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Gandolfi S, Pileyre B, Drouot L, Dubus I, Auquit-Auckbur I, Martinet J. Stromal vascular fraction in the treatment of myositis. Cell Death Discov 2023; 9:346. [PMID: 37726262 PMCID: PMC10509179 DOI: 10.1038/s41420-023-01605-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 09/21/2023] Open
Abstract
Muscle regeneration is a physiological process that converts satellite cells into mature myotubes under the influence of an inflammatory environment progressively replaced by an anti-inflammatory environment, with precise crosstalk between immune and muscular cells. If the succession of these phases is disturbed, the immune system can sometimes become auto-reactive, leading to chronic muscular inflammatory diseases, such as myositis. The triggers of these autoimmune myopathies remain mostly unknown, but the main mechanisms of pathogenesis are partially understood. They involve chronic inflammation, which could be associated with an auto-reactive immune response, and gradually with a decrease in the regenerative capacities of the muscle, leading to its degeneration, fibrosis and vascular architecture deterioration. Immunosuppressive treatments can block the first part of the process, but sometimes muscle remains weakened, or even still deteriorates, due to the exhaustion of its capacities. For patients refractory to immunosuppressive therapies, mesenchymal stem cells have shown interesting effects but their use is limited by their availability. Stromal vascular fraction, which can easily be extracted from adipose tissue, has shown good tolerance and possible therapeutic benefits in several degenerative and autoimmune diseases. However, despite the increasing use of stromal vascular fraction, the therapeutically active components within this heterogeneous cellular product are ill-defined and the mechanisms by which this therapy might be active remain insufficiently understood. We review herein the current knowledge on the mechanisms of action of stromal vascular fraction and hypothesise on how it could potentially respond to some of the unmet treatment needs of refractory myositis.
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Affiliation(s)
- S Gandolfi
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
- Toulouse University Hospital, Department of Plastic and Reconstructive Surgery, F-31000, Toulouse, France
| | - B Pileyre
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France.
- Centre Henri Becquerel, Department of Pharmacy, F-76000, Rouen, France.
| | - L Drouot
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - I Dubus
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - I Auquit-Auckbur
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, CHU Rouen, Department of Plastic, Reconstructive and Hand Surgery, F-76000, Rouen, France
| | - J Martinet
- Univ Rouen Normandie, INSERM U1234, FOCIS Center of Excellence PAn'THER, CHU Rouen, Department of Immunology and Biotherapy, F-76000, Rouen, France
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Chabridon AI, Payen M, Auquit-Auckbur I. MRI-Induced Third-Degree Finger Burn by Pulse Oximetry: A Case Report. J Magn Reson Imaging 2023; 58:977-979. [PMID: 36574217 DOI: 10.1002/jmri.28557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/28/2022] Open
Affiliation(s)
- Anne-Isabelle Chabridon
- Département de chirurgie plastique & chirurgie de la main, hôpital Charles Nicolle, CHU de Rouen, Rouen, France
| | - Mathilde Payen
- Clinique chirurgicale infantile, hôpital Charles-Nicolle, CHU de Rouen, Rouen, France
| | - Isabelle Auquit-Auckbur
- Département de chirurgie plastique & chirurgie de la main, hôpital Charles Nicolle, CHU de Rouen, Rouen, France
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Portenard AC, Pegot A, Lievain L, Michelin P, Angot É, Beccari R, Duparc F, Auquit-Auckbur I. The distal dorsal intermetacarpal ligament: characterization of an overlooked structure-an anatomical study of 25 hands. Surg Radiol Anat 2023; 45:673-679. [PMID: 37017796 DOI: 10.1007/s00276-023-03139-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE Exhaustive literature is available on the metacarpophalangeal joints of the long fingers, but the dorsal ligamentous structure overlaying the interosseous muscles and joining the metacarpal heads of the long fingers remains to be fully characterized. Previously, our surgical hand team observed a non-classically reported structure connecting the metacarpal heads of the long fingers, in the dorsal part of the intermetacarpal spaces. Therefore, the aim of this anatomical study was to characterize this ligamentous structure in terms of size, insertions, and anatomical position. METHODS Twenty-five hands were dissected for a total of 75 long finger intermetacarpal spaces. A ligamentous structure was exposed after cellular tissue excision and dorsal superficial fascia opening. The length and thickness were measured and anatomical position and insertions were studied. Histological analysis was performed on five specimens and ultrasound analysis in one healthy subject. RESULTS All 25 dissections revealed a dorsal ligamentous structure, hereafter named distal dorsal intermetacarpal ligament, which was inserted in the lateral tubercle of each adjacent long finger metacarpal head. This distal dorsal intermetacarpal ligament surrounded interosseous tendons. It was more proximal compared to oblique and transversal interosseous muscle fibers. Histological analysis confirmed the ligamentous nature of the structure. Ultrasound analysis showed that this structure was well identified under the dorsal aspect of the hand. CONCLUSION All dissections revealed a tense ligamentous structure between each metacarpal head of the long fingers. This was a constant structure meeting the definition of a ligament. The distal dorsal intermetacarpal ligament seems to stabilize the metacarpal heads at the second and fourth spaces by limiting hyperabduction.
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Affiliation(s)
- Anne-Carole Portenard
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, 37 Boulevard Gambetta, 76000, Rouen, France
| | - Alexandre Pegot
- Plastic and Aesthetic Surgery Department, Hôpital Privé Océane, 11 rue du Docteur-Audic, 56000, Vannes, France
| | - Ludovic Lievain
- Plastic and Aesthetic Surgery Department, Saint-Hilaire Clinic, 26 bis Boulevard Gambetta, 76044, Rouen Cedex, France
| | - Paul Michelin
- Department of Medical Imaging, Rouen University Hospital, 37 Boulevard Gambetta, 76000, Rouen, France
| | - Émilie Angot
- Department of Pathology, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, 76031, Rouen, France
| | - Roberto Beccari
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, 37 Boulevard Gambetta, 76000, Rouen, France
| | - Fabrice Duparc
- Laboratory of Anatomy, Faculty of Medicine and Pharmacy of Rouen, University of Normandy, 22 Boulevard Gambetta, 76000, Rouen, France.
| | - Isabelle Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, 37 Boulevard Gambetta, 76000, Rouen, France
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Dhellemmes O, Mouton J, Auquit-Auckbur I. Hand emergencies: patient information is often neglected. J Hand Surg Eur Vol 2023; 48:153-154. [PMID: 36324199 DOI: 10.1177/17531934221132638] [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] [Indexed: 11/06/2022]
Affiliation(s)
- Octave Dhellemmes
- Plastic and Hand Surgery Department, Rouen University Hospital, Rouen, France
| | - Jordane Mouton
- Hand Surgery Department, Clinique de l'Europe, Rouen, France
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Auquit-Auckbur I, Coquerel-Beghin D, Leger M, Vanaret J. Lambeau de Razemon: Une technique fiable pour le traitement chirurgical de la maladie de Dupuytren du 5eme doigt. Hand Surgery and Rehabilitation 2022. [DOI: 10.1016/j.hansur.2022.09.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leger M, Vanaret J, Garcia-Doldan M, Duparc F, Auquit-Auckbur I. Lambeau digito-metacarpien dorsal: Une solution de couverture des pertes de substances dorsales distales des doigts longs. Hand Surgery and Rehabilitation 2022. [DOI: 10.1016/j.hansur.2022.09.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leclercq M, Vannier M, Benhamou Y, Liard A, Gilard V, Auquit-Auckbur I, Levesque H, Sibert L, Schneider P. Identification des facteurs associés à la réussite aux examens cliniques objectifs et structurés dans la faculté de médecine de Rouen. Rev Med Interne 2022; 43:278-285. [DOI: 10.1016/j.revmed.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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Gandolfi S, Auquit-Auckbur I, Chaput B, Duparc F. Innervation of digital joints: an anatomical overview. Surg Radiol Anat 2021; 43:1635-1646. [PMID: 33956202 PMCID: PMC8101085 DOI: 10.1007/s00276-021-02754-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/16/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints. MATERIALS AND METHODS A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalangeal (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber. RESULTS In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC. DISCUSSION AND CONCLUSION Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source.
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Affiliation(s)
- S Gandolfi
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France
| | - I Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France
| | - B Chaput
- Department of Plastic and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - F Duparc
- Department of Orthopedic Surgery, Rouen University Hospital, Rouen, France.
- Laboratory of Anatomy, Faculty of Medicine, Rouen University, 22 boulevard Gambetta, 76183, Rouen, France.
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Carricaburu A, Mouton J, Nseir I, Beccari R, Gandolfi S, Auquit-Auckbur I. Ambulatory hand emergency: 2 years-experience in an public university hospital center. Acta Orthop Belg 2021. [DOI: 10.52628/87.2.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hand emergencies represent the most frequent traumatic injuries and outpatient surgery is still improving. It will achieve 70% of total surgeries by 2022.
Our hand trauma center has been able to set up an emergency day surgery department in a university hospital center.
