[Improvement of proximal interphalangeal flexion of the 5th finger in wounds or avulsions of the flexor profundus tendon].

The flexor superficialis of the little finger alone is frequently unable to provide good flexion of the PIP joint. This was verified in half of the hands tested in 45 normal volunteers. These data stress the mandatory repair of the flexor profundus tendon in emergency situations.

[Compression of the brachial plexus by a pseudarthrosis of the 1st rib].

The authors have described the case of a thoracic outlet syndrome with costoclavicular compression of the brachial plexus, secondary to non-union of a first rib fracture. Treatment consisted in transaxillary removal of the first rib, as described by Roos. Intrafascicular neurolysis of the posterior and medial trunks was performed at the same time, and was followed by quick clinical and electromyographical recovery.

[Ungual synthesis].

In case of dorsal sectioning of the distal phalanx, the nail can be used to mobilize and to bring the bone fragments together. A needle is passed through the nail and the nail bed, and the two fragments can be brought together with a metallic tension suture.

Toe-to-hand transfers in reconstructive surgery of the hand. Experience with seventy-one cases.

Based on a homogeneous series of 71 toe-to-hand transfers performed between February 1975 and December 1982 the same surgeon, the authors have tried to define their present day indications. Technical modifications have been described for the second toe transfer : isolated dorsal approach of the toe with early-stage resection of the second metatarsal bone, utilisation of the plantar metatarsal artery of the second interosseous space, utilisation of the volar vessels for the anastomosis at the recipient site, dorsal subcutaneous tunnel for the venous anastomosis of the hand. Aside from the usual indications for thumb reconstruction (11 cases) and 26 cases of transfers for reconstruction in long finger injuries, the indications for partial transfers have become more and more frequent : pulpar (9 cases), pulp + bone + nail (10 cases), isolated nail (1 case), nail + bone (2 cases), first web space (1 case), double twisted toe (5 cases) and articular (6 cases) transfers.

[Suture of flexor tendons by the Kleinert technic].

The authors attempt to delineate the current indications for the so-called "Kleinert suture" and the technical changes suggested by recent experimental work.

[Irreducible closed luxation of the distal interphalangeal joint. Apropos of 2 cases].

Two irreducible dislocations of the distal digital interphalangeal joint have been seen by the author. One was dorsally displaced with interposition of the extensor tendon, and the other was a palmar displacement with interposition of the flexor tendon. Both cases were successfully treated by open reduction.

The repair of peripheral nerve injuries in emergency.

Peripheral nerve injuries must be considered as serious surgical emergencies for they are often associated with vascular lesions. Primary repair of clean-cut injuries of peripheral nerves by microsurgical techniques yields better results than the best of secondary repairs.

[An unusual form of macrodactylia].

The authors report a rare case of macrodactyly of the thumb in a 36 year old woman. The hypertrophy predominates on the epiphyseal tissue with complete ankylosis of the trapezo-metacarpal metacarpo-phalangeal, and interphalangeal joints in an abnormal position. This results in total functional incapacity of the thumb.

On the mechanism of tRNATrp aminoacylation catalysed by beef tryptophanyl-tRNA synthetase using presteady-state kinetics.

The dimeric tryptophanyl-tRNA synthetase from beef pancreas has been found to activate 2 tryptophans/mol enzyme [Eur. J. Biochem.

Systemization of the vascularization of the ulnar nerve in its upper arm.

Vascularized free nerve grafts make possible the repair of extensive defects of large nerve trunks. Since the original observations of Taylor and Ham in 1976 many cases have been published. The ulnar nerve in the upper arm in most cases has a simple arteriovenous pedicle the anatomy of which has been precisely defined by cadaver dissections and intravascular injections.

Fascicular nerve graft using an empty perineurial tube: an experimental study in the rabbit.

An experimental model of a free, empty perineurial tube for use as a nerve graft is presented as an alternative to existing methods. The technique is described and the model compared with conventional nerve graft in the sciatic nerve of a rabbit. Results are evaluated with EMG studies, angiography, and histology.

Kinetic anticooperativity in pre-steady-state formation of tryptophanyl adenylate by tryptophanyl-tRNA synthetase from beef pancreas. A consequence of the tryptophan anticooperative binding.

The kinetics of formation of tryptophanyl adenylate by tryptophanyl-tRNA synthetase from beef pancreas has been followed by stopped-flow, using the quenching of fluorescence of the enzyme linked to the amino acid activation reaction. Both subunits of this alpha 2 enzyme catalyze the adenylate formation. At saturation with substrates the rate constant of the activation reaction is the same for both subunits.

[Subcutaneous angioma of the hand].

The authors describe the specific features of hemangiomas of the hand in adults (three cases). The clinical syndrome is described. The main examination is by arteriography of the hand which shows three principal aspects: the vascular topography; the volume of the tumors; the extension of the neighbouring tissue.

[The reversed de-epithelialized flap].

The reversed deepithelialized flap was used by Clodius for the lower limb and Pakian was the first to report on the use of this procedure in the hand. In the operation a classical cross-finger is deepithelialized and turned over on to an adjacent finger. The dermal part comes in contact with the exposed structures of the defect to be covered.

[An unusual form of macrodactyly].

The authors report a rare case of macrodactyly of the thumb in a 36 year old woman. The hypertrophy predominates on the epiphyseal tissue with complete ankylosis of the trapezo-metacarpal joints. The metacarpo-phalangeal joint and interphalangeal joints in an abnormal position.

[Prosthetic replacement of the semilunar bone].

Twenty-two protheses of the lunate were implanted in the osteonecrosis stage III described by Decoulx. The authors chose palmar approach to release the median nerve in the carpal tunnel. A dorsal incision is sometimes necessary to fix taut the dorsal capsular ligament.