Publications by authors named "Marin-Braun F"

The aim of this study was to evaluate the outcome of ulnar superficialis slip resection and to determine predictive factors for poor prognosis in patients with advanced trigger finger. Over a 5-year-period, 55 patients (58 fingers) were included. After surgery, two groups were identified: group 1, with complete extension or <10° extension deficit in the proximal interphalangeal (PIP) joint (n = 27 fingers/27 patients); and group 2, with ≥10° residual PIP extension deficit (n = 31 fingers/28 patients).

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Unlabelled: The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months.

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Carpal tunnel syndrome is the most common entrapment syndrome. The incidence of a bilateral condition varies between 22% and 87%. The aim of our study was to assess the level of satisfaction and the clinical outcomes in a group of patients operated on through a bilateral neurolysis on the median nerve in the carpal tunnel, in one operating session.

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Objectives: We report a retrospective series of 27 cases of composite island homodigital distal interphalangeal joint to replace proximal destroyed interphalangeal joint. Results of our series are compared with other procedures available in order to specify the place of pedicled articular transfers mainly for the proximal interphalangeal joint which is recognized as the most important joint in the finger.

Methods: The series included 27 cases of destroyed proximal interphalangeal joints with preservation of the distal interphalangeal joint, the flexor tendon and vascular pedicles.

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Efficiency of surgical treatment in Kienböck's disease has never been proven in the long term. We retrospectively reviewed the charts of the 104 patients treated by various techniques for Kienböck's disease from 1981 to 1999 in our unit. A comparison was made between 19 cases treated conservatively (amongst 59) and 11 cases (amongst 25) treated by scaphotrapeziotrapezoid (STT) arthrodesis with a mean follow-up of 13 years.

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For many years, bipedicled palmar advancement flaps were used rarely in fingers because they sacrificed the dorsal branches of the digital arteries, risking dorsal skin necrosis. In 1995, a short bipedicled neurovascular VY advancement flap raised distally to the PIP flexion crease, which spared the dorsal blood supply, was described by Elliot et al. (1995).

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All the FESUM centers in France, Belgium and Switzerland were invited to participate in this prospective audit, during 1 week in June 2002. In these FESUM centers, the patients are operated by senior hand surgeons or trainees graduated with a microsurgical and a hand surgery University degrees. All acute hand disorders, requiring surgery or not, were to be included.

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Introduction: The main goal of first carpometacarpal arthritis surgical treatment is to relieve pain. The main disadvantages of the usual techniques (trapeziectomy, implant arthroplasty) are loss of strength or presence of a prosthetic device. It is difficult to propose such extensive surgery at an early stage of the disease.

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A biopsy is needed when a solitary melanonychia striata in a white patient remains unexplained after careful clinical examination in order to rule out the development of a malignant melanoma. The ideal biopsy has to excise entirely the lesion and to provide enough tissue for pathological examination. The authors describe a new method of excisional biopsy based on primarily closure using a longitudinal closing wedge osteotomy of the distal phalanx.

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Introduction: In spite of the recent advances made in microsurgery, the reconstruction of oblique fingertip amputations remains problematical. In cases where reimplantation is technically impossible, the surgeon can utilize a number of different flaps to preserve digital length.

Methods: In certain cases, instead of local flap repair using an advancement flap, the nail complex can be recessed so that after bone shortening of the distal phalanx the free edge of the nail can be stitched to the skin without resulting tension.

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Fifty patients with camptodactyly of one or several fingers were seen in the Strasbourg SOS Main unit between 1980 and 1988. Classification of these lesions was based on the mobile or fixed nature of the deformity in flexion of the interphalangeal joint. This classification is useful for the therapeutic management.

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Lipofibroma is a rare, benign nerve tumour corresponding to diffuse fibroadipose infiltration of the nerve, dissociating the fasciculi without invading them. The authors report a case of lipofibroma of the median nerve in a 32 year old man presenting with a soft swelling of the palmar surface of the thumb. Treatment consisted of intraneurodissection of the tumour arising exclusively from the medial collateral nerve of the thumb.

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Nine cases of emergency proximal row carpectomy are analysed. In 3 cases, the resection was performed in the context of transcarpal amputation in which the bone shortening obtained by resection allowed revascularisation without a flap. The functional result was poor because of the severity of the initial lesion.

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Severe deformities of metacarpals and phalanges, whether isolated or associated with soft tissues lesions impair the hand function and are to be corrected. The authors initial proposal was the fixation after corrective osteotomy by wiring which have been proved to be suitable in the treatment of recent fractures. This technique was used in 25 cases out of 38 treated malunions with 21 satisfactory results.

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We present our results from a series of 26 partial toe transfers (11 pulp transfers and 15 composite tissue transfers) performed in posttraumatic reconstruction of the thumb (22 cases) and fingers II to V (4 cases). There was one failure due to arterial thrombosis. The results for sensitivity were satisfactory after pulp transfer (Weber-average of 9 mm), less satisfactory after composite transfer.

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Unlabelled: Seventy-seven flexor tendon lesions in zone I have been reinserted by the "rope down" technique using the Jennings barb-wire. They included 20 cases of repair of FPL. The patients were reviewed with an average follow-up of 4 years (minimum 3 months, maximum 10 years).

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This report compares the results obtained after treatment of reflex sympathetic dystrophies (algodystrophies) of the hand by pharmacological segmental blocks with buflomedil (51 cases) versus guanethidine (30 cases). The results were similar for all the different stages of algodystrophies treated: 65% satisfactory to excellent results with buflomedil, versus 63% with guanethidine. The sooner the algodystrophy is treated after its onset, the better the results.

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Forty-eight patients with lesions of the extensor apparatus of the hand were treated by primary repair with assisted post operative mobilisation by means of a dynamic extension, low profile splint. They were divided into three groups: 25 simple wounds of the extensor tendons of the fingers; 14 simple wounds of the extensor tendon of the thumb; 9 complex lesions. The mobility of the tendinous suture and the callus displacement were monitored by means of metallic markers implanted at operation.

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The surgical treatment of "swan-neck" deformities secondary to mallet finger using Littler's technique (Spiral Oblique Retinacular Ligament) in a series of 35 cases, led to a complete correction of the PIP joint hyperextension in 95% of the cases and a correction of the DIP joint flexure in 70% of the cases. This active tenodesis restores the physiology of the extension of the PIP and DIP joints as far as the surgical technique has been strictly respected.

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The importance of anatomical reduction of articular fractures and early mobilisation of these severe forms of trauma which frequently damage the extensor apparatus (58% of cases, led us to propose direct miniaturised osteosynthesis as described by the Nancy-Strasbourg team. Of the 1,000 cases of osteosynthesis performed between 1978 and 1985, we selected 12 fractures of the MP joint, 38 fractures of the PIP joint and 10 fractures of the DIP joint, differentiated into 4 stages according to the condition of the skin and tendons and into 9 categories according to the anatomical type and the site of the fracture. Direct osteosynthesis (screw, bolt, pin) was used in every case.

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A case is reported of a patient aged 32 years who suffered bilateral traumatic amputation of the legs by a wagon. Neither of his two feet could be re-implanted to its original site. In spite of the severity of the lesions, reconstructive surgery was attempted by crossed re-implantation of the right foot onto the stump of the left leg.

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