part of the abductor pollicis longus in a posterior and distal direction; (2) Transfert of the radial part of the extensor carpi radialis longus into the proximal first metacarpal; (3) Forming a loop around the flexor carpi radialis tendon with a distally inserted slip of abductor pollicis longus.
Asunto(s)
Huesos del Carpo , Inestabilidad de la Articulación/cirugía , Ligamentos Articulares/cirugía , Articulación Metacarpofalángica/cirugía , Pulgar , Adulto , Estudios de Seguimiento , Humanos , Inestabilidad de la Articulación/etiología , Inestabilidad de la Articulación/fisiopatología , Masculino , Articulación Metacarpofalángica/lesiones , Persona de Mediana Edad , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
With the experience obtained in a surgical air borne unit and the long term results in a rear zone hospital, we analyse treatments of bone and joint acute traumas in a field hospital. This injuries appear in a particular context: delayed treatments with little staff and equipment. The surgeon has to be fast with protective measures, debridement of soft tissues, bone stabilisation and vascular repair. We discuss the respective place of each treatment: amputations are dictated by the gravity of the wounds; orthopedic methods are used for the upper limb, for the lower limb they are waiting technics; external fixation stabilizes fastly bone injuries, facilitates transportation and permits delayed reconstruction technics. Indications have to be adapted to circumstances: in a surgical unit with rear evacuation possibility the dramatic choice of amputation is often avoided by external fixator; in a short time mission for civilian populations, amputations are more often used but if conservative treatment is preferred, external fixator must be widely used.
Asunto(s)
Huesos/lesiones , Articulaciones/lesiones , Guerra , Heridas y Lesiones/cirugía , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Medicina Militar , Estudios RetrospectivosRESUMEN
The authors report a new case of osteoid osteoma of the lunate. The absence of any specific clinical or radiographic features emphasises the importance of computed tomography, which not only confirms the diagnosis, but, more importantly, defines the topography and also guides the surgical approach and even the surgical technique.
Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Hueso Semilunar , Osteoma Osteoide/diagnóstico por imagen , Adulto , Neoplasias Óseas/diagnóstico , Humanos , Masculino , Osteoma Osteoide/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
Juxtacortical chondroma is the less common of the two varieties of chondroma which may develop in the hand. Two cases are reported, and the authors review the clinical, radiological, pathological and therapeutic data concerning this tumour which was first individualized by Lichtenstein and Hall in 1952. Clinicians should be well informed on the characteristics of juxtacortical chondroma, since its differential diagnosis with a malignant lesion may be extremely difficult, even at histology, and since conservative surgery with complete excision of the chondroma usually results in permanent cure.
Asunto(s)
Neoplasias Óseas/diagnóstico , Condroma/diagnóstico , Mano , Adulto , Neoplasias Óseas/cirugía , Condroma/cirugía , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
The authors report a new case of osteoid osteoma of the lunate. The absence of any specific clinical or radiographic features emphasises the importance of computed tomography, which not only confirms the diagnosis, but, more importantly, defines the topography and also guides the surgical approach and even the surgical technique.