With this article, we would like to report the ambula- tory care management and practice for hand emer- gencies in our university hospital center over 2 years. 892 patients suffering from hand traumas and managed in our day surgery department, were retro-spectively reviewed between January 2016 and December 2017. Patients’ demographic data, anesthe- tic data, trauma’s circumstances, medical care and surgical outcomes have been disclosed. A descriptive analysis and a statistical assessment was realized.
Cut injury was the most recorded case, followed by impactions. Tendon injuries were the most frequent (32%), followed by fractures (26%), and exposed joints (18%). 13% of injuries were nil findings. Average patient care delay was 1.16 days. Mean of hospitalization was 7.5 hours. 16/892 patients needing intravenous antibiotics required hospitalization. 41 complications including 27 secondary surgeries were reported.
Hospital facilities are forced to reassess their entire procedures to achieve efficiency and improvement for healthcare. Progress in outpatient surgery permits emergency management in hand surgery, improving patient cares both medically and economically.
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Daumas A, Magalon J, Jouve E, Casanova D, Philandrianos C, Abellan Lopez M, Mallet S, Veran J, Auquit-Auckbur I, Farge D, Levesque H, Benhamou Y, Arnaud L, Giraudo L, Dumoulin C, Giverne C, Boyer O, Giuliani A, Bourgarel V, Harlé JR, Schleinitz N, Brunet J, Pers YM, Ferreira R, Cras A, Bocara D, Larghero J, Château J, Hot A, Dignat-George F, Magalon G, Sabatier F, Granel B. Adipose tissue-derived stromal vascular fraction for treating hands of patients with systemic sclerosis: a multicentre randomized trial. Rheumatology (Oxford) 2021; 61:1936-1947. [PMID: 34297066 DOI: 10.1093/rheumatology/keab584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/17/2021] [Revised: 06/25/2021] [Accepted: 07/13/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To assess the superiority of adipose tissue-derived stromal vascular fraction (AD-SVF) injection into the fingers vs placebo in reducing hand disability in systemic sclerosis (SSc) patients. METHODS We performed a double-blind, multicentre, phase II trial from October 2015 to January 2018 in France. SSc patients with a Cochin Hand Function Scale (CHFS) ≥20/90 were randomized 1:1 to receive injection of AD-SVF or placebo. AD-SVF was obtained using the automated processing Celution®800/CRS system. The placebo was lactated Ringer's solution. The primary efficacy end point was the change of the CHFS score from baseline to 3 months. Secondary efficacy endpoints included the CHFS score at 6 months, hands function, vasculopathy, hands pain, skin fibrosis, sensitivity of the finger' pulps, Scleroderma Health Assessment Questionnaire, patients and physician satisfaction and the safety. RESULTS 40 patients were randomized. The AD-SVF and placebo groups were comparable for age, sex ratio, disease duration, skin fibrosis of the hands and main cause of hand disability. After 3 month-follow-up, hand function significantly improved in both groups with no between-group difference of CHFS (mean change of -9.2 ± 12.2 in the AD-SVF group vs -7.6 ± 13.2 in the placebo group). At 6 months, hand function improved in both groups. CONCLUSION This study showed an improvement of hand function in both groups other time, with no superiority of the AD-SVF. Considering the limits of this trial, studies on a larger population of patients with homogeneous phenotype and hand handicap, should be encouraged to accurately assess the benefit of AD-SVF therapy. TRIAL REGISTRATION ClinicalTrials.gov, https://clinicaltrials.gov, NCT02558543. Registered on September 24, 2015.
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Affiliation(s)
- Aurélie Daumas
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE.,Vascular Research Center Marseille, INSERM, INRA, Aix-Marseille University, MARSEILLE, FRANCE
| | - Jérémy Magalon
- Vascular Research Center Marseille, INSERM, INRA, Aix-Marseille University, MARSEILLE, FRANCE.,Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Elisabeth Jouve
- Pharmacometry CIC- CPCET, Clinical Pharmacology and Pharmacovigilance Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Dominique Casanova
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Cécile Philandrianos
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Maxime Abellan Lopez
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Stéphanie Mallet
- Department of Dermatology, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Julie Veran
- Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Isabelle Auquit-Auckbur
- Normandie Univ, UNIROUEN, INSERM, U1234, Rouen University Hospital, Department of Plastic, reconstructive and hand surgery, ROUEN, FRANCE
| | - Dominique Farge
- Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Autoimmune and Vascular Disease Unit, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R); Université de Paris, PARIS, EA, 3518, FRANCE.,Department of Medicine, McGill University, Montreal, QC, CANADA
| | - Hervé Levesque
- Department of Internal Medicine, Normandie Univ, UNIROUEN, INSERM U1096 EnVI, Rouen University Hospital, ROUEN, FRANCE
| | - Ygal Benhamou
- Department of Internal Medicine, Normandie Univ, UNIROUEN, INSERM U1096 EnVI, Rouen University Hospital, ROUEN, FRANCE
| | - Laurent Arnaud
- Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Laurent Giraudo
- Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Chloé Dumoulin
- Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Camille Giverne
- Normandie Univ, UNIROUEN, INSERM, U1234, Rouen University Hospital, Department of Immunology and Biotherapy, ROUEN, FRANCE
| | - Olivier Boyer
- Normandie Univ, UNIROUEN, INSERM, U1234, Rouen University Hospital, Department of Immunology and Biotherapy, ROUEN, FRANCE
| | - Alexandra Giuliani
- Health research department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Véronique Bourgarel
- Health research department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE.,Cancer Research Center of Marseille (CRCM), INSERM UMR1068, CNRS UMR7258, Aix-Marseille University, MARSEILLE, France
| | - Jean-Robert Harlé
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Nicolas Schleinitz
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Julie Brunet
- Health research department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Yves-Marie Pers
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Department of Rheumatology, Lapeyronie University Hospital, MONTPELLIER, France.,IRMB, University of Montpellier, INSERM U1183, CHU Montpellier, MONTPELLIER, France
| | - Rosanna Ferreira
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Department of Rheumatology, Lapeyronie University Hospital, MONTPELLIER, France
| | - Audrey Cras
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, PARIS, France.,INSERM U976 et CIC de Biothérapies CBT501, Université de Paris, PARIS, France
| | - David Bocara
- Department of Plastic, Reconstructive, and Esthetic Surgery, Saint Louis Hospital, Paris; Paris Diderot University, Sorbonne, Paris, France
| | - Jérome Larghero
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, PARIS, France.,INSERM UMR1140 et CIC de Biothérapies CBT501, Université de Paris, PARIS, France
| | - Joseph Château
- Department of Hand Surgery ICMMS, Medipole Hospital Lyon Villeurbanne; Department of plastic, reconstructive and aesthetic surgery, Hospital Jean Mermoz Lyon; CRIOac Lyon, Regional Reference center for the management of complex bone and joint infection, Hospices Civils de Lyon, LYON, France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot, LYON, F-69003, France
| | - Françoise Dignat-George
- Vascular Research Center Marseille, INSERM, INRA, Aix-Marseille University, MARSEILLE, FRANCE.,Hematology and Vascular Biology Laboratory, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, FRANCE
| | - Guy Magalon
- Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE.,Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE
| | - Florence Sabatier
- Vascular Research Center Marseille, INSERM, INRA, Aix-Marseille University, MARSEILLE, FRANCE.,Culture and Cell Therapy Laboratory, INSERM CIC BT 1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, MARSEILLE, FRANCE
| | - Brigitte Granel
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), MARSEILLE, FRANCE.,Vascular Research Center Marseille, INSERM, INRA, Aix-Marseille University, MARSEILLE, FRANCE
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Carricaburu A, Mouton J, Nseir I, Beccari R, Gandolfi S, Auquit-Auckbur I. Ambulatory hand emergency: 2 years-experience in an public university hospital center. Acta Orthop Belg 2021; 87:211-217. [PMID: 34529372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Hand emergencies represent the most frequent traumatic injuries and outpatient surgery is still improving. It will achieve 70% of total surgeries by 2022. Our hand trauma center has been able to set up an emergency day surgery department in a university hospital center. With this article, we would like to report the ambula- tory care management and practice for hand emer- gencies in our university hospital center over 2 years. 892 patients suffering from hand traumas and managed in our day surgery department, were retro-spectively reviewed between January 2016 and December 2017. Patients' demographic data, anesthe- tic data, trauma's circumstances, medical care and surgical outcomes have been disclosed. A descriptive analysis and a statistical assessment was realized. Cut injury was the most recorded case, followed by impactions. Tendon injuries were the most frequent (32%), followed by fractures (26%), and exposed joints (18%). 13% of injuries were nil findings. Average patient care delay was 1.16 days. Mean of hospitalization was 7.5 hours. 16/892 patients needing intravenous antibiotics required hospitalization. 41 complications including 27 secondary surgeries were reported. Hospital facilities are forced to reassess their entire procedures to achieve efficiency and improvement for healthcare. Progress in outpatient surgery permits emergency management in hand surgery, improving patient cares both medically and economically.
