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Barry M, Barry F, Gun M, Padurean P, Ikoli JF, Havet E, Gara Ali B, Caus T. Influence of age and sex on the thickness of the radial artery wall. Curr Probl Cardiol 2024; 49:102523. [PMID: 38492619 DOI: 10.1016/j.cpcardiol.2024.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The aim of this study is to investigate whether there is a relationship between age or sex and the thickness of the radial artery wall. MATERIALS AND METHODS We harvested human radial arteries from 48 cadavers (30 men and 18 women) in the anatomy laboratory. Histological sections of 3 μm thickness were prepared at the Laboratory of Anatomy and Pathological Cytology, mounted on slides, and stained with hematoxylin-phloxine-safran, Masson's trichrome, and orcein. The thickness of each radial artery wall (intima-media thickness) was measured using optical microscopy, and an average measurement was established among the three thicknesses (upper third, middle third, and lower third). STATISTICAL METHODS Statistical analyses were performed using the R software. Means and standard deviations were utilized. A correlation analysis was also conducted to assess the relationship between radial artery wall thickness and subjects' age. RESULTS On average, the thickness of the left radial artery wall and that of the right radial artery measured 282 (34) micrometers (μm). We found a correlation between radial artery wall thickness and age in both men (p < 0.001) and women (p < 0.001). CONCLUSIONS In conclusion, this study elucidates that radial artery wall thickness is related to age and sex in its assessment.
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Affiliation(s)
- Misbaou Barry
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France.
| | - Fatoumata Barry
- Department of Pathological Anatomy and Cytology, Ambroise-Paré Hospital, AP-HP, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - Mesut Gun
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France
| | - Paul Padurean
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France
| | - Jean Fortuné Ikoli
- Department of Pathological Anatomy and Cytology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France
| | - Eric Havet
- Anatomy Laboratory Faculty of Medicine, University of Amiens, Amiens, Cedex1, France
| | - Bessem Gara Ali
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France
| | - Thierry Caus
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054 Amiens, Cedex1, France
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Barry M, Gun M, Chabry Y, Trojette F, Chardon K, Padurean P, Peltier J, Havet E, Caus T. Optimizing coronary artery opacification and 3D reconstruction from human cadaver hearts in anatomy research. Curr Probl Cardiol 2024; 49:102216. [PMID: 37993008 DOI: 10.1016/j.cpcardiol.2023.102216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE This study seeks to identify the ideal dilution rate of a radiopaque product to optimize the visualization of coronary arteries and their branches within human cadaver hearts. The process involves obtaining images in the anatomy laboratory and subsequently constructing a three-dimensional model. MATERIALS AND METHODS We utilized 30 human hearts fixed in 10 % formalin (9 females and 21 males) with a mean age of 79 ± 5 years. The initial experiment, involving the first four hearts (referred to as "group 1"), encountered difficulties in opacifying coronary arteries. In this phase, a probabilistic injection of 20 % Visipaque and 80 % latex, with coronary sinus ostium closure, was performed. The optimal mixture ratio was then determined as 33 % Visipaque and 66 % latex. Recognizing the need for on-site injection at the CT Scan table, this protocol was applied to the subsequent 11 hearts in "group 2." Closure of the coronary sinus was deemed unnecessary. The final 15 hearts, constituting "group 3," revealed that the injection should be gradual, maintaining controlled pressure between 120 and 150 mm Hg. Post-injection, hearts were scanned with the injected coronary arteries using an Optima 660 CT scanner. Two-dimensional images were acquired with parameters set at 64 × 0.625 mm, 100 kV, 300-400 mA, and a rotation of 0.5 s. Subsequently, 3D reconstruction was conducted using Advantage Workstation 4.7 (GE Healthcare) and volume rendering with Volume Viewer software, version 15. RESULTS Significant differences in the percentage of opacified coronaries were observed among the three groups (p < 0.005). This variation underscores the learning curve and comprehension required before establishing a reliable method. Group 1 (N = 4) demonstrated minimal opacification, group 2 (N = 11) displayed partial opacification, while group 3 (N = 15) achieved 100 % opacification of coronary arteries. CONCLUSION The successive experiments culminated in the development of a protocol for CT imaging, enabling accurate three-dimensional reconstruction of the normal anatomy of the main and secondary coronary arteries. Our work is grounded in a series of progressively refined and successful experiments.
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Affiliation(s)
- Misbaou Barry
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France; Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France.
| | - Mesut Gun
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Yuthiline Chabry
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Faouzi Trojette
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Karen Chardon
- Perinatality and Toxic Risks Laboratory, University of Picardie, CHU Amiens - CURS Building, Avenue René Laënnec, Salouël, 80480, France
| | - Paul Padurean
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Johann Peltier
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France
| | - Eric Havet
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France
| | - Thierry Caus
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
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Barry M, Gun M, Chabry Y, Harmouche M, Padurean P, Peltier J, Caus T, Havet E. Anatomical and biometric study of the radial artery on human cadavers dissected in the anatomy laboratory. Surg Radiol Anat 2023; 45:1089-1095. [PMID: 37452194 DOI: 10.1007/s00276-023-03190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To study the anatomy and biometry of the radial artery and to report the implications of this study for daily practice in Cardiac Surgery. METHOD Radial arteries from 45 human cadavers (28 males and 17 females, average age 79.2 (92) fixed in 10% formalin were dissected. The proximal and distal internal calibers and lengths of these radial arteries were measured. RESULTS Our results showed the presence of a single radial artery variation in 2.3% of the entire sample (1.1% of the 90 dissected upper limbs). The distance between the epicondyle and the emergence of the radial artery was 32.4 (6.67) mm in men and 30.7 (9.00) mm in women, with an average of 31.8 (7.58) mm. For the right upper limb, the mean proximal internal caliber of the radial artery was 3.16 (0.56) mm and its mean distal internal caliber was 2.62 (0.66) mm. For the left upper limb, the mean proximal internal caliber of the radial artery was 3.17 (0.59) mm and its mean distal internal caliber was 2.64 (0.68) mm. The mean length of the left radial artery was 197.0 (17) mm. The mean length of the right radial artery was 201.0 (33) mm. CONCLUSION It is very important to be aware of the possible anatomical variation of the radial artery. Despite its rarity, this knowledge may ensure a better safety and reliability of the harvesting technique for use as a graft.
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Affiliation(s)
- Misbaou Barry
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France.
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France.
- Heart-Chest-Vascular Surgery, Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France.
| | - Mesut Gun
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Yuthiline Chabry
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Majid Harmouche
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Paul Padurean
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Johann Peltier
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France
| | - Thierry Caus
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Eric Havet
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France
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Barry M, Gun M, Hun-Chabry Y, Harmouche M, Peltier J, Caus T, Havet E. Anatomical and biometric study of the mitral valve apparatus: application in valve repair surgery. J Cardiothorac Surg 2023; 18:141. [PMID: 37060017 PMCID: PMC10105398 DOI: 10.1186/s13019-023-02232-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/02/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE Most mitral valve repair techniques provide excellent surgical results by removing regurgitation, but all of these techniques simultaneously reduce posterior valve mobility. A comprehensive biometric study of the mitral valve apparatus will provide landmarks that would help improve this posterior valve mobility. MATERIALS AND METHODS Thirty one (31) human hearts have been studied, from 14 women and 17 men. The characteristics of the studied sample were analyzed descriptively. The difference in means of the variables between women and men were tested using a Student t test. Correlations between the different measures were determined by simple regression analysis. Mean values are shown with ± 1 standard deviation and the limit of significance was set at 0.05. RESULTS The mean weight of the hearts was 275.3 ± 2.4 g. The anteroposterior diameter of the mitral annulus was 29.3 ± 1.22 mm, the intertrigonal distance was 25.2 ± 3.50 mm and the anterior leaflet to posterior leaflet ratio was 1.9 ± 0.10, the length of the chordae A2 = 19.4 ± 1.15 mm and P2 = 14.5 ± 0.85 mm. The length of the anterior papillary muscle averaged 30.9 ± 7.20 mm and that of the posterior one 30.0 ± 8.75 mm. The comparison of the different values measured between women and men showed no statistically significant difference (p > 0.05). There was no correlation between these different measured values (p > 0.05). CONCLUSION A perfect knowledge of anatomy and biometry is therefore essential to offer alternative techniques that reproduce the real anatomy and physiology with a complete reconstruction of the mitral valve.
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Affiliation(s)
- Misbaou Barry
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France.
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex1, France.
| | - Mesut Gun
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex 1, France
| | - Yuthiline Hun-Chabry
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex1, France
| | - Majid Harmouche
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex1, France
| | - Johann Peltier
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France
| | - Thierry Caus
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex1, France
| | - Eric Havet
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, Amiens, France
- Department of Radiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens Cedex 1, France
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Pasinato G, Draily R, Launois PH, Bonnaire B, Peltier J, Havet E. Incidental discovery of a sacral rib: a case report. Surg Radiol Anat 2023; 45:661-663. [PMID: 36871113 DOI: 10.1007/s00276-023-03113-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE The observation of an accessory bone joined to the sacrum (suggestive of a sacral rib) prompted us to describe the structure's morphology and its anatomic relationships and to consider its morphogenesis and clinical implications. METHOD A 38-year-old woman underwent computed tomography, to characterize the extension of a thoracic mass. We compared our observations with the literature data. RESULTS We observed a voluminous accessory bone located behind and to the right of the sacrum. The bone was articulated with the third sacral vertebra and featured a head and three processes. These characteristics were suggestive of a sacral rib. We also observed involution of the gluteus maximus. CONCLUSION This accessory bone probably resulted from overdevelopment of a costal process and an absence of fusion with the primitive vertebral body. Sacral ribs are rare and usually asymptomatic but appear to be more prevalent in young women. The adjacent muscles are often abnormal. Awareness of the potential presence of this bone is essential for surgeons who operate on the lumbosacral junction.
