Publications by authors named "Goubier J"

Purpose: Restoring shoulder function after axillary nerve injury is always a challenge. Transferring a branch of the radial nerve destined to the triceps onto the anterior division of the axillary nerve has become the preferred technique. However, this is not always possible, especially when the axillary nerve is severely injured around the posterior part of the humeral neck.

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Primary ectopic extradural and extraspinal meningiomas are rare. We present a unique case of this type of meningioma in the brachial plexus. A 25-year-old man consulted us because of neuropathic supraclavicular pain and the appearance of a supraclavicular mass whose volume had increased.

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Article Synopsis
  • - Techniques like nerve grafting, tendon transfer, and joint fusion are commonly used to enhance upper limb function for patients with brachial plexus palsies.
  • - Innovative methods, like nerve transfers, are particularly beneficial for restoring function in cases of total root avulsions and improving movement in partial injuries.
  • - Intraoperative electrical stimulation helps identify injured nerves for targeted treatment, and evaluating postoperative outcomes is essential for assessing the effectiveness of these techniques.
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Objectives: This study aimed to evaluate the outcomes of the tendon transfer from a reinnervated triceps to biceps in the context of total brachial plexus palsy.

Methods: We conducted a retrospective study. Patients had reinnervation of the triceps either by spontaneous recovery or by nerve transfer.

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Article Synopsis
  • - This study addresses the limitations of 2D X-rays for assessing hand functional disorders by introducing a 3D reconstruction method using biplanar X-rays, offering more detailed information about bone structures.
  • - The reconstruction method was validated by comparing results to CT scans, demonstrating high precision with differences in measurements typically less than 1.55mm, as well as consistent results among different operators.
  • - The findings suggest that this method can enhance understanding of hand anatomy, providing more accurate and objective data for diagnosing and treating hand conditions, with potential for further automation.
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Article Synopsis
  • * Early diagnosis allows for nerve transfers, while later intervention might require tendon transfers to restore finger and thumb movements.
  • * Additional surgical techniques, such as tenodesis and nerve transfers, can enhance finger function and sensitivity, reducing the risk of injuries.
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Background: The prevalence of subscapularis (SSC) tendon tears is often underestimated. This negatively impacts the shoulder function because the SSC muscle is a powerful internal rotator. The primary aim of this study was to compare a blended clinical and radiological preoperative index of suspicion for SSC tears to the arthroscopic findings.

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Restoration of shoulder external rotation in partial brachial plexus palsies is a real challenge. The transfer of the spinal accessory nerve to the suprascapular nerve remains the gold standard. This transfer, however, cannot be always performed.

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Elbow flexion is the first goal in upper partial brachial plexus palsy treatment. However, elbow extension is essential for daily living activities. To recover this function, one fascicle of ulnar nerve can be transferred to the branch of the long head of the triceps, but this procedure has been previously published in only two patients.

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Complete femoral nerve palsies are uncommon but devastating injuries when they are caused by large nerve defects. Direct repair is usually not possible and nerve grafting renders uncertain outcomes. Recent studies proposed different peripheral nerve transfers as treatment strategies for large femoral nerve defects.

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Purpose: Studies have shown that isolated tenotomy of the long head of the biceps (LHB) improves significantly pain scores, active range of motion and Constant score in elderly patients with massive and irreparable cuff tears with no osteoarthritis. This cadaveric study was performed to assess the feasibility of a tenotomy of the LHB and subacromial corticosteroid injection using a minimally invasive in-office setting under local anaesthesia on awake patients.

Materials And Methods: Twenty scare-free shoulders were included in the study.

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The objective of our study was to evaluate the reliability of clinical examination paired with MRI to determine whether one or both of the superior C5 and C6 roots are graftable in cases of complete brachial plexus palsy. We conducted a retrospective study from 2013 to 2018. Twenty-seven patients who had total brachial plexus palsy and were more than 18 years of age were included.

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Article Synopsis
  • The case involves a 55-year-old man with severe wrist problems due to scaphoid nonunion advanced collapse (SNAC) III and bone loss in the capitate, leading to major functional impairment and pain.
  • Three treatment options were considered: proximal row carpectomy (PRC) with a pyrocarbon implant, an adaptive scaphoid implant, or total wrist fusion (arthrodesis).
  • The patient underwent PRC with a pyrocarbon prosthesis and a bone graft, resulting in successful pain relief and improved wrist mobility, indicating this approach can be effective for similar cases.
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Neuropathies of digital nerves are an infrequent phenomenon and their causes are most often mechanical. A rare cause of acute neuropathy is hourglass-like fascicular constriction of a nerve due to torsion. Although several cases of hourglass-like constriction have been described in the literature, none to our knowledge involved digital nerves.

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Article Synopsis
  • * The average age of the patients was 42 years, with initial extension deficits measured at 64 degrees and a slight hyperextension of 10 degrees in the distal interphalangeal joint before surgery.
  • * Post-surgery, 10 out of 11 patients experienced significant improvements, achieving an average lack of extension of just 8 degrees in the PIP joint and 80 degrees of active flexion at the distal interphalangeal joint, highlighting
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Recovery of shoulder function is a real challenge in cases of partial brachial plexus palsy. Currently, in C5-C6 root injuries, transfer of the long head of the triceps brachii branch is done to revive the deltoid muscle. Spinal accessory nerve transfer is typically used for reanimation of the suprascapular nerve.

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We present a case of suprascapular nerve idiopathic total palsy lasting for 2 years, with intraoperative finding of suprascapular nerve partial section by the superior transverse scapular ligament. This highlights the importance of early surgical management with an open procedure for suprascapular neuropathy of unknown etiology.

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Paralysis of the suprascapular nerve, in partial injuries of the brachial plexus, most often warrants a nerve transfer. Transfer of the spinal accessory nerve to the suprascapular nerve is performed most often. We propose to directly transfer the nerve of the rhomboid muscles (branch of the dorsal scapular nerve) to the suprascapular nerve in the supraspinatus fossa.

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The long head of the biceps tendon is frequently involved in shoulder pathologies, often in relation to inflammatory or degenerative damage to the rotator cuff. Biceps tenodesis in the bicipital groove and tenotomy are the main treatment options. Tenotomy of the long head of the biceps tendon is a simpler and quicker procedure than tenodesis, and it does not require the use of implants.

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Article Synopsis
  • * A new surgical technique, called pulley plasty, was developed to allow for immediate retraining and reduce interference with tendon sutures when treating these injuries.
  • * In a study with ten patients, most achieved good recovery in finger motion, and the procedure was found to be simple, effective, and supportive of quicker rehabilitation.
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Post-traumatic radioulnar synostosis is a rare complication of forearm fracture. Resulting in loss of forearm axial rotation, it is functionally very disabling. The surgical indication, timing of operation, surgical technique, interest and type of adjuvant treatment are all issues with which physicians managing radioulnar synostosis must deal.

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Article Synopsis
  • Femoral nerve injuries can disrupt knee function due to loss of the quadriceps muscle's locking mechanism, prompting a need for new treatment options.* -
  • A new procedure was proposed to connect the motor branches of the obturator nerve to the femoral nerve, tested on five cadavers.* -
  • Findings showed a 26 mm overlap and compatible diameters between the two nerves, allowing for easy and tension-free direct sutures, suggesting potential clinical benefits for treating femoral nerve injuries.*
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Objectives: Scapholunate ligament injuries may lead to scapholunate instability and wrist osteoarthritis. Many surgical techniques have been described to repair these injuries. The goal of our study is to assess the clinical results after capsulodesis with the scaphotriquetral ligament for scapholunate instabilities.

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