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12
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Gandolfi S, Laloze J, Chaput B, Auquit-Auckbur I, Grolleau JL, Bertheuil N, Carloni R. Nostril Surgery: Indications, Surgical Procedures and Outcomes-A Systematic Review of Published Cases. Aesthetic Plast Surg 2020; 44:2219-2229. [PMID: 32812083 DOI: 10.1007/s00266-020-01911-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/18/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To achieve adequate nasal proportions, nostril surgery can be a complementary technique useful in facial surgery. To help surgeons with the decision to realize nostril surgery, we conducted a systematic review to summarize reported cases on surgical procedures with a specific interest on indications, surgical procedures and postoperative outcomes. A therapeutic algorithm is also proposed. METHOD We carried out this review in accordance with the PRISMA criteria. Twenty-two eligible studies were identified using Medical databases, including 1599 patients. A qualitative and quantitative analysis was carried out. DISCUSSION Excision techniques were realized on 728 patients (45.5%), followed by cinching sutures on 642 patients (40%) and combined techniques: excision techniques with flap advancement techniques in 189 cases (12%), excision techniques with flap advancement techniques and cinching suture in 40 patients (2.5%). When excessive alar flaring was present, alar wedge resection was preferred in the 92% of followed by alar and sill resection. Cinching sutures were realized when excessive alar flaring was associated with a vertical alar axis, in cases of wide alar base, of associated orthognathic surgery. When excessive alar flaring was associated with wide alar bases, indications changed basing on the associated deformities. In 795 patients, nostril surgery was conducted simultaneously with rhinoplasty. CONCLUSION Nostril surgery through excision techniques, cinching sutures or flaps advancement techniques, reveals good outcomes and can be complementary to rhinoplasty or orthognathic surgery. Through this systematic review, we tried to orient surgeons to find the best treatment for nostril base surgery. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- S Gandolfi
- Department of Plastic and Reconstructive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - J Laloze
- Department of Maxillo-Facial and Reconstructive Surgery, Dupuytren University Hospital, Limoges, France
| | - B Chaput
- Department of Plastic and Reconstructive Surgery, Rangueil University Hospital, Toulouse, France
| | - I Auquit-Auckbur
- Department of Plastic and Reconstructive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - J L Grolleau
- Department of Plastic and Reconstructive Surgery, Rangueil University Hospital, Toulouse, France
| | - N Bertheuil
- Department of Plastic and Reconstructive Surgery, Rennes University Hospital, Rennes, France
| | - R Carloni
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hopital Privé de L'Estuaire, 505 Rue Irène Joliot Curie, 76620, Le Havre, France.
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Carricaburu A, Nseir I, Vanaret J, Auquit-Auckbur I, Carloni R. [Dorsal skin defect: What solutions exist?]. ANN CHIR PLAST ESTH 2020; 66:184-192. [PMID: 32896452 DOI: 10.1016/j.anplas.2020.07.002] [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: 05/29/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 11/26/2022]
Abstract
Dorsal subcutaneous or cutaneous defects can be of multiple origin: tumor, congenital malformation, trauma, chronic radiodermitis ulceration, parting of sutures or spine surgery infection, pressure sore, etc. Wound healing of these defects can be really difficult to obtain with simple processes, such as direct sutures or skingrafts, and often implies skin flap surgery. The rarity of recipients vessels from the dorsal area makes free flaps surgery harduous. Various local or locoregional back cover solutions are available: muscular or musculocutaneous flaps (latissimus dorsi, trapezius muscle, spinal muscles, gluteus maximus), perforator flaps (DICAP, DLICAP, SCAP and IGAP…), random flaps. These flaps are really useful and must be mastered in order to propose the best-suited cover solution for each patient after a precise evaluation of their medical and clinical background. Our study, based on the Literature and some clinical cases, aims to draw up a complete table of local, locoregional and microsurgical coverage solutions by anatomical area for median and paramedian back wound defects and thus to produce a decisional algorithm facilitating our care.
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Affiliation(s)
- A Carricaburu
- Service de chirurgie plastique et de la main, centre hospitalier universitaire Charles-Nicolle, Rouen, France.
| | - I Nseir
- Service de chirurgie plastique, clinique mutualiste de Pessac, 45, avenue du Dr-Albert-Schweitzer, 33600 Pessac, France
| | - J Vanaret
- Service de chirurgie plastique et de la main, centre hospitalier universitaire Charles-Nicolle, Rouen, France
| | - I Auquit-Auckbur
- Service de chirurgie plastique et de la main, centre hospitalier universitaire Charles-Nicolle, Rouen, France
| | - R Carloni
- Service de chirurgie plastique, hôpital Jacques-Monod, 29, avenue Pierre-Mendès-France, 76290 Montivilliers, France
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Auquit-Auckbur I, Coquerel-Beghin D, Vanaret J. Coverage losses of substance in the shoulder. ANN CHIR PLAST ESTH 2020; 65:570-588. [PMID: 32807532 DOI: 10.1016/j.anplas.2020.06.008] [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: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 11/26/2022]
Abstract
Losses of substance of the shoulder are less common than elsewhere in the upper limb. They arise essentially from tumors (sarcomas), infectious diseases (hidradenitis) or traumatic events, (burns). The objectives of reconstruction depend on whether the losses of substance are located on the curve of the shoulder or in the axillary area. There exist numerous regional solutions, including perforator, propeller, pedicled and free flaps. The donor region may be the thorax (latissimus dorsi, serratus anterior), the back (trapezium, scapular or subscapular flaps, occipito-cervico-thoracic flap), the anterior surface of the thorax (pectoralis major or minor, supraclavicular, perforators of the acromiothoracic artery, delto-pectoral flap) or arm (brachial lateral or medial). Multitissular reconstructions are also possible in regional and pedicled form, as well as microanastomosed flaps in exceptional conditions.
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Affiliation(s)
- I Auquit-Auckbur
- Plastic and reconstructive hand surgery unit, CHU de Rouen, 3rd floor Pavillon DEVE, 1, rue de Germont, 76031 Rouen cedex, France.
| | - D Coquerel-Beghin
- Plastic and reconstructive hand surgery unit, CHU de Rouen, 3rd floor Pavillon DEVE, 1, rue de Germont, 76031 Rouen cedex, France
| | - J Vanaret
- Plastic and reconstructive hand surgery unit, CHU de Rouen, 3rd floor Pavillon DEVE, 1, rue de Germont, 76031 Rouen cedex, France
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Gandolfi S, Carloni R, Mouton J, Auquit-Auckbur I. Finger joint denervation in hand osteoarthritis: Indications, surgical techniques and outcomes. A systematic review of published cases. Hand Surg Rehabil 2020; 39:239-250. [PMID: 32171925 DOI: 10.1016/j.hansur.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/02/2020] [Accepted: 02/08/2020] [Indexed: 10/24/2022]
Abstract
In cases of osteoarthritis with preserved motion, joint denervation can be an effective alternative to arthroplasty or arthrodesis to reduce joint-related pain. Although denervation is a standardized procedure for wrist osteoarthritis, it is used sparingly for finger joints. We conducted a systematic review to summarize reported cases of finger joint denervation in hand osteoarthritis with a specific focus on surgical procedures and postoperative outcomes. PubMed, Cochrane and Science Direct databases were searched from 1998 to 2019 and 13 relevant articles were selected. Three hundred and twenty-five denervations were conducted on 291 patients. Distal interphalangeal (DIP) joint denervation was performed through a dorsal approach; 83% of patients were satisfied with the surgery and complications occurred in 58%. Proximal interphalangeal (PIP) joint denervation was performed through a palmar approach; 90% of patients were satisfied with the surgery; complications were observed in 14%. Good results were observed in 95% of patients who underwent metacarpophalangeal (MCP) joint denervation; complications were observed in 26%; denervation was carried out with dorsal and palmar approaches in all cases. Denervation of the trapeziometacarpal (TMC) joint was achieved through the Wagner approach (61%), multiple incisions (26%), or dorsal approach (13%); satisfaction rate was 91%, with a 6% complication rate. Finger joint denervation in hand osteoarthritis is a simple and effective procedure, providing satisfactory pain relief. Good results are reported in all studies, especially for PIP and TMC joint denervation. Further investigations should be conducted on DIP and MCP joint denervation.
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Affiliation(s)
- S Gandolfi
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, 1, rue de Germont, 76000 Rouen, France.
| | - R Carloni
- Department of Plastic, Reconstructive Surgery, Hopital Privé de l'Estuaire, 505, rue Irène Joliot-Curie, 76620 Le Havre, France
| | - J Mouton
- Department of Orthopedic Surgery, Charles Nicolle University Hospital, 1, rue de Germont, 76000 Rouen, France
| | - I Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, 1, rue de Germont, 76000 Rouen, France
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Gandolfi S, Postel F, Auquit-Auckbur I, Boissière F, Pelissier P, Casoli V, Duparc F. Vascularization of the superficial circumflex iliac perforator flap (SCIP flap): an anatomical study. Surg Radiol Anat 2020; 42:473-481. [PMID: 31897652 DOI: 10.1007/s00276-019-02402-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 09/17/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The superficial circumflex iliac artery perforator flap (SCIP) has gained widespread popularity as local or free flap to cover soft tissue defects. However, there are numerous anatomical variations in terms of size, location and reliability of its perforators This cadaveric study aimed to focus on the anatomical bases of this flap. MATERIALS AND METHODS A bilateral dissection of seven cadavers was performed to harvest 14 flaps. Superficial circumflex iliac artery parameters, number, length and diameters of perforators were measured. Correspondent perforasomes were highlighted through semi-selective injections. RESULTS The major perforator of the superficial branch had a mean caliber of 2.0 mm, and a mean length of 1.8 mm. The major perforator of the deep branch had a mean caliber of 2.1 mm and a mean length of 1.43 mm. The mean area of the superficial pattern perforasome was 178.6 cm2 and the mean measured surface of the deep pattern perforasome was 156.2 cm2. The descending branches of the deep branch anastomosing with the ascending branch of the lateral circumflex femoral artery were found in three cases. CONCLUSION Several anatomical variations were observed in this anatomical study, but major perforators supplying large perforasomes were always found.