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Affiliation(s)
- Gaétan Pasinato
- Laboratoire d'anatomie, Université de Picardie Jules Verne, Amiens, France.
| | | | | | | | - Johann Peltier
- Laboratoire d'anatomie, Université de Picardie Jules Verne, Amiens, France
| | - Eric Havet
- Laboratoire d'anatomie, Université de Picardie Jules Verne, Amiens, France
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Bulaïd Y, Djebara AE, Belhaouane R, Havet E, Dehl M, Mertl P. Beneficial effect of a zirconium-nitride-coated implant in total knee arthroplasty revision for suspected metal hypersensitivity. Orthop Traumatol Surg Res 2022; 108:103320. [PMID: 35577273 DOI: 10.1016/j.otsr.2022.103320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/03/2021] [Accepted: 05/25/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Revision of total knee arthroplasty (rTKA) for suspicion of metal hypersensitivity (MHS) may require hypoallergenic implants. Results for coated implants have not been reported. The aim of the present study was to assess short-term results and survival of rTKA for MHS using a multilayer implant coating. HYPOTHESIS Multilayer implant coating improves functional results in rTKA, with survival comparable to primary coated implants. MATERIAL AND METHODS A single-center retrospective observational study included 28 patients (30 knees) undergoing rTKA for MHS using a coated implant between May 2011 and November 2016. Exclusion criteria comprised implant malpositioning and history of infection in the affected knee. Clinical and radiological results were assessed on the International Knee Society (IKS) and SF-36 functional scores and Ewald radiological score. Survival was calculated on Kaplan-Meier estimation. RESULTS Mean follow-up was 3.8 years. Mean IKS score increased by 40.2 points (40%) [range, 28.1-52.3] (p<0.05). Mean range of motion increased by 17° [range, 9.5-24.5°] (p<0.05). Mean physical and mental SF-36 components were respectively 44.7 and 46.1. Survivorship was 93%. DISCUSSION There was significant functional improvement after rTKA for MHS. There were no short-term complications related to the zirconium nitrate coating. However, studies with longer follow-up will be needed for confirmation. LEVEL OF EVIDENCE IV; retrospective study.
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Affiliation(s)
- Yassine Bulaïd
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France
| | - Az-Eddine Djebara
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France.
| | - Ramy Belhaouane
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France
| | - Eric Havet
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France
| | - Massinissa Dehl
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France
| | - Patrice Mertl
- Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France
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Qassemyar Q, Michel G, Gianfermi M, Atlan M, Havet E, Luca-Pozner V. Sutureless venous microanastomosis using thermosensitive poloxamer and cyanoacrylate: experimental study on a rat model. J Plast Reconstr Aesthet Surg 2021; 75:433-438. [PMID: 34247962 DOI: 10.1016/j.bjps.2021.05.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 05/08/2021] [Accepted: 05/28/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Sutureless microvascular anastomoses could simplify the microvascular field, shortening operative time and improving the final outcome. The use of thermosensitive poloxamers (TP407) together with the application of cyanoacrylate as an alternative method for conventional sutures was well-documented for arteries, but not for veins. The purpose of our study was to prove the feasibility of this technique for venous anastomoses and compare it with the traditional hand-sewn technique on a rat model. MATERIALS AND METHODS Twenty male Sprague-Dawley rats that weighed between 265 and 310 g were used. In the sutureless group (SG), 20 left external jugular veins (LEJV) end-to-end anastomoses were performed using a T704 and cyanoacrylate glue. They were compared to 20 right external jugular veins (REJV) anastomoses sutured with conventional 10-0 stitches (control group - CG). Diameters of veins, anastomosis time, and patency rate at 15 days were reported. Foreign body reaction was assessed histologically. RESULTS The mean diameter of the LEJV was 0.94 ± 0.1 mm and 0.95 ± 0.09 mm for the REJV. The mean anastomosis time was 11.9 ± 1.37 min for the SG and 27.75 ± 3.31 min for the CG. In the latter group, the immediate patency rate was 95% and 90% at 15 days. For the SG group, 90% of the anastomoses were patent immediately and 85% at 15 days. CONCLUSION TP407 and cyanoacrylate could offer a fast and reliable technique for sutureless venous anastomoses. Before human application, effectiveness of this method remains to be confirmed in larger animals in a long-term follow-up.
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Affiliation(s)
- Q Qassemyar
- Department of Plastic and Reconstructive Surgery, University Hospital Armand-Trousseau, 26 avenue du Dr Arnold Netter, 75012 Paris, France; Faculty of Medicine, Sorbonne University, 91 boulevard de l'hôpital, 75013 Paris, France; Anatomy Department, University of Picardie, Rue des Louvels, 80000 Amiens, France
| | - G Michel
- Anatomy Department, University of Picardie, Rue des Louvels, 80000 Amiens, France
| | - M Gianfermi
- Anatomy Department, University of Picardie, Rue des Louvels, 80000 Amiens, France
| | - M Atlan
- Faculty of Medicine, Sorbonne University, 91 boulevard de l'hôpital, 75013 Paris, France; Department of Plastic Surgery, Tenon Hospital, 4 Rue de la Chine, 75020 Paris, France
| | - E Havet
- Anatomy Department, University of Picardie, Rue des Louvels, 80000 Amiens, France
| | - V Luca-Pozner
- Department of Plastic and Reconstructive Surgery, University Hospital Armand-Trousseau, 26 avenue du Dr Arnold Netter, 75012 Paris, France; Faculty of Medicine, Sorbonne University, 91 boulevard de l'hôpital, 75013 Paris, France.
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Sanguin S, Roman H, Foulon A, Gondry J, Havet E, Klein C. Deep infiltrating endometriosis with sacral plexus involvement: Improving knowledge through human cadaver dissection. J Gynecol Obstet Hum Reprod 2021; 50:102129. [PMID: 33781973 DOI: 10.1016/j.jogoh.2021.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/19/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to assess a human cadaver model of sacral plexus dissection for learning about deep innervation in the female pelvis, and the latter's relationship with deep infiltrating endometriosis. METHODS This was a prospective, observational study. Eight residents in obstetrics and gynecology were tested before and after a lecture on innervation of the female pelvis and a cadaver dissection class. Standardized cadaver dissection was used to identify the sacral nerve roots S2 to S4, superior and inferior hypogastric plexuses, hypogastric nerve, and splanchnic nerves. RESULTS The residents' level of knowledge improved significantly after a one-hour lecture (p = 0.9.10-5) and after a cadaver dissection class (p = 0.6.10-6). The improvement was significantly greater for the dissection class (p = 0.0003). All the pelvic nerve structures were identified in all but one of the cadavers and had similar measurements. A vascular anatomical variant was observed in one case. CONCLUSION A human cadaver model is of value for learning about deep pelvic innervation and the latter's relationship with deep infiltrating endometriosis. The reproducibility and safety of cadaver dissection might improve surgical skills.
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Affiliation(s)
- Sophie Sanguin
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Horace Roman
- Endometriosis Center, Clinique Tivoli-Ducos, F- 33000, Bordeaux, France; Department of Gynecology and Obstetrics, Aarhus University Medical Center, Nordre Ringgade 1, 8000 Aarhus C, Denmark
| | - Arthur Foulon
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Jean Gondry
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Eric Havet
- Anatomy Laboratory, Jules Verne University of Picardie, Amiens, F-80054, France
| | - Céline Klein
- Anatomy Laboratory, Jules Verne University of Picardie, Amiens, F-80054, France; Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, F-80054, France.
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Chenin L, Toussaint P, Lefranc M, Havet E, Peltier J. Microsurgical anatomy of the inferior intercavernous sinus. Surg Radiol Anat 2020; 43:211-218. [PMID: 32975638 DOI: 10.1007/s00276-020-02581-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Intercavernous sinuses (ICSs) are physiological communications between the cavernous sinuses. The ICSs run between the endosteal and meningeal layers of the dura mater of the sella turcica. Whereas the anterior and posterior ICSs have been frequently described, the inferior ICS (iICS) has been less well studied in the literature; however, poor awareness of the ICS's anatomy can lead to serious problems during transsphenoidal, transsellar surgery. The objective of the present anatomical study was to describe the iICS in detail. METHODS The study was carried out over a 6-month period in a university hospital's anatomy laboratory, using brains extracted from human cadavers. The brains were injected with colored neoprene latex and dissected to study the iICS (presence or absence, shape, diameter, length, distance between inferior and anterior ICSs, distance between inferior and posterior ICSs, relationships, and boundaries). RESULTS Seventeen cadaveric specimens were studied, and an iICS was found in all cases (100%). The shape was variously plexiform (47.1%), filiform (35.3%), or punctiform (17.6%). The mean ± standard deviation diameter and length of the iICS were 3.75 ± 2.90 mm and 11.92 ± 2.96 mm, respectively. The mean iICS-anterior ICS and iICS-posterior ICS distances were 5.36 ± 1.99 mm and 7.03 ± 2.28 mm, respectively. CONCLUSION The iICS has been poorly described in the literature. However, damage to the iICS during transsphenoidal, transsellar surgery could lead to serious vascular complications. A precise radiological assessment appears to be essential for a safe surgical approach.
