Anatomical variations in the sensory innervation of the dorsal surface of the first digit space, a cadaveric study with clinical consequences.

Introduction: Radial nerve palsy is a classical complication of a humeral shaft fracture. In clinical practice, motor palsy of the radial nerve is sometimes observed without an abnormality felt in the sensory territory.

Hypothesis: We hypothesised that this dissociation between sensory and motor involvement is related to anatomical variations of the sensory innervation of the dorsal surface of the first digit space, thus, we decided to study the nature and frequency of these variations.

Induced membrane technique with sequential internal fixation: use of a reinforced spacer for reconstruction of infected bone defects.

Purpose: To evaluate a novel sequential internal fixation strategy using a reinforced spacer for infected bone defect reconstruction by the induced membrane technique (IMT).

Methods: A retrospective case study was performed among patients treated for infected bone defects by applying this strategy. Following radical debridement, temporary stabilization was provided by a massive cement spacer combined with minimal intramedullary fixation during step 1.

Very long-term results of post-traumatic bone defect reconstruction by the induced membrane technique.

Introduction: The induced membrane technique for bone defect reconstruction is now well recognized, and short-term results for bone healing are consistent between published reports.

Objectives: To assess very long-term functional results in post-traumatic reconstruction using the induced membrane technique.

Method: Results for 18 patients undergoing bone defect reconstruction by induced membrane were retrospectively analyzed at 10 to 22years' follow-up.

A cadaver study into the number of fasciotomies required to decompress the anterior compartment in forearm compartment syndrome.

Purpose: There is no typical approach for decompression of forearm compartment syndrome, due to contradictory considerations regarding the characteristics of forearm anterior compartment deep fascia. The main purpose of this study was to determine how many fasciae should be opened to fully decompress the forearm anterior compartment. Further, the compliance of the deep anterior compartment was also investigated, to strengthen our results.

Induced Membrane Technique: Pearls and Pitfalls.

The induced membrane technique for reconstruction of bone defects has proved its effectiveness and is now widely accepted. The 2 stages procedure, implying a cement spacer in the first stage and a huge bone graft in the second stage, responds to rigorous technical details involving each phase of the procedure. Prerequisites for the technique, cement spacer, bone fixation, time between the 2 stages, grafting, and postoperative course are reported and discussed.

Circumferential bone grafting around an absorbable gelatin sponge core reduced the amount of grafted bone in the induced membrane technique for critical-size defects of long bones.

Objectives: The objectives of the study were to introduce a circumferential bone graft around an absorbable gelatin sponge core using an induced membrane technique, to assess its ability to reduce the required amount of graft and to maintain the bone graft, and to evaluate the clinical outcomes in the management of critical-size bone defects.

Patients And Methods: Circumferential bone grafting using a staged induced membrane technique for managing critical-size bone defects was performed in 21 patients. Postoperative computed tomography scans were performed 7days after Hemovac drain removal and 3 months after bone grafting.

Guidelines on smoking management during the perioperative period.

Smoking is a public health problem of particular importance during the perioperative period, since it exposes patients scheduled for surgery to risk increases of 20% in hospital mortality and 40% in major postoperative complications. In addition, current smoking increases almost all specific surgical complications. The perioperative period offers a genuine opportunity for smoking cessation.

Dual-acting biofunctionalised scaffolds for applications in regenerative medicine.

Off the shelf scaffolds for replacing ultra-small diameter vascular grafts are valuable for reconstruction of diseased or damaged vessels. The limitations for such grafts include optimal handling with ready availability of varied lengths of grafts, graft patency with the ability to replace the function of active cellular mechanisms and adequate mechanical properties to maintain physicochemical function. We used a well-established, solvent casting method for potential tissue replacement scaffold fabrication with incorporated bioactive molecules, which we have previously explored to confer haemocompatibility.

[François Humbert, an unknown orthopedist, initiator of cures for the "lame"].