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Affiliation(s)
- S Gandolfi
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France
| | - F Postel
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France
| | - I Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France
| | - F Boissière
- Department of Plastic and Reconstructive Surgery, Montpellier University Hospital, Montpellier, France
| | - P Pelissier
- Department of Plastic and Reconstructive Surgery, Bordeaux University Hospital, Bordeaux, France
| | - V Casoli
- Department of Plastic and Reconstructive Surgery, Bordeaux University Hospital, Bordeaux, France
| | - F Duparc
- Laboratory of Anatomy, Faculty of Medicine, Rouen University, 22 Boulevard Gambetta, 76183, Rouen, France.
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Carloni R, Gandolfi S, Elbaz B, Bonmarchand A, Beccari R, Auquit-Auckbur I. Dorsal Dupuytren's disease: a systematic review of published cases and treatment options. J Hand Surg Eur Vol 2019; 44:963-971. [PMID: 31184950 DOI: 10.1177/1753193419852171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 02/03/2023]
Abstract
Dorsal lesions in Dupuytren's disease are rare and data concerning their epidemiology and management are sparse. We conducted a systematic review to summarize reported cases of dorsal Dupuytren's disease. Pubmed, Cochrane, and Embase databases were searched from 1893 to 2018, and 17 articles were selected (525 patients). The male to female ratio was 3.8:1. The dorsal disease was bilateral in 225 patients (50%). The index was the most commonly affected finger (48 patients). The proximal interphalangeal joint was the most commonly affected (484 cases). The most frequently reported lesions were knuckle pads (503 patients), dorsal nodules between interphalangeal joints (14 patients), boutonnière deformities (12 patients), and swan-neck deformities (2 patients). Nearly half of the included patients were treated surgically. Postoperative functional result depended on the treated lesion. Most of the included studies had a low level of evidence. Higher-quality studies are necessary to confirm our findings.
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Affiliation(s)
| | - Silvia Gandolfi
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Benedicte Elbaz
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Albane Bonmarchand
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Roberto Beccari
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Isabelle Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
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Gandolfi S, Auquit-Auckbur I, Poirot Y, Bonmarchand A, Mouton J, Carloni R, Nseir I, Duparc F. Focus on anatomical aspects of soft tissue coverage options in elbow reconstruction: an updating review. Surg Radiol Anat 2018; 40:943-954. [DOI: 10.1007/s00276-018-2066-5] [Citation(s) in RCA: 4] [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: 06/07/2018] [Accepted: 07/05/2018] [Indexed: 11/30/2022]
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Abstract
Adipose tissue is an abundant source of various cell types including not only adipocytes, but also progenitor and endothelial cells from thestroma. Interest in adipose tissue has surged since the identification in 2001 of adipose-derived stem cells (ADSCs) and of the stromal vascular fraction (SVF) obtained from adipose tissue by enzymatic digestion and centrifugation. SVF has been proven effective in ensuring tissue regeneration, thus improving tissue trophicityand vascularisation. These effects have generated strong interest among both physicians and surgeons, particularly in the field of hand surgery. Several applications have been developed and used, for instance to treat Dupuytren's contracture, systemic sclerosis-related hand lesions, and skin ageing at the hand. Other uses are being evaluated in clinical or animal studies. The objective of this article is to review the capabilities of adipose tissue and their current and potential applications in hand surgery.
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Affiliation(s)
- I Nseir
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - F Delaunay
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - C Latrobe
- Service de chirurgie orthopédique et traumatologique, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - A Bonmarchand
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - D Coquerel-Beghin
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - I Auquit-Auckbur
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
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Adnot J, Langlois O, Tollard E, Crahes M, Auquit-Auckbur I, Marie JP. Lateral skull base chondroblastoma resected with facial nerve posterior transposition. Neurochirurgie 2017; 63:88-90. [DOI: 10.1016/j.neuchi.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/31/2017] [Accepted: 02/05/2017] [Indexed: 11/16/2022]
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Gabert PE, Bonmarchand A, Milliez PY, Auquit-Auckbur I. Malformation de Madelung : le ligament de Vickers serait-il un tendon du carré pronateur ? Hand Surgery and Rehabilitation 2016. [DOI: 10.1016/j.hansur.2016.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mouton J, Houdre H, Beccari R, Tarissi N, Autran M, Auquit-Auckbur I. Surgical exploration of hand wounds in the emergency room: Preliminary study of 80 personal injury claims. Orthop Traumatol Surg Res 2016; 102:1009-1012. [PMID: 27816609 DOI: 10.1016/j.otsr.2016.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 05/25/2016] [Revised: 09/04/2016] [Accepted: 09/16/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The SHAM Insurance Company in Lyon, France, estimated that inadequate hand wound exploration in the emergency room (ER) accounted for 10% of all ER-related personal injury claims in 2013. The objective of this study was to conduct a critical analysis of 80 claims that were related to hand wound management in the ER and led to compensation by SHAM. MATERIAL AND METHODS Eighty claims filed between 2007 and 2010 were anonymised then included into the study. To be eligible, claims had to be filed with SHAM, related to the ER management of a hand wound in an adult, and closed at the time of the study. Claims related to surgery were excluded. For each claim, we recorded 104 items (e.g., epidemiology, treatments offered, and impact on social and occupational activities) and analysed. RESULTS Of the 70 patients, 60% were manual workers. The advice of a surgeon was sought in 16% of cases. The most common wound sites were the thumb (33%) and index finger (17%). Among the missed lesions, most involved tendons (74%) or nerves (29%). Many patients had more than one reason for filing a claim. The main reasons were inadequate wound exploration (97%), stiffness (49%), and dysaesthesia (41%). One third of patients were unable to return to their previous job. Mean sick-leave duration was 148 days and mean time from discharge to best outcome was 4.19%. Most claims (79%) were settled directly with the insurance company, 16% after involvement of a public mediator, and 12% in court. The mean compensatory damages award was 4595Euros. CONCLUSION Inadequate surgical exploration of hand wounds is common in the ER, carries a risk of lasting and sometimes severe residual impairment, and generates considerable societal costs. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- J Mouton
- Service de chirurgie orthopédique et traumatologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - H Houdre
- Service de chirurgie orthopédique et traumatologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - R Beccari
- Service de chirurgie orthopédique et chirurgie de la main, clinique du Cèdre, 950, rue de la Haie, 76230 Bois-Guillaume, France.
| | - N Tarissi
- Service de chirurgie orthopédique et traumatologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France
| | - M Autran
- SHAM Insurance Company, 18, rue Édouard-Rochet, 69008 Lyon, France.
| | - I Auquit-Auckbur
- Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
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Affiliation(s)
- J C Lepivert
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie de la main et du poignet, CHU Charles Nicole, Rouen, France
| | - V Guinet
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie de la main et du poignet, CHU Charles Nicole, Rouen, France
| | - I Auquit-Auckbur
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie de la main et du poignet, CHU Charles Nicole, Rouen, France
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Nguyen-Khac B, Leca JB, Carre D, Coquerel-Beghin D, Auquit-Auckbur I. [Annular lipoatrophy of the ankles treated by fat grafting: Case report and review of the literature]. ANN CHIR PLAST ESTH 2015; 61:162-7. [PMID: 26146222 DOI: 10.1016/j.anplas.2015.06.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/13/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Annular lipoatrophy of the ankles is a rare disease. Eleven cases are described in the literature. CASE REPORT We report the case of a 10-year-old girl having an annular lipoatrophy of the ankles. The clinical history begins with the appearance of inflammatory infiltrated nodules at the two legs, which have evolved in a few months to a circumferential lipoatrophy of the ankles. Laboratory studies showed a very high antistreptolysin O titer, concluding streptococcal origin of this hypodermitis. After two years of stable lesions, the patient received two sessions of fat injection. RESULT/DISCUSSION A satisfactory outcome of the adipocyte graft was observed with reconstitution of shapely legs, stable over time. Eleven cases described in the literature are found. It is a pediatric pathology seen predominantly in female children. The evolution towards lipoatrophy is systematic with or without treatment initiated at the inflammatory phase. We first discuss the management of aesthetic sequelae of this disease. CONCLUSION Fat grafting appears to be a good indication for the treatment of the cosmetic sequelae seen in annular lipoatrophy of the ankles.