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Affiliation(s)
- Louis Chenin
- Department of Anatomy and Organogenesis, Faculty of Medicine, Jules Verne University of Picardie, 80000, Amiens, France. .,Department of Neurosurgery, Amiens University Hospital, 80000, Amiens, France.
| | - Patrick Toussaint
- Department of Neurosurgery, Amiens University Hospital, 80000, Amiens, France
| | - Michel Lefranc
- Department of Neurosurgery, Amiens University Hospital, 80000, Amiens, France
| | - Eric Havet
- Department of Anatomy and Organogenesis, Faculty of Medicine, Jules Verne University of Picardie, 80000, Amiens, France
| | - Johann Peltier
- Department of Anatomy and Organogenesis, Faculty of Medicine, Jules Verne University of Picardie, 80000, Amiens, France.,Department of Neurosurgery, Amiens University Hospital, 80000, Amiens, France
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Huette P, Abou-Arab O, Djebara AE, Terrasi B, Beyls C, Guinot PG, Havet E, Dupont H, Lorne E, Ntouba A, Mahjoub Y. Risk factors and mortality of patients undergoing hip fracture surgery: a one-year follow-up study. Sci Rep 2020; 10:9607. [PMID: 32541939 PMCID: PMC7296002 DOI: 10.1038/s41598-020-66614-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/22/2020] [Indexed: 12/03/2022] Open
Abstract
Hip fracture (HF) remains a main issue in the elderly patient. About 1.6 million patients a year worldwide are victims of a HF. Their incidence is expected to rise with the aging of the world’s population. Identifying risk factors is mandatory in order to reduce mortality and morbidity. The aim of the study was to identify risk factors of 1-year mortality after HF surgery. We performed an observational, prospective, single-center study at Amiens University Hospital (Amiens, France). After ethical approval, we consecutively included all patients with a HF who underwent surgery between June 2016 and June 2017. Perioperative data were collected from medical charts and by interviews. Mortality rate at 12 months was recorded. Univariate analysis was performed and mortality risk factors were investigated using a Cox model. 309 patients were analyzed during this follow-up. Mortality at 1 year was 23.9%. Time to surgery over 48 hours involved 181 patients (58.6%) while 128 patients (41.4%) had surgery within the 48 hours following the hospital admission. Independent factors associated with 1-year mortality were: age (HR at 1.059 (95%CI [1.005–1.116], p = 0,032), Lee score ≥ 3 (HR at 1,52 (95% CI [1,052–2,198], p = 0.026) and time to surgery over 48 hours (HR of 1.057 (95% CI [1.007–1.108], p = 0.024). Age, delayed surgical (over 48 hours) management and medical history are important risk factors of 1-year mortality in this French cohort
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Affiliation(s)
- Pierre Huette
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France.
| | - Osama Abou-Arab
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Az-Eddine Djebara
- Department of orthopedic surgery. Amiens University Hospital. F- 80054, Amiens, France
| | - Benjamin Terrasi
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Christophe Beyls
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Pierre-Grégoire Guinot
- Department of Anaesthesiology and Critical Care Medicine. Dijon University Hospital. F- 21000, Dijon, France
| | - Eric Havet
- Department of orthopedic surgery. Amiens University Hospital. F- 80054, Amiens, France
| | - Hervé Dupont
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Emmanuel Lorne
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Alexandre Ntouba
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
| | - Yazine Mahjoub
- Department of Anaesthesiology and Critical Care Medicine. Amiens University Hospital. F- 80054, Amiens, France
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Delforge X, Havet E, Mesureur S, Hamzy M, Haraux E, Buisson P. Congenital appendicoumbilical fistula. Pediatr Neonatol 2019; 60:684-685. [PMID: 31575459 DOI: 10.1016/j.pedneo.2019.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/29/2018] [Accepted: 09/09/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Xavier Delforge
- Department of Pediatric Surgery, CHU Amiens-Picardie, F-80054, Amiens, France.
| | - Eric Havet
- Department of Organogenesis and Anatomy, Université de Picardie Jules Verne, 80036, Amiens, France
| | - Sébastien Mesureur
- Department of Pediatric Surgery, CHU Amiens-Picardie, F-80054, Amiens, France
| | - Mounia Hamzy
- Department of Pediatric Surgery, CHU Amiens-Picardie, F-80054, Amiens, France
| | - Elodie Haraux
- Department of Pediatric Surgery, CHU Amiens-Picardie, F-80054, Amiens, France
| | - Philippe Buisson
- Department of Pediatric Surgery, CHU Amiens-Picardie, F-80054, Amiens, France
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12
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El Fatayri B, Bulaïd Y, Djebara AE, Havet E, Mertl P, Dehl M. A comparison of bone union and complication rates between locking and non-locking plates in distal fibular fracture: Retrospective study of 106 cases. Injury 2019; 50:2324-2331. [PMID: 31635907 DOI: 10.1016/j.injury.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ankle fractures represents the third most frequent fracture in elderly patients. There is a current tendency to fix long bones fractures with locking plates. However, we rarely find published accounts about the use of locking plates in distal fibula fractures, except for biomechanical ones, studying human cadaveric fibula. OBJECTIVES The main objective was to compare radiographic bone union rates at 6 and 12 weeks of follow up, then wound complications and hardware removal rates, and construct cost. STUDY DESIGN & METHODS We retrospectively analyzed 105 patients who underwent surgery with locking plates or non-locking plates over a two-year period, out of which 42 patients were treated with non-locking plates (VIVES™ - StrykerⓇ) and 63 with locking plates (VariAx™ - StrykerⓇ,). We analyzed bone union on anterior posterior and lateral X-rays of the ankle. We collected data of wound complications and hardware removal from patient records. Multiple linear regression techniques were performed after identifying dependent variables. RESULTS There was no significant difference between non-locking and locking plates in the radiographic bone union rate of distal fibula, respectively at 6 and 12 post-operative weeks (85.71% vs. 81%; p = 0.525 and 97.62% vs. 96.83%; p = 1). No significant difference was found in the wound complication rate between the two groups (11.9% vs. 11.12%; p = 0.9). No significant differences were found in the hardware removal rate, either with or without operative site's infection (respectively: 30.95% vs. 39.68%; p = 0.361 and 21.42% vs. 38.09%; p = 0.071). Cost efficiency is in the favor of non-locking plates. CONCLUSION Non-locking constructs are as effective as locking constructs in the treatment of displaced distal fibula fractures at a substantially lower cost. High-quality randomized controlled trials are needed in the future to verify the finding of this study.
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Affiliation(s)
- Bachar El Fatayri
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France.
| | - Yassine Bulaïd
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France
| | - Az-Eddine Djebara
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France
| | - Eric Havet
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France
| | - Patrice Mertl
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France
| | - Massinissa Dehl
- Orthopedic surgery department, CHU Amiens - Picardie, 80480, Salouël, France
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Roger C, Debuyzer E, Dehl M, Bulaïd Y, Lamrani A, Havet E, Mertl P. Factors associated with hospital stay length, discharge destination, and 30-day readmission rate after primary hip or knee arthroplasty: Retrospective Cohort Study. Orthop Traumatol Surg Res 2019; 105:949-955. [PMID: 31208932 DOI: 10.1016/j.otsr.2019.04.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/07/2019] [Accepted: 04/11/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In France and in the US, predictions for 2030 include an increased number of total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures together with an overall trend towards shorter hospital stays. Predictors of hospital length of stay (LOS) include the day of surgery, discharge destination, and patient comorbidities. Available data are conflicting, however, and to our knowledge predictors of LOS after THA or TKA have not been evaluated in France. Improved knowledge of these predictors would be expected to increase patient care efficiency. The objectives of this study were: (1) to determine whether the above-listed factors predict LOS after THA or TKA, (2) to identify predictors of discharge to a rehabilitation unit and of readmission within 30 days after surgery. HYPOTHESIS Both patient-related factors unamenable to modification and modifiable organisational factors are associated with LOS after THA or TKA. MATERIAL AND METHODS This large single-centre retrospective cohort study included all adults who underwent primary THA or TKA at our university hospital between 1 January 2015 and 31 December 2016. Non-inclusion criteria were revision arthroplasty, THA with femoral or acetabular reconstruction, TKA using a constrained hinged implant, and fracture as the reason for arthroplasty. Preoperative parameters, type of arthroplasty, and postoperative care were recorded. RESULTS We included 938 patients with THA and 725 patients with TKA. By multivariate analysis, the likelihood of being discharged by day 5 decreased with older age (HR, 0.986; 95%CI: 0.98-0.99) and was lower by 13% in females (HR, 0,871; 95%CI: 0.77-0.986), by 39% in patients with diabetes (HR, 0.606; 95%CI: 0.5-0.73), by 68% in patients discharged to rehabilitation units (HR, 0.322; 95%CI: 0.267-0.389), and by 27% in patients who had arthroplasty on a Friday (HR, 0.733; 95%CI: 0.631-0.852). Factors predicting discharge to rehabilitation unit were older age, female gender, chronic obstructive pulmonary disease, anxiety-depressive disorder, and a history of stroke. Risk factors for 30-day readmission were male gender, obesity, and discharge to rehabilitation unit. DISCUSSION In this study, predictors of LOS were identified using a survival model that considered age as a continuous variable, separate comorbidities, and the discharge destination. Our findings are consistent with earlier reports and confirm the strong associations linking LOS to diabetes, day of surgery, and discharge destination in France. We also identified predictors of discharge to rehabilitation and of readmission within 30 days. LEVEL OF EVIDENCE IV, retrospective observational cohort study.
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Affiliation(s)
- Corentin Roger
- Service d'orthopédie et traumatologie, CHU Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - Emmanuel Debuyzer
- Université de Lille Nord de France, 59000 Lille, France; Service d'orthopédie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille, France
| | - Massinissa Dehl
- Service d'orthopédie et traumatologie, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Yassine Bulaïd
- Service d'orthopédie et traumatologie, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Adnane Lamrani
- Direction de recherche clinique et innovation, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Eric Havet
- Service d'orthopédie et traumatologie, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Patrice Mertl
- Service d'orthopédie et traumatologie, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
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Chenin L, Kaoudi A, Foulon P, Havet E, Peltier J. Microsurgical anatomy of the subcallosal artery. Surg Radiol Anat 2019; 41:1037-1044. [DOI: 10.1007/s00276-019-02279-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 06/24/2019] [Indexed: 11/28/2022]
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15
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Klein C, Rotary V, Gouron R, Havet E. Development of a cadaveric training model for pollicization of the index finger. Hand Surgery and Rehabilitation 2019; 38:191-194. [DOI: 10.1016/j.hansur.2019.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/15/2019] [Accepted: 03/27/2019] [Indexed: 11/24/2022]
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16
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Barry M, Nader J, Hun Y, Havet E, Barry F, Laude M, Bonnaire B, Caus T. [Aberrant birth of a radial artery in the upper third of the forearm: A case report]. Morphologie 2018; 102:101-105. [PMID: 29615313 DOI: 10.1016/j.morpho.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 10/17/2022]
Abstract
We report the case of a 68-year-old patient, operated on in our department of a quadruple coronary bypass grafting. The grafting strategy consisted initially on harvesting the left internal thoracic artery and the left radial artery. The harvest of this latter failed because of a rare anatomical variation of the radial artery, which rose from the confluence of two branches: a superficial and a deep radial artery at the proximal third of the forearm approximately 10cm below the elbow.
