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Rosière C, Maximen J, Ebalard M, Lacroix PM, Ropars M, Dreano T. Functional and radiographic analysis of a cohort of 48 Tactys® prostheses with an average follow-up of 5 years: A retrospective study. Hand Surg Rehabil 2023; 42:517-523. [PMID: 37482275 DOI: 10.1016/j.hansur.2023.07.004] [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] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES The Tactys® prosthesis is an anatomical unconstrained sliding implant with 4 modular components, designed for proximal interphalangeal arthroplasty. The main objective of our study was to evaluate medium-term functional outcomes at a minimum follow-up of 1 year. MATERIALS AND METHODS Forty-eight implants were studied, with a mean follow-up of 4.8 years. The study retrospectively analyzed functional, clinical and radiological results. Complications and re-interventions were also analyzed. RESULTS Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation (PRWE) scores improved from 40.9 to 17.7 and from 47. 1 to 11 .2, respectively (p < 0.001) at last follow-up. Seventy-seven percent of patients rated their results as good or very good, and 83% were willing to undergo the procedure again. Pain on VAS improved significantly from 7.9 to 0.8/10 (p < 0.001). There was no significant difference in range of motion (53° vs 48°), grip strength (14.9 kgF vs 14.6 kgF), or pinch strength (3.4 kgF vs 3.4 kgF). There were no cases of fracture or loosening of implants. Periarticular ossification without functional impairment was observed in 31 patients. Axial deviation was generally corrected. Three surgical re-interventions were required, including 2 implant revisions using a silicone spacer. Five-year implant survival was 94%. CONCLUSION The Tactys® prosthesis was a reliable and effective option for the management of proximal interphalangeal osteoarthritis. Patient satisfaction was generally good, with improvement in pain and function; however, longer-term follow-up is needed.
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Affiliation(s)
- Clément Rosière
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France
| | - Julien Maximen
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France.
| | - Maud Ebalard
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France
| | - Paul-Maxime Lacroix
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France
| | - Mickaël Ropars
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France
| | - Thierry Dreano
- Orthopaedic and Trauma Surgery, CHU Rennes Pontchaillou, 2 Rue Henri le Guilloux, Rennes 35033, France
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Maximen J, Rossetti A, Vallée N, DE Geyer A, Dreano T, Ropars M. Fractures of the fifth metacarpal neck treated by syndactyly: functional and quality of life outcomes of a series of 39 patients. Acta Orthop Belg 2023; 89:225-231. [PMID: 37924538 DOI: 10.52628/89.2.11778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
The management of the fractures of the fifth metacarpal neck is still debated between surgical, orthopedic, and functional treatments. The main objective of our study was to report the functional results at two, six, and twelve weeks of patients treated with syndactyly for fifteen days for a fracture of the neck of the fifth metacarpal and to determine if these results were compatible with a short-term medical follow-up and if they allowed for a quick return to work. Thirty-nine patients were retrospectively included. Functional results and their variations were analyzed at two, six, and twelve weeks using self-questionnaires filled out during consultation (VAS scores, QuickDASH, EuroQol-5D-5L, and EuroQol- 5D-VAS). The duration of work leave was extracted from medical records. Two weeks after the trauma, patients mostly had a very moderate impact of their fracture on their daily life with an average VAS of 4.2±1, QuickDASH of 42.2±20.9, and EuroQol-5D-VAS of 78±11. QuickDASH and EuroQol-5D-VAS scores showed significant improvement between two and twelve weeks of follow-up, decreasing from 42.2±20.9 to 2.1±6 and from 78±11 to 96±6, respectively (p<0.0001). The dimensions of common activities, pain, and autonomy had the most patients in the "moderate impairment" subgroup at two weeks. Only the dimension of common activities still had 21% of patients moderately impacted. Twenty-five patients returned to work at an average of 21.8±1.5 days. Syndactyly treatment offers good functional results at two weeks that are confirmed during follow-up, compatible with reduced medical follow-up and early return to work.
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Renault A, Maximen J, Ebalard M, Mevel G, Ropars M, Dreano T. Arthrodèse de l’articulation interphalangienne distale et interphalangienne du pouce grâce à l’implant X-Fuse®? Une revue rétrospective de 64 doigts avec un recul moyen de 59,8 mois. Hand Surgery and Rehabilitation 2022. [DOI: 10.1016/j.hansur.2022.09.108] [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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Mevel G, De Geyer A, Kim W, Ebalard M, Ropars M, Dreano T. Four-corner arthrodesis using the 4Fusion® quadripodal shape memory staple: a long-term review. J Hand Surg Eur Vol 2022; 47:387-392. [PMID: 34851782 DOI: 10.1177/17531934211063614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We investigated the reliability of the 4Fusion® quadripodal memory staple in a consecutive series of 59 four-corner arthrodeses in a single centre. Forty-one patients (46 wrists) had a radiological and clinical assessment at a mean follow-up of 7.4 years. Thirteen patients (13 wrists) were lost to follow-up. Bone union was achieved in all but one patient. Seven patients were reoperated, six for device removal and one for nonunion. Most patients were satisfied, had a functional range of wrist mobility, good strength and were free of pain, comparable with the best previously reported series.Level of evidence: IV.