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Affiliation(s)
- B Nguyen-Khac
- Service de chirurgie plastique et chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
| | - J B Leca
- Clinique chirurgicale infantile, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
| | - D Carre
- Service de dermatologie, groupe hospitalier du Havre, BP 24, 76083 Le Havre cedex, France
| | - D Coquerel-Beghin
- Service de chirurgie plastique et chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
| | - I Auquit-Auckbur
- Service de chirurgie plastique et chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
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Payet E, Bourguignon D, Auquit-Auckbur I, Duparc F, Dujardin F. Radiographic evaluation of a novel horizontal dorsal intercarpal capsulodesis as a treatment of pre-arthritic scapholunate dissociation: a cadaver study. J Hand Surg Eur Vol 2015; 40:502-11. [PMID: 24664159 DOI: 10.1177/1753193414528094] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 11/29/2013] [Indexed: 02/03/2023]
Abstract
Dorsal capsulodesis is an important part of the treatment of pre-arthritic scapholunate instability. We designed an experimental study using 14 fresh-frozen cadaver wrists to demonstrate the efficacy of a new horizontal dorsal intercarpal capsulodesis. We sectioned the scapholunate ligament to create a scapholunate dislocation. Several radiographic views, static and 'in stress', were recorded and we statistically compared the scapholunate interval before and after the section of the scapholunate ligament, and after the creation of the capsulodesis. The results showed a significant decrease of the scapholunate interval after the creation of the capsulodesis, especially in neutral and maximal ulnar deviation of the wrist. They also proved that our cadaveric model is reliable. This study demonstrated that this novel capsulodesis reduces the scapholunate interval in a cadaveric model.
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Affiliation(s)
- E Payet
- Department of Orthopaedic and Traumatologic Surgery, Rouen University Hospital, Rouen, France
| | - D Bourguignon
- Hand Surgery Unit, Rouen University Hospital, Rouen, France
| | | | - F Duparc
- Laboratory of Anatomy, Rouen University Hospital, University of Rouen, Rouen, France
| | - F Dujardin
- Department of Orthopaedic and Traumatologic Surgery, Rouen University Hospital, Rouen, France
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Bourguignon D, Aktouf G, Coquerel D, Auquit-Auckbur I. Syndrome de la corde axillaire après chirurgie ganglionnaire dans un contexte de mélanome : 5 cas. Ann Dermatol Venereol 2015; 142:94-8. [DOI: 10.1016/j.annder.2014.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/11/2014] [Accepted: 11/07/2014] [Indexed: 11/25/2022]
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Abada H, Aktouf A, Delaunay F, Lievain L, Auquit-Auckbur I. [Alopecia reconstruction by expansion after a scalp burn injury caused by Taser(®): a case report]. Ann Dermatol Venereol 2014; 141:769-72. [PMID: 25433929 DOI: 10.1016/j.annder.2014.06.012] [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: 02/03/2014] [Revised: 04/22/2014] [Accepted: 06/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Scarring alopecia resulting from burns may be difficult to treat and involves various plastic surgery techniques such as expanded scalp flaps. OBSERVATION Herein, we report the case of a 19-year-old male patient who suffered burning of the scalp with scarring alopecia following an attack with a Taser(®) electrical gun. Given the extent and site of alopecia, we decided to create a prosthesis by means of scalp expansion. The cosmetic result was satisfactory. DISCUSSION Several scalp reconstruction techniques have been described for scarring alopecia, with the most widely used being expansion, scalp flaps, repeated excision and hair implants. CONCLUSION The present case suggests that scalp expansion offers an effective method for the reconstruction of scarring alopecia following burns with a Taser(®) device.
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Affiliation(s)
- H Abada
- Service de chirurgie plastique, reconstructrice et esthétique - SOS mains, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - A Aktouf
- Service de chirurgie plastique, reconstructrice et esthétique - SOS mains, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - F Delaunay
- Service de chirurgie plastique, reconstructrice et esthétique - SOS mains, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - L Lievain
- Service de chirurgie plastique, reconstructrice et esthétique - SOS mains, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - I Auquit-Auckbur
- Service de chirurgie plastique, reconstructrice et esthétique - SOS mains, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
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Biga N, Dujardin F, Duparc F, Milliez PY, Auquit-Auckbur I. Homage to Professor Jean-Michel Thomine. Orthop Traumatol Surg Res 2014; 100:839-40. [PMID: 25590103 DOI: 10.1016/j.otsr.2014.09.002] [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] [Indexed: 02/02/2023]
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Lievain L, Aktouf A, Auquit-Auckbur I, Coquerel-Beghin D, Scotte M, Milliez PY. [Abdominoplasty complications: particularities of the post-bariatric patients within a 238 patients series]. ANN CHIR PLAST ESTH 2014; 60:26-34. [PMID: 25245542 DOI: 10.1016/j.anplas.2014.08.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 06/18/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obesity is one of the health issues that is recently worldwide increasing, as well as in France. Variety of procedures of bariatric surgery have been developed over the past decade and are performed for morbid obesity hence. The demand of plastic surgery increased for body contouring and reshaping after dramatic weight loss, in which the abdominoplasty is considered as one of the most common procedures. The purpose of this study is to clarify the differences between the post-bariatric patients and others, and their influence on the occurrence of complications following abdominoplasty. PATIENTS AND METHODS Retrospective study involving a group of post-abdominoplasty patients collected from the same center between January 2000 and December 2010. RESULTS Among 238 reviewed patients' files; 114 of them are post-bariatric patients, and 124 are non-bariatric patients. Several differences were found between these two groups of patients including the maximum BMI, BMI at the time of surgery, the rates of cardiovascular risk factors, and a longer operative time in the post-bariatric group. The complication rate in these patients was significantly higher (55.3% against 26.6%) with mainly healing problems. Major maximum weight, obesity at the time of surgery, long operative time and postoperative drainage system are all considered as risk factors, which carry high rate of complications. CONCLUSION It appears that abdominoplasty in post-bariatric patients requires specific care because of particularities inherent in this population.
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Affiliation(s)
- L Lievain
- Service de chirurgie plastique esthétique reconstructrice, chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - A Aktouf
- Service de chirurgie plastique esthétique reconstructrice, chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - I Auquit-Auckbur
- Service de chirurgie plastique esthétique reconstructrice, chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - D Coquerel-Beghin
- Service de chirurgie plastique esthétique reconstructrice, chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - M Scotte
- Service de chirurgie viscérale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - P-Y Milliez
- Service de chirurgie plastique esthétique reconstructrice, chirurgie de la main, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
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Delaunay F, Pegot A, Coquerel-Beghin D, Aktouf A, Auquit-Auckbur I. Fasciites nécrosantes à Staphylococcus lugdunensis après dermolipectomie abdominale : à propos de deux cas et revue de la littérature. ANN CHIR PLAST ESTH 2014; 59:136-9. [DOI: 10.1016/j.anplas.2013.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 12/10/2013] [Indexed: 11/29/2022]
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Ould-Slimane M, Guinet V, Foulongne E, Melconian A, Beccari R, Milliez PY, Auquit-Auckbur I. [Razemon's lateral digital rotation flap in severe Dupuytren contracture of the fifth finger]. ACTA ACUST UNITED AC 2013; 32:317-21. [PMID: 24094664 DOI: 10.1016/j.main.2013.08.005] [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: 02/05/2013] [Revised: 08/21/2013] [Accepted: 08/21/2013] [Indexed: 11/20/2022]
Abstract
In Dupuytren's disease, correction of severe contracture deformities and excision of dermal lesions are often responsible for palmar skin defects. This study aimed to assess the results of the lateral digital flap described by Razemon. Thirty-seven patients were analysed retrospectively for functional and trophic results. Twelve months of follow-up were at least required. The lack of extension was appreciated through Thomine's coefficient. Subjective patient's opinion was noted about function of fifth finger and hand. The flap trophicity was evaluated through softness, coverage quality and esthetic aspect. In the preoperative period, the average lack of extension was 105°; 89% of the patients were ranked as stages 3 or 4 of Tubiana's classification. At the 12th month, the average Thomine's coefficient was 0.74; 70% of the patients were very satisfied. Two patients exhibited some lack of suppleness and seven a dyschromic scars. The lateral digital rotation flap is a quite simple surgical procedure. It allows satisfactory results corresponding to functional and trophic coverage in severe Dupuytren's contracture involving the fifth finger.
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Affiliation(s)
- M Ould-Slimane
- Service de chirurgie orthopédique et de traumatologie, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex 1, France.
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Pegot A, Aktouf A, Delpierre V, Milliez PY, Auquit-Auckbur I. Dermo-hypodermites nécrosantes du tablier abdominal chez l’obèse. À propos de deux cas cliniques révélateurs d’infections profondes abdomino-pelviennes. ANN CHIR PLAST ESTH 2013; 58:248-54. [DOI: 10.1016/j.anplas.2013.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 01/08/2013] [Indexed: 12/31/2022]
Affiliation(s)
- A Pegot
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, hôpital Charles-Nicolle, CHU de Rouen, 1 rue de Germont, Rouen, France.