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Affiliation(s)
- M Barry
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France; Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France.
| | - J Nader
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - Y Hun
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - E Havet
- Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France
| | - F Barry
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - M Laude
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France; Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France; Service d'imagerie et radiologie médicale, CHU Amiens-Picardie, 80080 Amiens, France
| | - B Bonnaire
- Service d'imagerie et radiologie médicale, CHU Amiens-Picardie, 80080 Amiens, France
| | - T Caus
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
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Chenin L, Tandabany S, Foulon P, Havet E, Peltier J. A median sacral artery anterior to the iliocaval junction: a case report-anatomical considerations and clinical relevance for spine surgery. Surg Radiol Anat 2017; 40:115-117. [PMID: 28875294 DOI: 10.1007/s00276-017-1917-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/23/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND IMPORTANCE The median sacral artery (MSA) is a relatively small vessel that always arises from the posterior, terminal part of the infrarenal aorta. In most cases, the MSA runs behind the iliocaval junction. Here, we describe a very rare case of an MSA running in front of this junction. CASE REPORT During a human cadaveric dissection of the retroperitoneal area, we unexpectedly observed that the MSA passed in front of the left common iliac vein. CONCLUSION The anatomy of the MSA has been extensively described and variations are quite rare. On the basis of this specific case, knowledge of the anatomic interactions between the MSA and other lumbar retroperitoneal vessels may help to avoid potential complications during surgery.
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Affiliation(s)
- Louis Chenin
- Department of Anatomy and Organogenesis, Jules Verne University of Picardie, 80054, Amiens cedex, France. .,Department of Neurosurgery, Amiens University Medical Center, Avenue René Laennec, Salouel, 80054, Amiens cedex 1, France.
| | - Sharmila Tandabany
- Department of Anatomy and Organogenesis, Jules Verne University of Picardie, 80054, Amiens cedex, France
| | - Pascal Foulon
- Department of Anatomy and Organogenesis, Jules Verne University of Picardie, 80054, Amiens cedex, France
| | - Eric Havet
- Department of Anatomy and Organogenesis, Jules Verne University of Picardie, 80054, Amiens cedex, France
| | - Johann Peltier
- Department of Anatomy and Organogenesis, Jules Verne University of Picardie, 80054, Amiens cedex, France.,Department of Neurosurgery, Amiens University Medical Center, Avenue René Laennec, Salouel, 80054, Amiens cedex 1, France
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18
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Fourdrain A, Lafitte S, Iquille J, De Dominicis F, Havet E, Peltier J, Bagan P, Berna P. Lymphatic drainage of lung segments in the visceral pleura: a cadaveric study. Surg Radiol Anat 2017; 40:15-19. [DOI: 10.1007/s00276-017-1910-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 08/10/2017] [Indexed: 10/19/2022]
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19
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Lenglet M, Dast S, Dessena L, Herlin C, Chaput B, Havet E, Sinna R. [Extension of the thoracodorsal artery perforator flap's pedicle: Anatomical study]. ANN CHIR PLAST ESTH 2017; 62:327-331. [PMID: 28363665 DOI: 10.1016/j.anplas.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/19/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE In recent years, the indications of latissimus dorsi myocutaneous flap decreased in favor of its version preserving muscle: the thoracodorsal artery perforator flap (TDAP). The intramuscular dissection reduce donor site morbidity but also allows an extension of the pedicle compared to conventional latissimus dorsi flap pedicle. The purpose of this study was to quantify objectively elongation of the pedicle when the perforator is dissected through the muscle. METHOD Sixteen TDAP flap were dissected in 9 cadavers. The pedicle was divided into 4 distinct parts: (1) hypodermis, (2) subcutaneous fat, (3) intramuscular, (4) conventional pedicle. RESULTS The length of the pedicle is significantly increased when the pedicle is dissected through the muscle. This extends the theoretical length from 5.25cm up to 9.19cm if the dissection is extended to the deep fat. Indeed, this results in a potentially exploitable TDAP pedicle length of 20.66cm. CONCLUSION The dissection of the perforator allows an extension of the pedicle of about 5 or 9cm if we continue the dissection in the subcutaneous fat. A long pedicle may be interesting in lower limb reconstructive surgery and facial reconstruction where microsurgery is not feasible.
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Affiliation(s)
- M Lenglet
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France
| | - S Dast
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France
| | - L Dessena
- Service de chirurgie plastique et craniofaciale, CHU de Montpellier, 34090 Montpellier, France
| | - C Herlin
- Service de chirurgie plastique et craniofaciale, CHU de Montpellier, 34090 Montpellier, France
| | - B Chaput
- Service de chirurgie plastique, reconstructive et esthétique, CHU de Toulouse, 31059 Toulouse, France
| | - E Havet
- Laboratoire d'anatomie, faculté d'Amiens, 3, rue des Louvels, 80036 Amiens, France
| | - R Sinna
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France; Laboratoire d'anatomie, faculté d'Amiens, 3, rue des Louvels, 80036 Amiens, France.
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Thieffry C, Chenin L, Foulon P, Havet E, Peltier J. Microsurgical anatomy of branches of musculocutaneous nerve: clinical relevance for spastic elbow surgery. Surg Radiol Anat 2017; 39:773-778. [PMID: 28039506 DOI: 10.1007/s00276-016-1800-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 12/15/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The neurotomy of musculocutaneous nerve is a treatment for patients who suffer from spastic elbow flexion when medical and reeducative treatments have failed. It consists in sectioning motor branches of musculocutaneous nerve which are destined to the biceps brachii and brachialis muscles, both being the main elbow flexor muscles. The aim of this study was to analyse the distance, where each motor branch arises from the musculocutaneous nerve to both biceps brachii and brachialis muscles, to establish precisely the localisation and length of the necessary incision to reach its branches for surgery. MATERIALS AND METHODS Eighteen musculocutaneous nerves from ten cadavers were dissected. None of them reported with a previous pathology. The cadavers were laid on the back with 30-35° of abduction, a complete extension, and supination of the upper limb. RESULTS The localization of motor branches was to be found in the middle third of the upper arm, with an average from the base of the humeral major tubercle of 11.46, 12.40, and 12.87 cm for the biceps brachii and 16.36, 19.10, and 16.88 cm for the brachialis muscle. CONCLUSION The incision needed to reach the motor branches of the musculocutaneous nerve should be localised between 10 and 20 cm from the major humeral tubercle and may be shorter than usual.
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Affiliation(s)
- C Thieffry
- Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France.
| | - L Chenin
- Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France
| | - P Foulon
- Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France
| | - E Havet
- Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France
| | - J Peltier
- Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France
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Affiliation(s)
- C. Roué
- Hospital of Valenciennes; Valenciennes France
| | - M. Wallaert
- Hospital of Valenciennes; Valenciennes France
| | - M. Kacha
- Hospital of Valenciennes; Valenciennes France
| | - E. Havet
- Hospital of Valenciennes; Valenciennes France
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N'da HA, Chenin L, Capel C, Havet E, Le Gars D, Peltier J. Microsurgical anatomy of the Adamkiewicz artery-anterior spinal artery junction. Surg Radiol Anat 2015; 38:563-7. [PMID: 26627692 DOI: 10.1007/s00276-015-1596-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/23/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study is to describe the anterior spinal artery-Adamkiewicz artery (ASA-AKA) junction and establish a classification allowing defining the neurological risk in either thoracoabdominal aorta aneurysm treatment and in anterior or transforaminal thoracolumbar spine surgery. METHODS Fifteen spinal cords of fresh cadavers were dissected. Both lumbar arteries and ASA were injected with strongly diluted red-colored silicon. RESULTS The dural crossing of AKA was located on the left side in 86 % of cases, between T8 and T10 in 73.33 % of cases and L1-L2 in 26.67 % of cases. The average diameter of the ascending branch of AKA was 1.10 mm (range 0.8-1.9 mm), and its average length was 30.27 mm (range 12.3-60 mm). The AKA's arch average diameter was 11.3 mm (range 9-20 mm) with an open downward angle average of 20.1° (range 11°-30°). The descending branch of AKA which was a continuation of ASA had an average diameter of 1.33 mm (range 0.8-1.86 mm). The ASA at the top of the arch had an average diameter of 0.74 mm (range 0.2-1.77 mm). According to these findings, we have proposed a new classification with two types of junctions. The type I and its variant correlated to high neurological risk were present in 93.33 % of cases. The type II, correlated to medium or low neurological risk, was present in 6.67 % of cases. CONCLUSION These anatomical findings allow a planning of the neurological risk before thoracoabdominal aorta aneurysm or thoracolumbar anterior or transforaminal spine surgery.
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Affiliation(s)
- Hermann Adonis N'da
- Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France.
| | - Louis Chenin
- Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France
| | - Cyril Capel
- Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France
| | - Eric Havet
- Laboratoire d'Anatomie et d'Organogénèse, Université de Picardie Jules Verne, 80036, Amiens Cedex 1, France
| | - Daniel Le Gars
- Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France.,Laboratoire d'Anatomie et d'Organogénèse, Université de Picardie Jules Verne, 80036, Amiens Cedex 1, France
| | - Johann Peltier
- Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France.,Laboratoire d'Anatomie et d'Organogénèse, Université de Picardie Jules Verne, 80036, Amiens Cedex 1, France
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Appy Fedida B, Krief E, Havet E, Massin P, Mertl P. Cruciate-sacrificing total knee arthroplasty and insert design: A radiologic study of sagittal laxity. Orthop Traumatol Surg Res 2015; 101:S1877-0568(15)00276-5. [PMID: 26778622 DOI: 10.1016/j.otsr.2015.07.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 07/15/2015] [Accepted: 07/27/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Ultracongruent inserts avoid some of the drawbacks of central spine postero-stabilized inserts. However, early wear has been reported, and may be due to increased sagittal laxity. The principal objective of the present study was to compare sagittal laxity in rotating platform total knee replacements (TKR) according to insert design: ultracongruent versus central spine. The principal hypothesis was that insert design influences global sagittal laxity. MATERIAL AND METHODS A retrospective comparative study recruited 3 consecutive series of patients treated for primary osteoarthritis of the knee, with a minimum 1 year's follow-up. The UC series comprised 35 knees in 34 patients, receiving a Total Knee Triathlon™ (Stryker Orthopaedics, Mahwah, NJ) TKR with ultracongruent insert, at a mean 2.0 years' follow-up. The UC+ series comprised 36 knees in 34 patients, receiving the BalanSys™ (Mathys Ltd, Bettlach, Switzerland) TKR with ultracongruent insert, at a mean 2.5 years' follow-up; in this model, the anterior edge of the insert is higher than in the UC series ("deep-dish" design). The PS series comprised 43 knees in 40 patients, receiving a Total Knee Triathlon™ (Stryker Orthopaedics, Mahwah, NJ) TKR with central spine posterior stabilization, at a mean 1.5 years' follow-up. The principal assessment criterion was sagittal laxity at 90° flexion as measured by the Telos Stress Device® (Metax GmbH, Hungen, Germany). RESULTS Sagittal laxity did not significantly differ between the UC and UC+ series: mean 8.2mm (range: 0-19.5mm) and 8.4mm (4.5-15.8mm), respectively. Sagittal laxity in the PS series was significantly less: 1.4mm (0.2-3.9) (P<0.0001). CONCLUSION Sagittal laxity was greater in ultracongruent than central spine posterior stabilized TKR. This anteroposterior movement may induce polyethylene wear. The ideal degree of sagittal laxity for ultracongruent inserts remains to be determined. LEVEL OF EVIDENCE IV - retrospective study.
