Surgical treatment of compression of the lateral antebrachial cutaneous nerve.

We describe an operation to relieve compression of the lateral antebrachial cutaneous nerve at the elbow. Between 1987 and 1997 we operated on seven patients, one with bilateral compression. In two the compression was associated with injury to biceps.

[Glomus tumor of the nail area. Apropos of a series of 55 patients].

Purpose Of The Study: Glomus tumors are infrequent in the hand. We have review 55 cases, localized in the nail area to discuss their diagnosis and surgical approach.

Material And Methods: Out of 80 glomus tumors of the hand seen in two hand units, 55 were located around the nail area, 33 in the nail bed area, 8 at the nail root and 14 laterally.

Primary synovial osteochondromatosis of the hand and wrist. Report of a series of 21 cases and literature review.

Objectives: To define the characteristics of synovial osteochondromatosis of the hand and wrist.

Patients And Methods: Retrospective study of 21 patients, including 11 with intraarticular and 10 with tenosynovial disease. Cases secondary to degenerative joint disease were excluded.

A glomus tumour with four recurrences.

A case of a glomus tumour of the distal segment of the ring finger, with four apparent recurrences in an 8-year period, is described. The patient was treated by two different surgeons (two and three times respectively) and obtained pain free intervals of between 4 and 11 months before recurrence. Histological examination confirmed the diagnosis of a glomus tumour in all five procedures.

Intraneural mucoid cysts of the upper limb.

Intraneural mucoid cysts are uncommon. They usually affect middle-aged men, presenting with pain and symptoms of nerve compression. We report on our series of six patients, three of whom had cysts involving the digital nerves.

Diagnosis of digital pulley rupture by computed tomography.

Seven patients who presented with a rupture of the digital pulley were investigated by computed tomography. The rupture involved the A2 and A4 pulleys in four cases, the A2 pulley in two cases and, in the final case, the A4 pulley alone. A sagittal-plane CT scan gave a precise analysis of the rupture in all cases.

Stabilized resection arthroplasty by an anterior approach in trapeziometacarpal arthritis: results and surgical technique.

Resection arthroplasties were performed through a carpal tunnel incision in 72 hands of 57 patients with trapeziometacarpal joint arthritis and coexistent pathology of the anterior hand or wrist. Sixty-nine hands were followed for an average of 44 (range, 12-74 months). Pain relief was excellent in 60 hands, good in 7, and fair in 2, and thumb motion was satisfactory in 64 hands.

[Fractures and luxations of the fingers].

Fracture and luxation of the long fingers are particularly frequent in hand trauma. Untreated or poorly treated, they may leave highly disabling sequelae. The aim of treatment is two-fold: to repair the anatomical lesion and to obtain movement as rapidly as possible, the only means of avoiding joint stiffening.

Wrist and hand injuries in platform diving.

To permit a smooth entry into the water, platform divers assume a special position with their hands. An older method consists of hitting the water with both fists closed while holding one thumb in the palm of the other hand. In a newer technique fingers and wrists are hyperextended, the forearms pronated, and the hands overlapped.

[Resectable tumors of the peripheral nerves. Apropos of 73 nerve tumors in 53 patients].

The authors report on a study of 53 patients suffering from resectable nerve tumors of the peripheral nerves, representing a total of 73 tumors. This concerns a round, hard swelling, with slight transversal movement, located along the course of a nerve. This swelling was painful and percussion led to lancinating pains along the course of the nerve.

A study of the orientation of the fibers of the flexor carpi radialis tendon: anatomy and clinical applications.

The authors report a series of 41 dissections of the forearm intended to study the orientation of the fibers of the flexor carpi radialis (FCR). This shows that there is a constant torsion of the fibers of the FCR by an average of 180 degrees. Half of this torsion occurs in the forearm and half in the sheath of the FCR at wrist level.

[Pseudarthrosis of the uncinate process].

Ten cases of nonunion of the hook of the hamate were observed, eight of which had occurred during athletic activity. The mean age was 31.1 years and the mean length of time between the accident and diagnosis was 8.

[Ulnar luxation of the extensor pollicis longus. Anatomic and clinical study].

The authors report five cases of ulnar dislocation of the Extensor pollicis longus caused by rupture of the hood at the metacarpophalangeal of joint the thumb. This rarely described lesion is well known in long fingers but seems to be less common in the thumb and no previous series can be found in the literature. This dislocation gives a deficit on active extension of the metacarpophalangeal joint of the thumb.

[De Quervain's tenosynovitis. Transversal scar and fixation of the capsular flap].

The authors report 62 cases of De Quervain tenosynovitis treated from 1983 to 1990 by the same surgeon. The de Quervain's tenosynovitis is an inadequation between the volume of the abductor pollicis longus and the extensor pollicis brevis and their tunnel above the radial styloid process producing a mechanical tenosynovitis. This disease occurs mostly in women with an average age of 47 and almost never before the age of 30.

[Carpal tunnel syndrome in hemodialysed patients. Analysis of 110 surgically-treated cases].

The retrospective study of this homogeneous series of 110 carpal tunnel syndromes in 70 patients on hemodialysis shows the usual severity of symptoms (right thenar amyotrophy in 56% of cases, advanced nerve lesions in 66%). Synovitis plays a major role, as demonstrated by the frequency of clicking fingers (45%), and requires synovectomy that allows thoroughly exploring the carpal tunnel and removing a highly aggressive element against tendons. In this study, fisculae do not seem to have the generally admitted importance, but it requires surgical caution.

Forty-eight glomus tumours of the hand. Retrospective study and four-year follow-up.

We report a series of 48 glomus tumours of the hand, which have been reviewed with an average follow-up of 4.5 years (2-14). The tumour was nearly always sited in the distal digit, para-ungual (22 cases), more rarely subungual or under the pulp, with an even distribution among the fingers.

[Frontal partial epicondylectomy for release of the ulnar nerve at the elbow].

The author reports about an original technique of release of the ulnar nerve in the elbow by frontal partial epicondylectomy. In our opinion, this technique has the advantage of leaving a natural protection for the ulnar nerve when leaning on the internal aspect of the elbow. After summing up the various elements of ulnar nerve compression in the elbow and the various surgical techniques to remove compression, we describe in detail the surgical technique that we propose.

[Traumatic luxation of the extensor apparatus of the dorsum of the metacarpophalangeal joint of the little finger. Six cases].

Dislocation of the extensor tendon over the MP joint as a result of trauma is a rare and unrecognized injury as our six patients were only operated subsequently. The diagnosis is simple: flexion is possible, while extension is not. The patient is able to hold the extension despie resistance if the dislocation is reduced by artificial extension.

Flexor tendon lengthening by tenotomy at the musculotendinous junction.

The author presents his experience with an established technique of flexor tendon lengthening by tenotomy at the musculotendinous junction. This technique can be used for digital stiffness of forearm origin when active extension is possible on flexion of the wrist. There must not be adherence in the carpal tunnel or in the digital sheath, and active flexion must be preserved.

Translocation of the fifth finger by intracarpal osteotomy.

We present an original technique of transposition of the fifth ray by intracarpal osteotomy. After a review of various techniques and their disadvantages, the principles of the procedure are described. It includes a resection of the whole fourth ray and translocation of the fifth ray following a wedge-shaped osteotomy of the lateral aspect of the hamate, and an arthrodesis between the capitate and the hamate.