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Aktouf A, Auquit-Auckbur I, Coquerel-Beghin D, Delpierre V, Milliez PY. Augmentation mammaire par prothèses en gel de silicone de la marque Poly Implant Prothèses (PIP) : étude rétrospective de 99 patientes. Analyse des ruptures et prise en charge. ANN CHIR PLAST ESTH 2012; 57:558-66. [DOI: 10.1016/j.anplas.2012.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 04/17/2012] [Indexed: 01/11/2023]
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Lanfant-Weybel K, Michot C, Daveau R, Milliez PY, Auquit-Auckbur I, Fardellone P, Brazier M, Mejjad O, Daragon A, Krzanowska K, Jouen F, Tron F, Le Loarer F, Le Loët X, Vittecoq O. Synovium CD20 expression is a potential new predictor of bone erosion progression in very-early arthritis treated by sequential DMARDs monotherapy -- a pilot study from the VErA cohort. Joint Bone Spine 2012; 79:574-80. [PMID: 22459417 DOI: 10.1016/j.jbspin.2011.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 11/21/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Because available biomarkers (rheumatoid factors [RF], anti-cyclic citrullinated autoantibodies [anti-CCP2], erythrocyte sedimentation rate at 1st hour [ESR]/C-reactive peptide [CRP] and bone erosions) are insufficient to predict rheumatoid arthritis (RA) structural damage, to determine whether synovium expression of greater or equal to 1 markers could constitute new prognostic factor(s). METHOD The study was conducted on 18 prospectively enrolled disease-modifying anti-rheumatic drug (DMARD)- and glucocorticoid-naïve, VErA cohort patients with very-early arthritis (median duration: 4months). Recorded at baseline were: clinical and biological (serum ESR, CRP, RF-isotypes, anti-CCP2, osteoprotegerin, receptor activator of nuclear κB-ligand [RANK-L] and cartilage oligomeric matrix protein [COMP] levels) data; synovium expression (HLA-DR, CD163, CD3, CD20, VEGF, osteoprotegerin, RANK-L, Bcl2 and global inflammation index) for a metacarpophalangeal joint-synovium biopsy. Baseline and 3-year hand-and-foot X-rays were graded with the van der Heijde-modified-Sharp score; the judgment criterion was its progression during follow-up. Pearson's product moment correlation statistics were used to test for association between paired samples. RESULTS A baseline, a significant relationship was found between erosive damage and markers of B-cell activation, notably the synovium CD20 expression (r=0.68; P=0.0001). Quantified by the modified-Sharp erosion score variation, the 3-year structural damage progression was significantly correlated with: serum levels of RF-IgG (r=0.75; P=0.0003), -IgM (r=0.69; P=0.001), anti-CCP2 (r=0.53; P=0.02) and RANK-L (r=0.61; P=0.007); synovium CD20 expression (r=0.70; P=0.001). CONCLUSION This analysis of the prognostic value of a large panel of synovium markers in a limited sample of prospectively followed, well-documented patients suggested that both synovial CD20 and serum RANK-L levels might be new predictors of structural damage progression in very-early RA.
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Affiliation(s)
- Karine Lanfant-Weybel
- INSERM U905, Department of Rheumatology, University of Rouen, Institute for Biomedical Research, Rouen University Hospital, Rouen, France
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Aktouf A, Auquit-Auckbur I, Mebtouche N, Mouilhade F, Le Moulec YP, Milliez PY, Duparc F. Anatomical study and clinical relevance of the flexor superficialis synovial flap: an assessment of 31 hand dissections. Surg Radiol Anat 2012; 34:493-8. [DOI: 10.1007/s00276-012-0942-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 02/07/2012] [Indexed: 11/29/2022]
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Auquit-Auckbur I, Caillot F, Arnoult C, Menard JF, Drouot L, Courville P, Tron F, Musette P. Role of toll-like receptor 4 in the inflammation reaction surrounding silicone prosthesis. Acta Biomater 2011; 7:2047-52. [PMID: 21272673 DOI: 10.1016/j.actbio.2011.01.030] [Citation(s) in RCA: 9] [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] [Received: 09/21/2010] [Revised: 01/07/2011] [Accepted: 01/21/2011] [Indexed: 12/12/2022]
Abstract
The inflammation which occurs around the silicone prosthesis is a complex process that can provoke the failure of the device and compromise the health of the implanted patient. Toll-like receptors (TLRs), which are transmembrane proteins, are now known to act in the innate immune response and in endogenous inflammation. The aim of our study was to assess the role of TLR4 in the foreign body reaction to a silicone shell prosthesis. Disks of shell silicone prosthesis were implanted in the subcutaneous tissue of C57BL6-TLR4-/- and C57BL6-WT mice. At day 14, inflammatory cell infiltrate and vessel sections around the prosthesis were less numerous in TLR4-/- than in WT mice. A histomorphometric analysis showed that the capsule around the implant was 1.96-fold less thick in depleted TLR4 than in wild-type mice. In addition, vascular endothelial growth factor and transforming growth factor 1 were underexpressed in the surrounding tissue of the prosthesis in TLR4-/- mice. Our study suggests, from this foreign body response model against silicone in mice, that TLR4 plays a key role in the reaction process around silicone implants.
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Lequerré T, Bansard C, Vittecoq O, Derambure C, Hiron M, Daveau M, Tron F, Ayral X, Biga N, Auquit-Auckbur I, Chiocchia G, Le Loët X, Salier JP. Early and long-standing rheumatoid arthritis: distinct molecular signatures identified by gene-expression profiling in synovia. Arthritis Res Ther 2009; 11:R99. [PMID: 19563633 PMCID: PMC2714155 DOI: 10.1186/ar2744] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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: 02/07/2009] [Revised: 06/09/2009] [Accepted: 06/29/2009] [Indexed: 11/16/2022] Open
Abstract
Introduction Rheumatoid arthritis (RA) is a heterogeneous disease and its underlying molecular mechanisms are still poorly understood. Because previous microarray studies have only focused on long-standing (LS) RA compared to osteoarthritis, we aimed to compare the molecular profiles of early and LS RA versus control synovia. Methods Synovial biopsies were obtained by arthroscopy from 15 patients (4 early untreated RA, 4 treated LS RA and 7 controls, who had traumatic or mechanical lesions). Extracted mRNAs were used for large-scale gene-expression profiling. The different gene-expression combinations identified by comparison of profiles of early, LS RA and healthy synovia were linked to the biological processes involved in each situation. Results Three combinations of 719, 116 and 52 transcripts discriminated, respectively, early from LS RA, and early or LS RA from healthy synovia. We identified several gene clusters and distinct molecular signatures specifically expressed during early or LS RA, thereby suggesting the involvement of different pathophysiological mechanisms during the course of RA. Conclusions Early and LS RA have distinct molecular signatures with different biological processes participating at different times during the course of the disease. These results suggest that better knowledge of the main biological processes involved at a given RA stage might help to choose the most appropriate treatment.
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Affiliation(s)
- Thierry Lequerré
- Department of Rheumatology, Rouen University Hospital and Inserm 905 & Institut Fédératif de Recherche Multidisciplinaire sur les Peptides 23, Institute for Biomedical Research, University of Rouen, 76031 Rouen Cedex, France.
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Dudrap E, Lemierre G, Auquit-Auckbur I, Courville P, Milliez PY. Tumeur d’Abrikossoff : à propos d’une localisation cutanée du sillon intermammaire et revue de la littérature. ANN CHIR PLAST ESTH 2008; 53:521-5. [DOI: 10.1016/j.anplas.2008.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 03/17/2008] [Indexed: 10/22/2022]
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Jean J, Compère V, Fourdrinier V, Marguerite C, Auquit-Auckbur I, Milliez PY, Dureuil B. The Risk of Pulmonary Aspiration in Patients After Weight Loss Due to Bariatric Surgery. Anesth Analg 2008; 107:1257-9. [DOI: 10.1213/ane.0b013e31817f1563] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- I Marie
- Department of Internal Medicine, Rouen University Hospital, 76031 Rouen Cedex, France.
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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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Verdier E, Auquit-Auckbur I, Young P, Corven C, Chomant J, Courville P, Vera P, Milliez PY, Joly P. Complications liées à l’exérèse du ganglion sentinelle dans le mélanome. Ann Dermatol Venereol 2007; 134:439-42. [PMID: 17507841 DOI: 10.1016/s0151-9638(07)89210-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 11/16/2022]
Abstract
INTRODUCTION Side-effects occurring after sentinel lymph node excision in malignant melanoma patients have been poorly evaluated to date. The aim of the present study was to assess the side-effects of sentinel lymph node excision in this population. PATIENTS AND METHODS All consecutive malignant melanoma patients undergoing sentinel lymph node excision between March 2000 and December 2002 were included in this retrospective study. Patients with a metastatic sentinel node subsequently undergoing lymph node dissection were excluded. Median follow-up of patients was 12.6 +/- 8.8 months. Complications were classified as "early" (i.e. occurring the month following surgery), or "late" (after this time). RESULTS Forty malignant melanoma patients (17 males, 23 females) with a normal histologic examination of their sentinel lymph node were included. They belonged to a series of sixty-one melanoma patients undergoing lymph node excision. Fourteen complications were observed in ten patients. Two early complications were seen: hematoma (n=1) and deep venous thrombosis with pulmonary embolism (n=1). Twelve late complications were observed: mild lymphoedema (n=5), hypertrophic scars (n=2), painful scars (n=4), and one chronic seroma (n=1). Many complications (33%) were observed after excision in the inguinal area. DISCUSSION The complications of sentinel lymph node excision must be considered in determining the benefit/risk ratio of this technique.