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Affiliation(s)
- B Appy Fedida
- Service de chirurgie orthopédique, hôpital Bichat-Claude Bernard, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; EA REMES, université Paris-Diderot, Sorbonne Paris Cité, 75010 Paris, France.
| | - E Krief
- Service de chirurgie orthopédique, CHU d'Amiens, avenue René-Laënnec-Salouel, 80054 Amiens, France
| | - E Havet
- Service de chirurgie orthopédique, CHU d'Amiens, avenue René-Laënnec-Salouel, 80054 Amiens, France
| | - P Massin
- Service de chirurgie orthopédique, hôpital Bichat-Claude Bernard, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; EA REMES, université Paris-Diderot, Sorbonne Paris Cité, 75010 Paris, France
| | - P Mertl
- Service de chirurgie orthopédique, CHU d'Amiens, avenue René-Laënnec-Salouel, 80054 Amiens, France
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Gignon M, Havet E, Ammirati C, Traullé S, Manaouil C, Balcaen T, Loas G, Dubois G, Ganry O. Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey. Workplace Health Saf 2015; 63:54-63. [PMID: 25881656 DOI: 10.1177/2165079915570917] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated addictive substance use by French medical students. A cross-sectional survey was distributed to 255 participants randomly selected from 1,021 second- to sixth-year medical students. Questionnaires were self-administered and included questions on sociodemographic characteristics, mental health, and alcohol (The Alcohol Use Disorders Identification Test [AUDIT test]), tobacco (Fagerstrom test), and illegal substance consumption (Cannabis Abuse Screening Test [CAST test]). The AUDIT scores indicated that 11% of the study participants were at risk for addiction and 21% were high-risk users. Tobacco dependence was strong or very strong for 12% of the participants. The CAST score showed that 5% of cannabis users needed health care services. Cannabis users were also more likely than non-users to fail their medical school examinations (89% vs. 39%, p<.01). One quarter of medical student participants (n=41) had used other illegal drugs, and 10% of study participants had considered committing suicide during the previous 12 months. Psychoactive substance consumption by French medical students requires preventive measures, screening, and health care services.
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Affiliation(s)
- M Gignon
- University Paris 13 Jules Verne University of Picardy Amiens University Hospital
| | - E Havet
- Jules Verne University of Picardy
| | - C Ammirati
- University Paris 13 Jules Verne University of Picardy
| | | | | | - T Balcaen
- Jules Verne University of Picardy Amiens University Hospital
| | - G Loas
- Jules Verne University of Picardy
| | - G Dubois
- Jules Verne University of Picardy Amiens University Hospital
| | - O Ganry
- Jules Verne University of Picardy Amiens University Hospital
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Gaumont-Darcissac M, Viart L, Foulon P, Le Gars D, Havet E, Peltier J. [The occipital sinus: a radioanatomic study]. Morphologie 2015; 99:18-22. [PMID: 25660165 DOI: 10.1016/j.morpho.2015.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 12/18/2014] [Accepted: 01/05/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. METHODS One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. RESULTS Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. CONCLUSION This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children.
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Affiliation(s)
- M Gaumont-Darcissac
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France.
| | - L Viart
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - P Foulon
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - D Le Gars
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - E Havet
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - J Peltier
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, 3, rue des Louvels, 80036 Amiens cedex 1, France
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Viart L, Peltier J, Forzini T, Page C, Foulon P, Saint F, Havet E. [Persistent Müllerian ducts syndrome: one case of late hypofertility]. Morphologie 2015; 99:23-28. [PMID: 25708641 DOI: 10.1016/j.morpho.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/16/2014] [Accepted: 01/02/2015] [Indexed: 06/04/2023]
Abstract
We report the case of a 35-year-old patient with a syndrome of persistent Müllerian ducts (PMDS) of the female type (group A). The diagnosis was made in adulthood during an infertility workup. Clinical examination revealed an empty scrotum, a normal penis and bilateral inguinal cystic masses. The spermogram found azoospermia. Imaging using MRI and tomotensidometry found the presence of an uterus, two fallopian tubes and two inguinal positions of polycystic testes. A surgical management was performed for surgical testicular biopsy. Histological examination then found a cystic formation of multi-celled mesothelial origin, with atrophic testis Sertoli cell involution and without sperm. PMDS is a rare form of pseudo-internal hermaphroditism characterized by the presence in a man of the uterus, fallopian tubes and upper vagina with external male genitalia and virilized characters. About 200 cases are reported in the literature. The diagnosis is often made in children intraoperatively during a cure of testicular ectopia. The karyotype is 46 XY type. The pathogenesis is related to a deficiency of anti-Müllerian hormone (AMH) or tissue resistance to its action by receptor abnormalities. The regression of the Müllerian duct derivatives can give three types of PMDS : masculine type, feminine type and a transverse type. Surgical treatment is difficult but necessary because of the risk of infertility and ectopic testicular degeneration.
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Affiliation(s)
- L Viart
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France; Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France.
| | - J Peltier
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - T Forzini
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - C Page
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - P Foulon
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - F Saint
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - E Havet
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
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Ego H, N'Da H, Viart L, Foulon P, Le Gars D, Havet E, Peltier J. [Microsurgical anatomy of perforating branches of anterior communicating artery]. Morphologie 2015; 99:6-13. [PMID: 25577410 DOI: 10.1016/j.morpho.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The anterior communicating artery (ACoA) gives perforating branches to the optic chiasma, the hypothalamus and the corpus callosum. Perforating branches are variable (number, direction). Nevertheless, their knowledge is crucial during surgery of this area to spare injuries leading to ischemic post-operative complications. OBJECTIVE The objective was to update the anatomical knowledge about perforating branches of the ACoA. METHODS The study was led on a series of seven brains taken from human cadavers. An injection of latex neoprene was performed for every case. The region of interest was observed under operating microscope. Were examined: the length of the ACoA, its diameter, its orientation, its configuration and perforating branches (number and areas). RESULTS Three cases on five presented with an anatomical variation at the level of the ACoA. The average length of AcoA was 2.1 millimeters (min: 2, max: 2.2). The average diameter of the ACoA was 1.67 mm (min: 1.1, max: 2.1). The average number of perforating branches was 4.2 (min: 2, max: 6). The presence of a median artery of the corpus callosum seemed to correlated with a low number of perforating branches. Branches supplying the optic chiasma seemed to be more numerous.
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Affiliation(s)
- H Ego
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France.
| | - H N'Da
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
| | - L Viart
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
| | - P Foulon
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
| | - D Le Gars
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
| | - E Havet
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
| | - J Peltier
- Laboratoire d'anatomie et d'organogenèse, université de Picardie-Jules-Verne, 3, rue des Louvels, 80036 Amiens, France
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Appy-Fedida B, Vernois J, Krief E, Gouron R, Mertl P, Havet E. Risk of sural nerve injury during lateral distal Achilles tendinoscopy: a cadaver study. Orthop Traumatol Surg Res 2015; 101:93-6. [PMID: 25595430 DOI: 10.1016/j.otsr.2014.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 09/30/2014] [Accepted: 10/22/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND The risk of damage to cutaneous sensory nerves located near portals has been evaluated for both conventional arthroscopy and extra-articular posterior ankle endoscopy. The objective of the anatomic study reported here was to assess the risk of injury to the sural nerve or lateral calcaneal nerve while using the distal lateral portal for the Achilles tendinoscopy procedure described by Vega et al. in 2008. MATERIALS AND METHODS We dissected the sural nerve and its branch, the lateral calcaneal nerve, of 13 human cadaver ankles in the prone position. We defined P as the point where the Achilles peritendon was opened during the distal lateral approach used for the study technique. P was adjacent to the lateral edge of the Achilles tendon, 2 cm proximal to the postero-superior edge of the calcaneal tuberosity. T was defined as the attachment site of the most lateral fibres of the Achilles tendon to the postero-superior edge of the calcaneal tuberosity. We evaluated the origin of the lateral calcaneal nerve relative to T and we measured the shortest distances separating P from the sural nerve and lateral calcaneal nerve. RESULTS A lateral calcaneal nerve was identified in 10 (77%) ankles and originated a mean of 39.1mm (range, 25.0-65.0mm) proximal to T. P was at a mean distance from the sural nerve of 12.3mm (range, 5.0-18.0mm) and from the lateral calcaneal nerve of 6.8mm (range, 4.0-9.0mm). The median difference between these two distances was statistically significant (P=0.002). DISCUSSION While using the distal lateral portal for Achilles tendinoscopy, the lateral calcaneal nerve is at greater risk for injury than is the sural nerve. LEVEL OF EVIDENCE Level IV. Anatomic Study.
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Affiliation(s)
- B Appy-Fedida
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - J Vernois
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - E Krief
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - R Gouron
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - P Mertl
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - E Havet
- Laboratoire d'anatomie, faculté de médecine, université Picardie Jules-Verne, centre hospitalier universitaire d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France.
