[Should we reconstruct the flexor retinaculum in the carpal tunnel?].

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.

Vascularised pisiform bone graft. Indications, technique and long-term results.

The authors report their experience with the use of a vascularised pisiform bone graft based on the dorsal branch of the ulnar artery to provide osseous support and an efficient vascular aid especially in non-unions of the carpal navicular bone with avascular necrosis of its proximal pole and in stage III Kienböck's disease. The pisiform can replace the proximal pole of the navicular bone in totality. When implanted into the lunate, it stops its collapse and helps to revascularize it.

[Aponeuroses and superficial fascia. Mechanical and structural properties].

Eleven superficial aponeuroses have been examined in order to study their biomechanical and structural properties. Specimens were taken from 5 fresh cadavers, 3 males, 2 females with a mean age between 40 and 60 years. The study was done by two methods: biomechanical and histological.

The distal ligamentous complex of the scaphoid and the scapho-lunate ligament. An anatomic, histological and biomechanical study.

22 fresh cadaver specimens have been examined to study the anatomy, histology and biomechanical features of the ligaments of the proximal and distal poles of the scaphoid. The biomechanical study was carried out by two methods: an analytical one on an Instron machine, and a global one in situ. The different experiments show the predominant rôle of the distal ligamentous complex of the scaphoid over the scapho-lunate ligament.