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Affiliation(s)
- E Verdier
- Clinique Dermatologique, Hôpital Charles Nicolle, Rouen Cedex, France
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Denis MH, Dudrap E, Courville P, Auquit-Auckbur I, Joly P, Milliez PY. Influence de la taille et de la localisation des métastases dans les ganglions sentinelles de mélanome sur le résultat du curage, à propos de 35 cas. ANN CHIR PLAST ESTH 2007; 52:28-34. [PMID: 17056170 DOI: 10.1016/j.anplas.2006.08.001] [Citation(s) in RCA: 2] [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] [Received: 11/04/2005] [Accepted: 08/01/2006] [Indexed: 11/28/2022]
Abstract
AIM Thirty-five cases of lymphadenectomy carried out in the context of positive sentinel lymph node for malignant melanoma have been reviewed to assess the prognostic value of certain metastatic charachteristics. We have checked wether the type (macro or micrometastasis) and localisation (subcapsular or intraparenchymal) in the sentinel lymph node had predictive value for the lymphadenectomy outcome and evolution of the case. MATERIAL AND METHODS The retrospective study relates to 35 cases (with an average 2 years history) taken from a total of 87 sentinel lymph node protocols; average age 46.5 years, Breslow 2.5 mm with an history of 25 months. RESULTS Among the 35 positive sentinel lymph nodes we have 19 cases (54.2%) of micrometastasis. Among the 35 lymphadenectomy 5 cases (14.28%) turned out positive, 3 of which concerned micrometastatic sentinel lymph nodes. In our cohort the micrometastatic nature of sentinel lymph nodes did not have statistically significant impact upon the lymphadenectomy result but showed more favourable short-term evolution with 68.42% metastatic free evolution as against 43.75% in case of initial macrometastasis. The subcapsular localisation of micrometastasis equally represents a factor of improved prognosis (69.2% of metastatic free evolution against of 30.8% in the case of intraparenchymal localistion). CONCLUSION Unfortunately, none of the studied criteria justifies a modification of our present clinical attitude whereby a systematic lymphadenectomy in cases of positive sentinel lymph nodes is performed, whatever the type or localisation of the relevant metastases.
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Affiliation(s)
- M-H Denis
- Service de chirurgie plastique, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
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Mouilhade F, Auquit-Auckbur I, Duparc F, Beccari R, Biga N, Milliez PY. Anatomical comparative study of two vascularized bone grafts for the wrist. Surg Radiol Anat 2006; 29:15-20. [PMID: 17146602 DOI: 10.1007/s00276-006-0164-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 05/22/2006] [Accepted: 10/23/2006] [Indexed: 11/24/2022]
Abstract
Atrophic scaphoid non-union and lunate necrosis can be treated with vascularized bone grafting; through a posterior approach as described by Zaidemberg, based on a supraretinacular artery, or through an anterior approach, based on the volar carpal artery, according to Kuhlmann's procedure. The aim of our study was to determine the area covered by each of these two grafts and their respective future applications. Fifteen hands from eight adult human cadavers, free of any scar, were dissected after injection of colored fluid latex, through dorso-radial approach for Zaidemberg's graft and through volar approach for Kuhlmann's. We observed the morphological parameters of the pedicles and the arc of rotation of each flap. The volar vascularized graft had a constant origin and it could be transferred to the scaphoid, the lunate and the scapholunate joint. The posterior graft of Zaidemberg was technically more difficult to harvest because of the anatomical variations. It made it possible to reach the scaphoid, the trapezium and the scaphotrapeziotrapezoid joint line. Both these two vascularized bone grafts represent interesting procedures for treatment of scaphoid non-union or lunate necrosis, or intracarpal bones arthrodesis. They bring various possibilities of bone covering, related to specific area of mobilization and are not opposite procedures, but have different targeted indications. One must better define the respective places of the vascularized bone grafts, compared with the traditional free (non-vascularized) graft.
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Affiliation(s)
- F Mouilhade
- Department of Orthopedics and Plastic Surgery, Rouen University Hospital, 1, rue de Germont, Rouen, 76000, France.
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Abstract
Plastic surgeons have sometimes to face large pelvic tissue defects, particularly in paraplegic patients with recurrent pressure sores. This is frequently a reconstructive challenge and different locoregional flaps may be useful to manage those wounds when medical solutions were unsuccessful. However, in cases when other reconstructive options have been exhausted the total thigh flap represents the last acceptable solution to cover the defects by providing a large volume of healthy tissue. We remind here the operative technique and its interest in reconstructive surgery by reporting our experience in two patients for which this flap was successfully used.
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Affiliation(s)
- C-C Lazar
- Unité de chirurgie plastique et reconstructrice-chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Coquerel-Beghin D, Milliez PY, Auquit-Auckbur I, Lemierre G, Duparc F. The gracilis musculocutaneous flap: vascular supply of the muscle and skin components. Surg Radiol Anat 2006; 28:588-95. [PMID: 17143568 DOI: 10.1007/s00276-006-0150-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [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: 04/05/2006] [Accepted: 08/24/2006] [Indexed: 12/01/2022]
Abstract
UNLABELLED In reconstructive techniques, the use of the composite gracilis skin flap may be complicated by a total or partial necrosis of the cutaneous paddle. Our study was aimed to describe the vascular anatomy of the gracilis muscle and the related skin, in order to have a better understanding of the skin's blood supply, and to help in determining a safer cutaneous paddle during transfer. MATERIALS AND METHODS We performed a detailed anatomical description of the gracilis vessels on 32 human cadavers' thighs. Selective injections of methylene blue and then colored fluid latex were carried out in the principal pedicle of the gracilis, to color and to measure the perforator vessels and the associated cutaneous paddle. The contour and the anatomical situation of the paddles were digitized in order to have precise data and to try to model a standard theoretical skin paddle. RESULTS The 32 dissections showed that the principal pedicle of the gracilis originated mainly from the adductor artery (26/32), it penetrated into the muscle 92.8 mm (78-114) below the pubis with a small dispersion of the values that assessed a rather reliable parameter of location. Each muscle had 1-6 perforators (at mean 3.78); 80% of these perforators had their exits from the opposite side to the principal pedicle, included within a 60 mm length of muscle. A skin paddle was quite constantly colored (31/32), located over the proximal half of the muscle with a complex design. Its mean dimensions of length and width were 110 (72-158) and 91.4 mm (65-144), respectively. The computerized surface of the paddle was at a mean of 79.5 cm(2) (42.4-139.3), and it was significantly correlated to the number of the perforators from the muscle. DISCUSSION Our quantitative values concerning the skin paddle related to the perforator arteries may be of significant interest to the surgeon who aims to harvest a composite musculocutaneous gracilis flap, in order to improve its reliability by reducing the risk of cutaneous necrosis.
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Affiliation(s)
- Dorothée Coquerel-Beghin
- Laboratory of Anatomy, Faculty of Medicine and Pharmacy, University of Rouen, 22 boulevard Gambetta, Rouen 76183-1, France
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Lemierre G, Bony-Rerolle S, El-Haïté A, Auquit-Auckbur I, Milliez PY. [Recurrence of a basal cell carcinoma in a skin graft in spite of total excision. A case report]. ANN CHIR PLAST ESTH 2006; 52:71-4. [PMID: 17126980 DOI: 10.1016/j.anplas.2006.10.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Accepted: 10/09/2006] [Indexed: 10/23/2022]
Abstract
The authors report an original case of a recurrence of basal cell carcinoma in a skin graft recipient site. The skin graft was used to resurface the defect following complete excision of basal cell carcinoma in the mandibular angle area. Three answers can be given to the question of the origin of that new carcinoma: recurrence of the primary carcinoma, metastasis to a lymph node or a transfer of a basal cell carcinoma located into the skin graft which grew further. This last hypothesis remains the most probable because the histology of the two carcinomas was different and that the patient presented many others locations of basal cell carcinomas. Skin grafted areas must be checked for recurrence of basal cell carcinoma in such patients because invisible basal cell carcinoma can be transferred within the graft where they can grow for their own.
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Affiliation(s)
- G Lemierre
- Unité de chirurgie plastique et reconstructrice, chirurgie de la main, CHU de Rouen, Rouen, France.