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Jendrzejewski F, Peltier J, Havet E, Page C, Foulon P, Gondry J, Le Gars D. [The conflict between obturator nerve and ovary: a cadaveric and radioanatomic study]. Morphologie 2013; 97:54-8. [PMID: 23796698 DOI: 10.1016/j.morpho.2013.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 04/18/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to describe the anatomical relationships between the ovary and the obturator nerve in its intrapelvic portion. Seven embalmed cadavers were dissected; 20 MRIs were then analyzed. The main distance between the lateral pole of the ovary and the obturator nerve was 29 mm. The authors describe various etiologies responsible for obturator neuralgia. An underdiagnosed cause is gonadal hypertrophy.
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Affiliation(s)
- F Jendrzejewski
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, université de Picardie Jules-Verne, rue des Louvels, 80036 Amiens cedex 1, France.
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Delabie A, Peltier J, Havet E, Page C, Foulon P, Le Gars D. [Relationships between piriformis muscle and sciatic nerve: radioanatomical study with 104 buttocks]. Morphologie 2013; 97:12-8. [PMID: 23414787 DOI: 10.1016/j.morpho.2012.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 09/26/2012] [Accepted: 10/21/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The relationships between the piriformis muscle and the sciatic nerve are close and may be changing. In some cases, these relationships are the cause of a piriformis syndrome, an under-diagnosed etiology of non discal sciatica. The aim of the study was to explore, by the MRI, the sciatic nerve and the piriformis muscle. MATERIELS AND METHODS: One hundred and four buttocks were explored by MRI for 52 randomly selected patients. RESULTS In 59.6% of cases, no variation of the piriformis muscle and sciatic nerve were found. In 26% of cases, the sciatic nerve was divided into the pelvis. In 9.6% of cases, it was divided into the pelvis, the piriformis muscle was bifid and the common peroneal nerve ran between both heads. The piriformis muscle was bifid in 10.6% of cases, hypertrophic in 13.5% of cases and atrophic in 2.9% of cases.
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Affiliation(s)
- A Delabie
- Laboratoire d'anatomie et d'organogenèse, faculté de médecine, université de Picardie Jules-Verne, rue des Louvels, 80036 Amiens cedex 1, France.
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Rotari V, Moussallem CD, David E, Mertl P, Havet E. Position of the anterior branch of the axillary nerve in relation to the humeral bone length. Am J Orthop (Belle Mead NJ) 2012; 41:452-455. [PMID: 23376988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Many studies have attempted to define a safety zone for the axillary nerve in lateral approaches to the deltoid, but with varying results. The main objective of our study was to analyze the variations in the position of this nerve, especially in relation to the length of the humerus. Overall, 16 cadaveric shoulders were dissected. The distances between both the anterolateral edge of the acromin (anterior distance) and the lateral edge of the acromion (posterior distance) to the axillary nerve were measured; the length of the humerus was also measured. Correlation analysis was performed between each distance and the length of the humerus. The average anterior and posterior distance were 7.2 cm ± 0.84 cm and 7.9 cm ± 0.92 cm, respectively; the average length of the humerus was 30.7 cm ± 3.2 cm. A significantly high positive correlation was found between the length of the humerus and both anterior distance (P = .94), and posterior distance (P = .92). In shoulder surgery, prior measurement of the length of the humerus could predict the distance between the acromion and the axillary nerve, and determine its position.
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Affiliation(s)
- Vladimir Rotari
- Resident, Department of Orthopedic Surgery, Amiens University Medical Center, Jules Verne University, Picardie, France.
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Hannequin P, Peltier J, Destrieux C, Velut S, Havet E, Le Gars D. The inter-optic course of a unique precommunicating anterior cerebral artery with aberrant origin of an ophthalmic artery: an anatomic case report. Surg Radiol Anat 2012; 35:269-71. [PMID: 23053121 DOI: 10.1007/s00276-012-1028-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/23/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND IMPORTANCE Some variations of the cerebral arterial circle of Willis, such as an inter-optic course of the anterior cerebral artery are exceedingly rare. Imaging of very rare anatomical features may be of interest. CLINICAL PRESENTATION In a 67-year-old male individual, the unique precommunicating part of the left anterior cerebral artery was found to course between both optic nerves. There was an agenesis of the right precommunicating cerebral artery. This variation was associated with an aberrant origin of the ophthalmic artery, arising from the anterior cerebral artery. The anatomic features, the possible high prevalence of associated aneurysms of the anterior communicating artery complex as well as implications for surgical planning or endovascular treatments are outlined and embryologic considerations are discussed. CONCLUSION To the best of our knowledge, this is a very rare illustrated case of an inter-optic course of a unique precommunicating anterior cerebral artery with aberrant origin of an ophthalmic artery.
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Affiliation(s)
- Pierre Hannequin
- Department of Neurosurgery, University of Amiens, CHU AMIENS Nord, Place Victor Pauchet, 80054, AMIENS Cedex 1, France.
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Manopoulos P, Havet E, Pearce O, Lardanchet JF, Mertl P. Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components. ACTA ACUST UNITED AC 2012; 94:937-40. [DOI: 10.1302/0301-620x.94b7.26943] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This was a retrospective analysis of the medium- to long-term results of 46 TC3 Sigma revision total knee replacements using long uncemented stems in press-fit mode. Clinical and radiological analysis took place pre-operatively, at two years post-operatively, and at a mean follow-up of 8.5 years (4 to 12). The mean pre-operative International Knee Society (IKS) clinical score was 42 points (0 to 74), improving to 83.7 (52 to 100) by the final follow-up. The mean IKS score for function improved from 34.3 points (0 to 80) to 64.2 (15 to 100) at the final follow-up. At the final follow-up 30 knees (65.2%) had an excellent result, seven (15.2%) a good result, one (2.2%) a medium and eight (17.4%) a poor result. There were two failures, one with anteroposterior instability and one with aseptic loosening. The TC3 revision knee system, when used with press-fit for long intramedullary stems and cemented femoral and tibial components, in both septic and aseptic revisions, results in a satisfactory clinical and radiological outcome, and has a good medium- to long-term survival rate.
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Affiliation(s)
- P. Manopoulos
- Pole Euromediterranéen des pathologies
de l’appareil locomoteur, Hôpital Paul Desbief, Marseille
13003, France
| | - E. Havet
- Université Picardie Jules Verne, Place
Victor Pauchet, Amiens 80000, France
| | - O. Pearce
- Milton Keynes NHS Foundation Trust, Standing
Way, Eaglestone, Milton
Keynes MK6 5LD, UK
| | - J. F. Lardanchet
- Université Picardie Jules Verne, Place
Victor Pauchet, Amiens 80000, France
| | - P. Mertl
- Université Picardie Jules Verne, Place
Victor Pauchet, Amiens 80000, France
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Peltier J, Verclytte S, Delmaire C, Pruvo JP, Havet E, Le Gars D. Microsurgical anatomy of the anterior commissure: correlations with diffusion tensor imaging fiber tracking and clinical relevance. Neurosurgery 2012; 69:ons241-6; discussion ons246-7. [PMID: 21499149 DOI: 10.1227/neu.0b013e31821bc822] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Detailed anatomy of the anterior commissure is unknown in the literature. OBJECTIVE To describe the anterior commissure with the use of a fiber dissection technique by focusing on the morphology (length and breadth of the 2 portions), the course, and the relations with neighboring fasciculi, particularly in the temporal stem. METHODS We dissected 8 previously frozen, formalin-fixed human brains under the operating microscope using the fiber dissection described by Klingler. Lateral, inferior, and medial approaches were made. RESULTS The anterior olfactive limb of the anterior commissure was sometimes absent during dissection. The cross-sectional 3-dimensional magnetic resonance rendering images showed that fibers of the anterior commissure curved laterally within the basal forebrain. The tip of the temporal limb of the anterior commissure was intermingled with other fasciculi in various directions to form a dense 3-dimensional network. CONCLUSION Functional anatomy and comparative anatomy are described. The anterior commissure can be involved in various pathologies such as diffuse axonal injury, schizophrenia, and cerebral tumoral dissemination.
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Affiliation(s)
- Johann Peltier
- Laboratoire d'Anatomie et d'Organogenèse, Université de Picardie Jules Verne, Amiens, France.
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Moussallem CD, Abou Hamad I, El-Yahchouchi CA, Moussallem MD, Arnalsteen DM, Mertl P, Havet E. Relationship of the lumbar lordosis angle to the abdominal aortic bifurcation and inferior vena cava confluence levels. Clin Anat 2012; 25:866-71. [PMID: 22275156 DOI: 10.1002/ca.22030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 12/10/2011] [Accepted: 12/16/2011] [Indexed: 11/11/2022]
Abstract
The objective of this study is to determine the relationship of the variations of the lumbar lordosis angle (LLA) to the aortic bifurcation level and inferior vena cava (IVC) confluence level using CT angiography. A retrospective study was conducted using the data available on abdominopelvic CT angiography scans. The LLA, the level and angle of bifurcation of the aorta, the level and angle of confluence of the IVC were identified using multiplanar and 3D reconstruction. Linear regression models were fitted to the data. We interpreted 181 scans for 181 individuals having a mean age of 55 years (18-89). The most common site of aortic bifurcation was at L4-L5 disc space (34.8%) and that of vena confluence was at the upper of L5 (29.3%). The mean LLA was 34.65° (13°-77°). The mean aortic bifurcation angle was 47.43° (17°-100°) and the mean IVC confluence angle was 71.86° (30°-120°). The positions of the aortic bifurcation and venous confluence levels showed a proximal shift with an increasing LLA P < 0.001. This study showed that the level of bifurcation of the aorta and the level of confluence of the IVC may vary with the variations of the LLA.
