Case report: Revision of failed Sauvé-Kapandji procedure with an ulnar head prosthesis

The Sauvé-Kapandji procedure has been developed in order to solve distal radioulnar joint (DRUJ) disorders. Postoperative results are variable. Complications such as painful ulnar stump, ulnar instability and loss of grip strength have often been described. We report the case of a painful ulnar stump instability resulting from a Sauvé-Kapandji procedure. After several attempted salvage procedures, a custom-made Herbert distal ulnar head prosthesis was implanted. Long-term results showed complete pain relief, improvement of the range of motion and satisfactory grip strength recovery. Our findings confirm that the Herbert custom-made ulnar head prosthesis appear to be a reliable salvage solution for failed Sauvé-Kapandji procedures. © 2008 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Prise en charge de la lésion méniscale.

About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.English AbstractJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Fracture complexe de la cheville traitée par clou transplantaire rétrograde verrouillé: Un cas clinique

Compound fracture of the ankle treated by locked retrograde transplantar nailing: a case report. The authors describe the use of a locked retrograde plantar nailing as primary treatment for a severe trauma of the ankle (trimalleolar fracture associated with posterior dislocation and a compound talus fracture).SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Total knee arthroplasty after former knee fusion in a patient with ehlers danlos syndrome

A 46-year-old female patient with Ehlers-Danlos Syndrome had undergone fusion of her right knee 25 years before presentation. This markedly affected her quality of life. She underwent a two-stage conversion to a constrained rotating-hinge total knee arthroplasty. She regained a satisfiing range of motion and she has a painfree, mobile and stable knee at 42 months follow-up. Conversion of knee fusion to TKA is a demanding procedure that should only be performed by experienced knee surgeons, in selected cases and on highly motivated patients. Complication and revision rates are reportedly very high but global satisfaction is surprisingly good. Ehlers-Danlos Syndrome was not shown to be a contraindication for such surgeries. © 2013, Acta Orthopaedica Belgica.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

One-stage elbow interposition arthroplasty with a fasciocutaneous distally planned lateral arm flap

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Pseudoaneurysm of the ulnar artery following use of an external fixator - A case report

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Les lésions ligamentaires intracarpiennes associées aux fractures du poignet: Étude prospective radio-clinique sur 40 cas

Purpose of the study We performed a prospective study to search for arthrographic signs in favor of intracarpal ligament lesions occurring concomitantly with wrist fractures. We looked for a relationship between type of fracture and displacement and examined their impact on early functional outcome. Material and methods The series included 40 patients treated over a 1-year period. All 40 patients had a displaced wrist fracture requiring surgical treatment. A three-phase arthrography was performed during the initial operation in order to search for injuries involving the scapho-lunate, luno-pyramidal or triangular complex ligaments. A second arthrography was performed at the time the osteosynthesis material was removed. All patients were followed one year postperatively. Functional outcome was recorded at one year. Results Abnormal images were found in 57% of the patients at the first arthrography. Injury to the triangular complex predominated, followed by combined injuries. There was no statistical correlation between type of fracture, degree of displacement, and presence of ligament lesions (p > 0.05). Lesions of the triangular fibrocartilaginous complex (TFCC) were significantly increased (p = 0.04) in the event of intra-articular fracture. Age and gender did not influence ligament injury. At one year, the functional outcome was statistically comparable between patients with and without ligament injury. At the second arthrography, we observed only five cases where cure of the luno-pyramidal ligament had been achieved. Discussion Intracarpal ligament injuries associated with wrist fractures are frequent. Age had no effect on occurrence of ligament injury in our series, similar to findings reported by others. Likewise, the type of fracture had no effect. Data in the literature show that intra-articular fractures and highly-displaced fractures aggravate ligament injury. Our functional results at one year did riot demonstrate any significant difference in patients with and without ligament injury. A 3 or 5-year follow-up might provide further insight. Nevertheless, neglected scapho-lunate lesions still have a bad reputation in the literature, leading us to search for such lesions and to provide adapted treatment in all patients aged less than 50 years presenting a displaced fracture of the wrist.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Anterior flap for coverage following hip disarticulation for osteomyelitis

The use of a posterior myocutaneous flap is the most common method of coverage following hip disarticulation. Other options for coverage following hemipelvectomy have been described mainly when the conventional flap is unavailable owing to tumor involvement. We report a case of hip disarticulation for a decubitus ulcer with underlying osteomyelitis of the proximal femur; coverage was obtained using an anterior myocutaneous flap. In this case, two previous unsuccessful attempts at wound coverage prior to the hip disarticulation using a lateral and a posterior flap made the anterior flap the best available option for closure. Complete healing was achieved within two months.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Le chondrome extrasquelettique de la main, une cause rare de canal carpien

The authors report the case of a 18 years old girl presenting with a carpal tunnel syndrome, with no historyof trauma and a progression of the symptoms in 2 months. Surgery was performed and the diagnosis seems to be an extraskeletal chondroma of the hand © 2003 Éditions scientifiques et médicales Elsevier SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Modifications of arterial blood flow to the hand after carpal tunnel release

Any surgical procedure is followed by an inflammatory reaction, associated with arteriolar dilatation and increased capillary permeability. The normal evolution is in most cases a progressive decrease of the inflammatory signs. Some patients however, particularly after orthopedic trauma affecting the extremities, develop algodystrophy, initially characterized by arterial vasodilatation and low capillary flow. In an effort to better understand the normal phenomena seen after uncomplicated hand surgery, the authors have evaluated the postoperative arterial blood flow using the Duplex flowmetry ultrasound technique in 13 patients operated for carpal tunnel syndrome, who did not subsequently develop algodystrophy. After measurement of the transverse section of the ulnar and radial arteries, and longitudinal measurement of the mean velocimetry, the arterial blood flow was calculated. The measurements were done 1, 2 and 4 weeks after the operative procedure. The study demonstrated a moderate (15% - 30%) but significant increase in the arterial blood flow to the hand, related to arterial dilatation of the vessels and to an increase in blood velocimetry.SCOPUS: ar.jinfo:eu-repo/semantics/publishe