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Lazar CC, Auquit-Auckbur I, Milliez PY. [Hereditary neuropathy with liability to pressure palsies (HNPP) in hand surgery: reminds and warn against a usually unrecognised disease]. ANN CHIR PLAST ESTH 2006; 52:606-8. [PMID: 17030391 DOI: 10.1016/j.anplas.2006.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 01/10/2006] [Accepted: 08/01/2006] [Indexed: 11/21/2022]
Abstract
Tomacula is a rare hereditary disease due to a deletion on chromosome 17. Clinical presentation varies but patients usually complain of recurrent paraesthesiaes and palsies related to compression or trauma of a peripheral nerve. Diagnosis is based on electrophysiological studies, nerve biopsies and genetic tests. Implications for the patient and family members are a genetic counselling and some simple preventive measures. Although there is no curative treatment for this neuropathy, surgery can be useful for decompression of nerves and neurolysis. However, the surgical act increases the risk of nerve damage. Knowing about the diagnosis can help the patient and the surgical team avoid causing lesions.
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Affiliation(s)
- C-C Lazar
- Unité de chirurgie plastique, esthétique et reconstructrice, service de chirurgie de la main du Professeur-Milliez, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Duparc F, Noyon M, Ozeel J, Gerometta A, Michot C, Tadjalli M, Moslemy H, Safaei S, Heiman A, Wish-Baratz S, Melnikov T, Smoliar E, Hakan AY, Yucel F, Kachlík DK, Pešl MP, Báča VB, Stingl JS, Kachlík KD, Čech ČP, Báča BV, Mompeó B, Marrero-Rodriguez A, Zeybek A, Sağlam B, Çikler E, Çetinel Ş, Ercan F, Şener G, Kawawa Y, Kohda E, Tatsuya T, Moroi M, Kunimasa T, Nagamoto M, Terada H, Labuschagne BCJ, van der Krieke TJ, Hoogland PV, Muller CJF, Lyners R, Vorster W, Matusz P, Zaboi DE, Xu SC, Tu LL, Wang Q, Zhang M, Han H, Tao W, Jiao Y, Pang G, Aydin ME, Kopuz C, Demir MT, Yildirim M, Kale A, Ince Y, Khamanarong K, Jeeravipoolvarn P, Chaijaroonkhanarak W, Gawgleun W, Fujino T, Uz A, Apaydin N, Bozkurt M, Elhan A, Sheibani MT, Adibmoradi M, Jahovic N, Alican I, Erkanli G, Arbak S, Karakaş S, Taşer F, Güneş H, Yildiz Y, Yazici Y, Aland RC, Kippers V, Song WC, Park SH, Shin C, Koh KS, Russo G, Pomara F, Veca M, Cacciola F, Martorana U, Gravante G, Tobenas-Dujardin AC, Laquerrière A, Muller JM, Fréger P, López-Serna N, Álvarez-González E, Torres-Gonzàlez V, Laredo-López G, Esparza-González GV, Álvarez-Cantú R, Garza-González CE, Guzmán-López S, Aldur MM, Çelik HH, Sürücü S, Denk C, Yang HJ, Gil YC, Kim TJ, Lee HY, Lee WJ, Lee H, Hu KS, Akita K, Kim HJ, Jung HS, Gurbuz H, Balik S, Wavreille G, Chantelot C, Demondion X, Fontaine C, Çavdar S, Yalin A, Saka E, Özdoǧmuş Ö, Çakmak Ö, Elevli L, Saǧlam B, Coquerel-Beghin D, Milliez PY, Lemierre G, Oktem G, Vatansever S, Ayla S, Uysal A, Aktas S, Karabulut B, Bilir A, Uslu S, Aktug H, Yurtseven ME, Celik HH, Tatar I, Surucu S, Karaduman A, Tunali S, Neuhüttler S, Kröll A, Moriggl B, Brenner E, Loukas M, Arora S, Louis RG, Fogg QA, Wagner T, Tedman RA, Ching HY, Eze N, Bottrill ID, Blyth P, Faull RLM, Vuletic J, Elizondo-Omaña RE, Rodríguez MAG, López SG, de la Garza OT, Liu YH, Zhang KL, Lu DH, Kwak HH, Park HD, Youn KH, Kang HJ, Kang HC, Han SH, Ikiz ZAA, Ucerler H, Uygur M, Kutoglu T, Dina C, Iliescu D, Şapte E, Bordei P, Lekšan I, Marcikić M, Radić R, Nikolić V, Kurbel S, Selthofer R, Báča V, Doubková A, Kachlík D, Stingl J, Džupa V, Grill R, Nam YS, Paik DJ, Shin CS, Kim SJ, Kim DG, Jin CS, Kim DI, Lee UY, Kwak DS, Lee JH, Han CH, Carpino A, Rago V, Romeo F, Carani C, Andò S, Arican RY, Coskun N, Sarikcioglu L, Sindel M, Arican YR, Altun U, Ozsoy U, Oguz N, Yildirim FB, Nakajima K, Duygulu E, Aydin H, Gurer EI, Ozkan O, Tuzuner S, Özsoy U, Çubukçu S, Demirel BM, Akkin SM, Marur T, Weiglein AH, Maghiar TT, Borza C, Bumbu A, Bumbu G, Polle G, Auquit-Auckbur I, Dujardin F, Biga N, Olivier E, Defives T, Ghazali S, Anastasi G, Rizzo G, Favaloro A, Miliardi D, Giacobbe O, Santoro G, Trimarchi F, Cutroneo G, Govsa F, Bilge O, Ozer MA, Erdogmus S, Grizzi F, Pelillo F, Mori M, Franceschini B, Portinaro N, Godlewski G, Viala M, Rouanet JP, Prat D, Rahmé ZS, Prudhomme M, Eken E, Kwiatkowska M, Liegmann J, Chmielewski R, Grimmond J, Kwiatkowski M, Schintler MV, Windisch G, Wittgruber G, Prandl EC, Prodinger P, Anderhuber F, Scharnagl E, Gerbino A, Buscemi M, Leone A, Mandracchia R, Peri G, Lipari D, Farina-Lipari E, Valentino B, D’Arpa S, Cordova A, Bucchieri F, Ribbene A, David S, Palma A, Davies DE, Haitchi HM, Holgate ST, La Rocca G, Anzalone R, Campanella C, Rappa F, Bartolotta T, Cappello F, Bellafiore M, Sivverini G, Palumbo D, Macaluso F, Farina F, Di Felice V, Montalbano A, Ardizzone N, Marcianò V, Zummo G, Tanyeli E, Üzel M, Carini F, Scardina GA, Varia P, Valenza V, Messina P, Meiring JH, Schumann C, Whitmore I, Greyling LM, Hamel O, Hamel A, Robert R, Garçon M, Lagier S, Blin Y, Armstrong O, Rogez JM, Le Borgne J, Ifrim CF, Maghiar A, Botea M, Ifrim M, Pop O, Sandor M, Behdadipour Z, Saberi M, Esfandiary E, Gentile C, Marconi A, Livrea MA, Uzan G, D’Alessio P, Ridola CG, Grassi N, Pantuso G, Bottino A, Cacace E, Li Petri S, Di Gaudio F, Guercio G, Latteri MA, Nobile D, Cipolla C, Caruso G, Salvaggio G, Lo Cascio A, Fatta G, Lagalla R, Campisi A, Verderame F, Martegani A, Cardinale AE, Luedinghausen MV. Poster presentation. Surg Radiol Anat 2005. [DOI: 10.1007/bf03371476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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El Ayoubi L, Karmouta A, Roussignol X, Auquit-Auckbur I, Milliez PY, Duparc F. [Anterior radial nerve transposition in humerus midshaft fractures: anatomic and clinical study]. Rev Chir Orthop Reparatrice Appar Mot 2003; 89:537-43. [PMID: 14593291] [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: 04/27/2023]
Abstract
PURPOSE OF THE STUDY Plate fixation of midshaft humerus fractures raises the risk of radial nerve injury. Anterior transposition of the radial nerve has been proposed as a possible solution but few reports have been published. The purpose of the present study was to validate the effect of transposition on the transposed radial nerve and its branches. MATERIAL AND METHODS We conducted an anatomic study on 10 cadavers. The length of the radial nerve between 2 anatomic landmarks was determined before and after transposition and plate fixation. A clinical evaluation was performed four years after surgery in 6 patients with midshaft humerus fractures treated with plate fixation after radial nerve transposition. RESULTS The anatomic study demonstrated a mean gain of 11 mm in the length of the radial nerve with no problem for the transposed nerve or its branches. Clinically, osteosynthesis was facilitated and tension on the nerve was reduced. DISCUSSION These 2 complementary studies demonstrated the releasing effect of transposition on the radial nerve and the facilitated osteosynthesis reported by others. The benefit of transposition is particularly important when bone fixation is particularly difficult to achieve without risk of injuring the radial nerve. Transposition does however require an extensive dissection, and the patient must be informed. CONCLUSION The ideal indication for anterior transposition of the radial nerve is an oblique fracture of the mid-third to lower-third of the humeral shaft with radial palsy at onset. A certain degree of comminution facilitates the technique. Indications for this technique could however be widened to include cases of difficult osteosynthesis where the option to transpose the radial nerve is always a peroperative decision.
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Affiliation(s)
- L El Ayoubi
- Département de Chirurgie Orthopédique Traumatologique et Plastique, CHU de Rouen, 1, rue Germont, 76000 Rouen
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