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Affiliation(s)
- Charbel D Moussallem
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
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Havet E, Duparc F, Peltier J, Tobenas-Dujardin AC, Fréger P. The article critique as a problem-based teaching method for medical students early in their training: a French example using anatomy. Surg Radiol Anat 2011; 34:81-4. [PMID: 22130493 DOI: 10.1007/s00276-011-0911-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 11/22/2011] [Indexed: 12/01/2022]
Abstract
In France, "article critique" became a particular teaching method in the second part of the medical curriculum. It approaches a reading exercise of scientific medical papers similar to that of journal club. It could be compared to reviewing a paper as performed by reviewers of a scientific journal. We studied the relevancy of that teaching method for the youngest medical students. Our questions were about the understanding and the analyzing ability of a scientific paper while students have just learned basic medical sciences as anatomy. We have included 54 "article critique" written by voluntary students in second and third years of medical cursus. All of the IMRaD structure items (introduction, materials and methods, results and discussion) were analyzed using a qualitative scale for understanding as for analyzing ability. For understanding, 89-96% was good or fair and for the analyzing ability, 93-100% was good or fair. The anatomical papers were better understood than therapeutic or paraclinical studies, but without statistical difference, except for the introduction chapter. Results for analyzing ability were various according to the subject of the papers. This teaching method could be compared to a self-learning method, but also to a problem-based learning method. For the youngest students, the lack of medical knowledge aroused the curiosity. Their enthusiasm to learn new medical subjects remained full. The authors would insist on the requirement of rigorous lessons about evidence-based medicine and IMRaD structure and on a necessary companionship of the students by the teachers.
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Affiliation(s)
- Eric Havet
- Laboratory of Anatomy, Faculty of Medicine, Rouen University, 22 Boulevard Gambetta, 76183-1, Rouen, France.
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Zunon-Kipré Y, Peltier J, Haïdara A, Havet E, Kakou M, Le Gars D. Microsurgical anatomy of distal medial striate artery (recurrent artery of Heubner). Surg Radiol Anat 2011; 34:15-20. [PMID: 22116404 DOI: 10.1007/s00276-011-0888-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 10/06/2011] [Indexed: 10/15/2022]
Abstract
INTRODUCTION In literature, many controversies exist about courses and terminology of the distal medial striate artery (DMSA) or recurrent artery first described by Heubner near 1872. The purpose of this study was to define the accurate anatomy of this artery, to help the practitioners during surgery of the anterior cerebral-anterior communicating arteries (ACA-ACoA) complex. MATERIALS AND METHODS 20 cranial bases were examined using magnification of the surgical microscope. One half for which the internal carotid arteries and internal jugular veins were dissected, cannulated and perfused with colored silicon on fresh cadavers; the other half only with arterial injection of formalin-fixed normal adult human brains. RESULTS The artery arose principally from A2 segment (58%), always less than 5 mm up to downstream from ACA to ACoA junction. In 59.5% it had a recurrent course anterior to A1 segment. It terminated in one to three stems which entered the medial part of the anterior perforated substance. The DMSA was present as a single vessel in 95% of cases. Its main outer diameter was 0.7 mm and the length had an average of 24 mm. CONCLUSION Iatrogenic damage or occlusion leads to a mediobasal striatum infarction with important neurological deficits such as brachiofacial hemiparesis and aphasia. This artery should be routinely identified during clipping of ACoA aneurysm. Special attention in this study was given to atypical posterior course or anatomic variations such as double DMSA on a same side.
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Affiliation(s)
- Yvan Zunon-Kipré
- Laboratoire d' Anatomie, Faculté de Médecine, Université de Picardie Jules Verne, rue des Louvels, 80000, Amiens, France.
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Peltier J, Baroncini M, Zunon-Kipré Y, Haidara A, Havet E, Foulon P, Page C, Lejeune JP, Le Gars D. [Arteries and veins of the lateral ventricle]. Neurochirurgie 2011; 57:156-60. [PMID: 22030174 DOI: 10.1016/j.neuchi.2011.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 09/11/2011] [Indexed: 11/15/2022]
Abstract
Tumors of the frontal horn of the lateral ventricle (LV) are only supplied by the posteromedial choroidal artery. Tumors of the body of the LV are supplied by the same artery. Tumors of the atrium of the LV with anterior extension are supplied by both posteromedial choroidal and posterolateral arteries. Tumors of the atrium with inferior extension are supplied by both anterior choroidal artery and posterolateral choroidal arteries. Tumors of the inferior horn are only supplied by anterior choroidal artery. The tumoral venous drainage is organized with three main groups of veins: a medial group, a lateral group and a choroidal group.
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Affiliation(s)
- J Peltier
- Laboratoire d'anatomie et d'organogénèse, faculté de médecine, rue des Louvels, 80036 Amiens cedex 1, France.
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Peltier J, Nicot B, Baroncini M, Zunon-Kipré Y, Haidara A, Havet E, Foulon P, Page C, Lejeune JP, Le Gars D. [Anatomy of the periventricular white matter]. Neurochirurgie 2011; 57:151-5. [PMID: 22032888 DOI: 10.1016/j.neuchi.2011.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 09/11/2011] [Indexed: 11/29/2022]
Abstract
The lateral ventricle (LV) has a deep position within the cerebral hemisphere. The LV is covered by white matter with important functional role in the dominant hemisphere. Lateral wall of the frontal horn is covered by the inferior occipitofrontal fasciculus (IOFF) and its roof by the corpus callosum (CC). The body of the LV has the same cranial relationship and is covered laterally by fibers of internal capsula and arcuate fasciculus; its lower part is in relationship with the body of the fornix. The atrium of the LV is covered by the arcuate fasciculus and its lower part is covered by the IOFF and optic radiations. The inferior horn or temporal horn is covered by optic radiations in depth of middle temporal gyrus (T2). The auditive radiations crossed the optic radiations at the level of the roof of the inferior horn.
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Affiliation(s)
- J Peltier
- Laboratoire d'anatomie et d'organogénèse, faculté de médecine, rue des Louvels, 80036 Amiens cedex 1, France.
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Mertl P, Boughebri O, Havet E, Triclot P, Lardanchet JF, Gabrion A. Large diameter head metal-on-metal bearings total hip arthroplasty: preliminary results. Orthop Traumatol Surg Res 2010; 96:14-20. [PMID: 20170852 DOI: 10.1016/j.rcot.2009.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 09/17/2009] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although the use of the metal-on-metal bearings has been validated over the long term in total hip arthroplasty (THA) for standard 28 and 32 mm diameters, and over the medium term in resurfacing procedures, the use of larger metal head size in conventional THA has not yet been extensively reported. HYPOTHESIS The large-diameter metal-on-metal head is beneficial in terms of implant stability without altering the result in terms of function and bone fixation compared to the standard 28 and 32 mm diameters. OBJECTIVE The objective was to test this hypothesis by assessing the short-term clinical and radio graphic results of a metal-on-metal large-diameter heads THA system, using cups from the resurfacing hip concept. MATERIAL AND METHODS We conducted a retrospective study on a continuous series of 106 uncemented acetabular cups (Durom) implanted in 102 patients (mean age, 66 years): 93 cases of primary or secondary coxarthrosis, 11 cases of aseptic osteonecrosis, one fracture of the femoral neck, and one case of rheumatoid arthritis of the hip. At 30 months of follow-up,the Harris Hip Score and the Merle d'Aubigné (PMA) score were calculated. The radiological investigation included comparison of the implant head with native head diameters, variations of acetabular center of rotation, inspection for implant migration, and search for a gap or radiolucent line. RESULTS The series included two post-traumatic dislocations as well as spontaneously receding tendinitis of the gluteus medius with no further recurrence. The mean Harris Hip Score improved from 49.3 preoperatively to 91.6 at the latest follow-up and the mean PMA score ranged from 12 to 17. The results were excellent for 70 cases, good for 31 cases, fair for three cases, and poor for two cases. In the last five cases, the overall results were undermined by low pain subscore,with no identifiable explanation. Restoration of the original head diameter was verified for 65 hips. No cup migration was observed. Measurement of the acetabular centre of rotation showed a mean lateralization of 1.1mm. Of the 67 immediate postoperative gaps, only two did no disappear at follow-up. Implant head diameter, cup position, and the existence of a gap were not correlated with the clinical results. DISCUSSION These results are comparable to 28 mm-diameter metal-on-metal heads in uncemented cups but with improved stability but without demonstrable alteration of the quality of the bone fixation. We found no mechanical or medical cause that could explain the five cases of persistent pain leading to fair or poor results. Long-term follow-up will validate these theoretical advantages in terms of wear and implant survival. LEVEL OF EVIDENCE IV. Retrospective series.
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Affiliation(s)
- P Mertl
- Service d'orthopédie traumatologie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80053 Amiens cedex, France.
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Sinna R, Hajji H, Qassemyar Q, Perignon D, Benhaim T, Havet E. Anatomical background of the perforator flap based on the deep branch of the superficial circumflex iliac artery (SCIP Flap): a cadaveric study. Eplasty 2010; 10:e11. [PMID: 20090859 PMCID: PMC2808053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The groin flap, based on the superficial circumflex iliac artery, was the first successful free flap. However, its popularity was lost essentially due to variable arterial anatomy. Clinical applications of perforator flap based on superficial circumflex iliac artery suggest that a dominant perforator based on his deep branch is enough to supply a large groin flap. METHODS Fresh cadaveric dissections were performed and the perforators of Sartorius based on the deep branch of superficial circumflex iliac artery were identified. The dominant perforator was isolated and injected selectively with methylene blue solution. RESULTS We performed 20 dissections of superficial circumflex iliac artery and the deep branch. We found a deep branch with 2 perforators penetrating the Sartorius muscle. The diameter of the dominant perforator of the deep branch was 0.85 mm on average and the mean injected skin area was 162 cm(2). CONCLUSIONS These findings are in agreement with early clinical suggestion. The dominant musculocutaneous perforator of the deep branch of superficial circumflex iliac artery provides constant and reliable blood supply to ensure a relatively large perforator groin flap.
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Affiliation(s)
- Raphael Sinna
- aDepartment of Plastic, Reconstructive and Aesthetic Surgery, Amiens North Hospital, University of Picardie, place Victor Pauchet, 80054 Amiens, France,Correspondence:
| | - Hassene Hajji
- bDepartment of Anatomy, University of Tunis, Tunis, Tunisia
| | - Quentin Qassemyar
- aDepartment of Plastic, Reconstructive and Aesthetic Surgery, Amiens North Hospital, University of Picardie, place Victor Pauchet, 80054 Amiens, France
| | - David Perignon
- aDepartment of Plastic, Reconstructive and Aesthetic Surgery, Amiens North Hospital, University of Picardie, place Victor Pauchet, 80054 Amiens, France
| | - Thomas Benhaim
- aDepartment of Plastic, Reconstructive and Aesthetic Surgery, Amiens North Hospital, University of Picardie, place Victor Pauchet, 80054 Amiens, France
| | - Eric Havet
- cDepartment of Anatomy, University of Picardie, Amiens, France
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Affiliation(s)
- E Havet
- Service d'orthopédie, hôpital d'Amiens, place Victor-Pauchet, 80054 Amiens, France.