François Humbert (1776-1850) created in 1817 the first French orthopaedic institution, at a great turning point in orthopedics. Interested in "lame people" and "hunchbacks", he treated congenital hip dislocation and scoliosis, for about 30 years. Humbert's medical practice illustrated very well the deep transformation which occured in orthopedics at the beginning of the 19th century.

[Psychogenic contracture, a trap for the orthopedic surgeon].

Dysfunctional posture is an enigmatic pathological entity now attributed to a conversion reaction (formerly to hysteria). When localized to the limbs, the main clinical feature is a contracture of one or several articular segments inflexion or extension. Most of the time, the contracture is released by anesthesia.

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: preliminary results of five cases.

Purpose: The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT).

Methods: Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification.

[Hand allograft transplantation: what are the implications?].

The first hand allograft transplantation was performed in 1998 by a French surgeons team and has opened the era of functional allotransfers. In France, the authorized preliminary study included five patients who sustained traumatic amputation of both hands. All patients had bilateral hand allograft transplantation.

[The anatomy lesson of Doctor Tulp].

The Dr Tulp's Anatomy Lesson is one of Rembrandt's most famous paintings. Analysis of scene suggest that Dr Tulp is demonstrating the action of the flexor digitorum superficialis muscle on the flexion of the fingers PIP joints. Rembrandt's painting is a true lesson of the connection between an anatomic structure and a function.

The concept of induced membrane for reconstruction of long bone defects.

Clinical, experimental, and fundamental studies have shown the interest of a foreign body-induced membrane to promote the consolidation of a conventional cancellous bone autograft for reconstruction of long bone defects. The main properties of the membrane are to prevent the resorption of the graft and to secrete growth factors. The induced membrane appears as a biological chamber, which allows the conception of numerous experimental models of bone reconstruction.

Bone regeneration in long-bone defects: tissue compartmentalisation? In vivo study on bone defects in sheep.

Regeneration of living tissue varies with species, age and type of tissue, and undoubtedly with the biological and mechanical environment of the precise tissue. Autologous cancellous bone grafting is a well-known technique that provides bony regeneration. We investigated the efficiency of autologous bone grafting in a well-vascularised muscle environment, and additionally when isolated from the muscle and connected only to the bony environment.

Closed rupture of the tibialis anterior tendon: a report of 2 cases.

Unlabelled: Closed rupture of the tibialis anterior tendon is a rare injury, and it usually affects individuals older than 50 years of age. This rare injury tends to occur spontaneously, and this often delays diagnosis and adequate treatment. Although direct surgical repair of the ruptured tibialis anterior tendon is generally considered the treatment of choice, nonanatomic repair, tendon lengthening, or tendon transfer might be necessary in cases where shortening of the muscle-tendon unit has taken place.

Case report: reconstruction of a 16-cm diaphyseal defect after Ewing's resection in a child.

Numerous options exist for intercalary segmental reconstruction after bone tumor resection. We present the extension of a recently developed surgical two-stage technique that involves insertion of a cement spacer, induction of a membrane, and reconstruction of the defect with cancellous and cortical bone autograft in a 12-year-old child. The boy was referred to our center for treatment of a right femoral diaphyseal Ewing's sarcoma.

Experimental animal model proving the benefit of primary defatting of full-thickness random-pattern skin flaps by suppressing "perfusion steal".

Background: The value of primary flap defatting remains unclear. This experimental animal study provides a novel theory on the problem of primary defatting, "steal of perfusion" to the skin by fat. This theory is based on the fact that the fat brings blood supply to the proximal flap portion but blood is sequestered in the fat of the distal flap portion, to the disadvantage of skin perfusion.

Arterial vascularization of the proximal extensor carpi radialis brevis tendon.

The macroscopic arterial vascularization of the extensor carpi radialis brevis tendon was investigated in 12 elbows from cadavers to provide fundamental anatomic information of this tendon which has been associated with lateral epicondylitis. The arterial blood supply of the extensor carpi radialis brevis tendon was highly consistent. The radial recurrent artery vascularized the entire proximal tendon through direct branches to the medial and lateral border of the tendon forming a network of small vessels on the surface of the tendon.