Early vs late surgical treatment of radial instability of the thumb metacarpophalangeal joint. A retrospective cohort study.

There is no clear evidence in the literature whether treating thumb radial collateral ligament (RCL) injury in the acute phase improves outcome. The purpose of the present study was to compare the clinical and radiological results of RCL repair in acute and chronic settings. Fourteen patients were included.

Osteoblastoma of the carpal scaphoid frequency and treatment.

A rare case of osteoblastoma of the carpal scaphoid is presented. Review of the literature revealed two more cases that have been previously reported. The authors present the diagnostic difficulties and the treatment which was applied: proximal row carpectomy and tendon transfers for wrist stabilization.

Non rheumatoid closed rupture of extensor carpi ulnaris tendon. Report of a case in a professional athlete.

A rare case of closed, non-rheumatoid rupture of the extensor carpi ulnaris tendon, that occurred in a professional tennis player, is presented. The authors describe the diagnostic problems and the treatment. They discuss the anatomical particularities of the area, the probable pathological mechanisms that lead to the lesion and the best ways of dealing with the problem.

[Tendinitis of the long palmar muscle tendon. Physiopathology and results of surgical treatment. Apropos of 28 cases].

The results of a 27 cases of flexor carpi radialis tenosynovitis, operated between 1984 and 1992 and followed for an average of 30 months, are reported. This study confirms the female predominance of this disease (25 women for two men) and its development mainly after the age of fifty. Pain along the course of the tendon is a constant sign, frequently associated with dysaesthesia in the territory of the palmaris brevis branch of the median nerve as well as synovial swelling.

[Treatment of recurrent Dupuytren's disease by scalar incision and firebreak graft].

We report our experience of the use of a scalar type incision associated with a total skin graft in the treatment of recurrences of Dupuytren's contracture. This is not an original technique, but one described by Hueston in 1984, which consists of a "Fire Break" skin graft after a simple transverse incision of recurrent Dupuytren's contracture. We attribute the absence of recurrence with this graft to the impossibility of the disease to affect the thin tissue between the skin graft and the underlying tendons.

Yersinia enterocolitica tenosynovitis. The first case.

We describe a case of tenosynovitis of tibialis posterior due to Yersinia enterocolitica occurring after injury by a plant thorn in a 55-year-old man. The illness was chronic with 2 recurrences in spite of antibiotic treatment. Full recovery was obtained only after surgical intervention.

[Replantations and devascularization. VBS (Vessel-Bone-Skin) emergencies].

The reimplanting activity initiated by Professor Raymond Vilain at Boucicaut Hospital in 1972 allowed emphasizing that, in addition to the reimplantation of a completely severed segment, there existed a parallel activity including microsurgical steps, bone surgery and skin plasties, all of which were gathered under the term of VBS, or Vessels-Bone-Skin, emergencies. Other terms are used (stage 3 fracture with vascular involvement, stage 4 fracture) for the same ultra-emergent pathology, in which many diagnostic problems as to the significance and extent of ischemia are associated with therapeutic issues. The results of an operation performed by one surgeon possessing all the desirable skills and working in a specialist Center allowed demonstrating that the quality of the results was such as could be hoped for: an overall survival rate of about 60%, little second surgery, blood consumption lower than 10 bottles per patient in average.

[Carpal tunnel syndrome and pseudarthrosis of the scaphoid. Apropos of 2 cases].

Two cases were seen in elderly patients in which a carpal tunnel syndrome was present in association with an ununited scaphoid fracture. The carpus had remodelled and the lunate was dorsi-flexed. Its upper end bulged into the tunnel and was the cause of the nerve compression.

[A case of simultaneous luxation of the metacarpophalangeal and interphalangeal joints of the thumb].

A rare case of simultaneous dislocation of the interphalangeal and metacarpo-phalangeal joints of the thumb is reported. The displacement was first reduced conservatively and the ligaments of the metacarpo-phalangeal joint repaired surgically at a later date. The result was satisfactory.

[Carpal tunnel syndrome. Cosmetic incision (author's transl)].

The median nerve compressed in the carpal tunnel can be released by an incision in the "line of life", a natural fold along the axis of the third metacarpal bone. By sectioning the carpal tunnel in the palm of the hand, on the cubital side of the median nerve, division of the external branch and of the sensory cutaneous rami of the nerve can be avoided. Hypertrophic scars are prevented.