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El Samad Y, Havet E, Bentayeb H, Olory B, Canarelli B, Lardanchet JF, Douadi Y, Rousseau F, Lescure FX, Mertl P, Eb F, Schmit JL. Traitement des infections ostéoarticulaires par clindamycine chez l’adulte. Med Mal Infect 2008; 38:465-70. [DOI: 10.1016/j.medmal.2008.06.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Revised: 02/27/2008] [Accepted: 06/23/2008] [Indexed: 11/30/2022]
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Beldame J, Havet E, Auquit-Auckbur I, Lefebvre B, Mure JP, Duparc F. Arterial anatomical basis of the dorsal digito-metacarpal flap for long fingers. Surg Radiol Anat 2008; 30:429-35. [DOI: 10.1007/s00276-008-0347-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Accepted: 03/27/2008] [Indexed: 11/25/2022]
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Peltier J, Fichten A, Page C, Havet E, Foulon P, Mertl P, Le Gars D, Laude M. [Endoscopic anatomy of the terminal portion of the basilar artery and its distal perforating branches]. Morphologie 2008; 92:31-36. [PMID: 18424150 DOI: 10.1016/j.morpho.2008.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this study was to describe and highlight the endoscopic anatomy of the tip of the basilar artery and its perforating branches. Knowledges of the anatomy are crucial for neurosurgeons to avoid pitfalls during endoscopic third ventriculostomy.
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Affiliation(s)
- J Peltier
- Laboratoire d'Anatomie et d'Organogenèse, Faculté de Médecine, Université de Picardie-Jules-Verne, Amiens, France.
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Havet E, Duparc F, Tobenas-Dujardin AC, Muller JM, Fréger P. Morphometric study of the shoulder and subclavicular innervation by the intermediate and lateral branches of supraclavicular nerves. Surg Radiol Anat 2007; 29:605-10. [PMID: 17851634 DOI: 10.1007/s00276-007-0258-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 08/23/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND The supraclavicular (intermediate) and supra-acromial (lateral) branches of supraclavicular nerves contribute to the innervation of the thorax, shoulder, and neck. Despite their clinical and surgical interest, they are not often considered for descriptive anatomy. The goal of this work was to clarify the morphometric knowledge of these two branches and to discuss the clinical relevance of the anatomical features. METHODS Intermediate and lateral branches of supraclavicular nerves of 14 necks (8 embalmed cadavers) were dissected using magnifying glasses. Macroscopic parameters were measured and nerve relationships were recorded. RESULTS In 12 cases, the intermediate and lateral branches arose from a common trunk behind the posterior border of the sternocleidomastoideus muscle, at a mean distance of 96 mm (70-137) from the sternal angle. The intermediate branch divided into two or three secondary rami. Its most internal ramus crossed the middle third of the clavicle and its most external ramus crossed the second lateral quarter of the bone. The distance between the two farthest nerve endings of this branch was at mean of 98 mm (85-125). The mean distance of the most distal nerve ending from the clavicle was 46 mm (30-63). The lateral branch divided into two or three rami in eight cases and did not divide in six cases. Its most anterior rami crossed the trapezius muscle at a mean distance from the clavicular insertion of 17 mm (12-24). In 13 cases, these rami ended posteriorly or at the level of the anterior border of the acromion process and in 12 cases, they ended laterally or at the level of the acromion process with a mean distance 10.4 mm (0-24). CONCLUSION In case of deficiency of these nerves, pain or sensitive deficit can occur without motor trouble. The factors of acute or chronic injury are direct compression, nerve stretching, repetitive stresses, and direct wound. Moreover, several neck or shoulder surgical approaches are dangerous for these nerves.
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Affiliation(s)
- Eric Havet
- Rouen University Hospital, Laboratory of Anatomy, Faculty of Medicine and Pharmacy, University of Rouen, 22 boulevard Gambetta, Rouen, France.
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Peltier J, Fichten A, Havet E, Page C, Foulon P, Laude M, Le Gars D. The infra-optic course of the anterior cerebral arteries: an anatomic case report. Surg Radiol Anat 2007; 29:389-92. [PMID: 17599237 DOI: 10.1007/s00276-007-0221-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 05/21/2007] [Indexed: 10/23/2022]
Abstract
Although variations of the anterior part of the cerebral arterial circle of Willis are quite well known, though some anomalies are exceedingly rare. In a 61-year-old female individual, on both sides the precommunicating parts of the anterior cerebral artery were found to course inferiorly to the ipsilateral optic nerves. This anomaly was associated with an agenesis of a left posterior communicating artery. The anatomic features, the possible high prevalence of associated aneurysms of the anterior communicating artery complex as well as implications for surgical planning or endovascular treatment are outlined and embryologic considerations and discussed.
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Affiliation(s)
- J Peltier
- Laboratoire d'Anatomie, Faculté de Médecine, Université Picardie Jules Verne, 3 rue des Louvels, 80000 Amiens, France.
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Boughebri O, Havet E, Sanguina M, Daumas L, Jacob P, Zerkly B, Heissler P. Traitement des fractures de l’extrémité proximale de l’humérus par clou Télégraph®. ACTA ACUST UNITED AC 2007; 93:325-32. [PMID: 17646812 DOI: 10.1016/s0035-1040(07)90272-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE OF THE STUDY Many developments have been devoted to improving osteosynthesis of proximal humeral fractures, but indications remain controversial. Anterograde nailing using a locked self-stabilizing nail is an attractive conception which has provided promising results. The purpose of this study was to assess the early results observed in a series of patients treated with a first-intention Telegraph nail. MATERIAL AND METHOD Thirty-four patients were reviewed for a prospective clinical and radiological assessment. Mean follow-up was 13.6 months (range 3-34 months). Mean age at the time of the accident was 68 years (20-90 years). There were 24 women and 10 men: the left shoulder was fractured in 22 patients. All fractures healed within 1 to 4 months. Groups for statistical analysis were determined by type of fracture using the Neer and Duparc classifications. Qualitative functional analysis used the Constant score in comparison with the opposite side. Anatomic analysis of fracture reduction after healing was based on plain x-rays (ap view in neutral rotation) by measuring the angle of inclination of the head in relation to the diaphyseal axis (alphaF). Normal was 45 degrees; reduction was considered adequate for an alphaF angle between 30 degrees and 60 degrees. The lateral view was used to search for posterior or anterior tilt of the humeral head. RESULTS Necrosis of the humeral head was observed in four shoulders (11.8%). Three of them after displaced joint fractures. These cases were retained for the analysis. Considering all patients in the study, the raw mean Constant score was 62 points and the age- and sex-weighted score was 82.5%. For two- and three-fragment extra-articular fractures, the mean Constant score was 82.3% (21 shoulders); it was 89% for simple joint fractures (5 shoulders) and 79% for complex joint fractures (8 shoulders). The differential Constant scores, comparing the healthy side with the operated shoulder, showed a difference of 20 points on average (range 0-43 points). 52.9% of patients reviewed displayed mild deficit, 20.6% moderate deficit, and 26.5% major deficit. The mean alphaF angle was 38 degrees (range 0-80 degrees). Reduction was considered good in 18 shoulders with a mean Constant score of 88.7%. Reduction was considered poor in 16 shoulders with a mean Constant score of 75.6%. Four shoulders exhibited posterior tilt of the humeral head, all associated with healing in a valgus position. DISCUSSION The Telegraph nail provides reliable fixation for the treatment of extra-articular and simple articular fractures of the proximal humerus. Dislocated fractures are classical indications for arthroplasty, with acceptable results for a only slightly invasive procedure. The risk of osteonecrosis does not necessarily deteriorate shoulder function and secondary revision for insertion of a prosthesis is still possible. The radio-clinical correlations show the importance of reduction quality to obtain a good final clinical result. Among the nine cases of poor outcome, six were related to a misaligned callus with persistent valgus deviation of the head (alpha F<30 degrees ) and in some cases, excessive posterior tilt. The solidity and stability achieved with the Telegraph nail enabled healing in all cases of fracture in this series with immediate postoperative reduction in most. The stability being related to the quality of bone stock, primary arthroplasty remains an important indication when it appears that a solid osteosynthesis cannot be achieved.
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Affiliation(s)
- O Boughebri
- Service de Chirurgie Orthopédique et Traumatologique, CHU Amiens Nord, 2, place Victor-Pauchet, 80080 Amiens.
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Havet E, Gabrion A, Leiber-Wackenheim F, Vernois J, Olory B, Mertl P. Radiological study of the knee joint line position measured from the fibular head and proximal tibial landmarks. Surg Radiol Anat 2007; 29:285-9. [PMID: 17440678 DOI: 10.1007/s00276-007-0207-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2006] [Accepted: 04/02/2007] [Indexed: 10/23/2022]
Abstract
Restoring the joint line level is one of the surgical challenges during revision of total knee arthroplasty. The position of the tibial surface is commonly estimated by its distance to the apex of fibular head, but no study evaluating this distance accurately has been published yet. The purpose of this work was to study the distance between the knee joint line and the apex of the fibular head and the proximal tibia, particularly the tibial tuberosity. Variability with clinical data and relations with other local measurements have been evaluated on knee radiographs (an antero-posterior view, a medio-lateral view and an anteroposterior full length view) of 100 subjects (125 knees). Results showed no correlation between the joint line-fibular head apex distance and any clinical data of the patients, or any other performed measurements. Relations between tibial measurements and the sexe or the height of the subjects were noted. Besides, the review of the 25 bilateral cases did not show statistically significant side difference but the descriptive analysis showed too large discrepancies for the joint line-fibular head apex distance to be used as a landmark. We conclude that the fibular head apex cannot be used as a morphologic landmark to determine the knee joint line position. Its interest in clinical and surgical practice must be discussed.
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Affiliation(s)
- Eric Havet
- Department of Anatomy, Medical University, 3 rue des Louvels, 80000 Amiens, France.
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