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Affiliation(s)
- Gwenaël Mevel
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
- Université de Rennes-1 UFR Médecine, Rennes, France
| | - Aymeric De Geyer
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
- Université de Rennes-1 UFR Médecine, Rennes, France
| | - Warren Kim
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
| | - Maud Ebalard
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
| | - Mickaël Ropars
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
- Université de Rennes-1 UFR Médecine, Rennes, France
| | - Thierry Dreano
- Service de chirurgie orthopédique et traumatologie, CHU Pontchaillou, Rennes, France
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Rossetti A, Fily A, Dreano T, Ropars M, Maximen J. Parosteal osteosarcoma of the thumb: a case report and literature review. Hand Surgery and Rehabilitation 2022; 41:273-277. [DOI: 10.1016/j.hansur.2022.01.005] [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] [Received: 11/26/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
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Causeret A, Lapègue F, Bruneau B, Dreano T, Ropars M, Guillin R. Painful Traumatic Neuromas in Subcutaneous Fat: Visibility and Morphologic Features With Ultrasound. J Ultrasound Med 2019; 38:2457-2467. [PMID: 30690764 DOI: 10.1002/jum.14944] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/10/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Subcutaneous neuromas usually result from trauma and may lead to dissatisfaction in patients with a trigger point, loss of sensitivity in the relevant territory of innervation, and spontaneous neuropathic pain. Confirming clinically suspected cases of neuroma may prove difficult. The objective of this study was to evaluate the visibility and morphologic features of traumatic subcutaneous neuromas of the limbs with ultrasound (US). METHODS Between January 2012 and August 2016, 38 consecutive patients clinically suspected of having subcutaneous neuromas were investigated with US. The diagnosis was confirmed on the basis of a focal morphologic abnormality of the nerve associated with trigger pain. Each neuroma was classified into 1 of 3 subtypes based on its injury pattern. The subtypes were terminal neuroma, spindle neuroma, and scar encasement, either isolated or associated with these subtypes. RESULTS Forty-four lesions were found in the 38 patients, including 29 spindle neuromas (65.9%), 14 terminal neuromas (31.8%) and 1 scar encasement with no nerve caliber abnormality (2.3%). Fifteen neuromas (35% of all neuromas) were associated with scar encasement. In 13 cases that required surgery, the diagnosis of neuroma or scar encasement could be surgically proven and confirmed the validity of the US findings. CONCLUSIONS Ultrasound can be used to show and classify subcutaneous nerves of the upper and lower limbs with high accuracy. The US trigger sign provides an indication of neuroma involvement in pain. This modality can play a substantial role both in the preoperative planning of neuroma surgery and in therapeutic US-guided procedures.
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Affiliation(s)
- Anne Causeret
- Department of Medical Imaging, Rennes University Hospitals, Sud Hospital, Rennes, France
| | - Franck Lapègue
- Department of Medical Imaging, Toulouse University Hospital, Toulouse, France
| | - Bertrand Bruneau
- Department of Medical Imaging, Rennes University Hospitals, Sud Hospital, Rennes, France
| | - Thierry Dreano
- Department of Orthopedics and Traumatology, Rennes University Hospital, Rennes, France
| | - Mickaël Ropars
- Department of Orthopedics and Traumatology, Rennes University Hospital, Rennes, France
| | - Raphaël Guillin
- Department of Medical Imaging, Rennes University Hospitals, Sud Hospital, Rennes, France
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Leconte D, Beloeil H, Dreano T, Ecoffey C. Post Ambulatory Discharge Follow-up Using Automated Text Messaging. J Med Syst 2019; 43:217. [PMID: 31172292 DOI: 10.1007/s10916-019-1278-5] [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] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
Abstract
Ambulatory surgery has grown to be the most common procedure in developed countries. Efficient quality of care and safety often require calling patient at day one after outpatient surgery to check patient's recovery and search for complications. This increasing flow in same day surgery centres motivates the use of automatic systems to contact patients. The overall objective of this study was to evaluate automated software sending text messages (TM) to patients at day 1 after ambulatory surgery compared to classical phone calls. This prospective study took place in Rennes Teaching Hospital, France, from June 1st, 2015 to December 15th, 2016. All patients owning a mobile phone were included, adults and children by means of their parents. The primary end point was the rate of successfully contacted patients, compared to usual phone calls in 2014. In cases of no response or an abnormal response, an automatic alert was sent to the ambulatory unit. Within the 7246 patients included, response rate to TM was significantly higher than response to phone calls in 2014 (87% vs 57%, respectively p < 0.0001). Most patients (85%) responded in less than 60 min. The TM algorithm detected 36% alerts (12% for lack of response to TM and 24% for TM's content). The total of reached patients' rate with TM and then phone call after an alert was 90%. Post ambulatory discharge follow-up using automated TM was successfully and easily experienced as more patients were contacted.
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Affiliation(s)
- David Leconte
- Université Rennes, CHU Rennes, Pôle Anesthésie-Samu-Urgences-Réanimations, F-35033, Rennes, France
| | - Hélène Beloeil
- Université Rennes, INSERM, INRA, CIC 1414, Numecan, CHU Rennes, Pôle Anesthésie-Samu-Urgences-Réanimations, 2 Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
| | - Thierry Dreano
- CHU Rennes, Service d'orthopédie et de traumatologie, F-35033, Rennes, France
| | - Claude Ecoffey
- Université Rennes, CHU Rennes, CIC 1414, Pôle Anesthésie-Samu-Urgences-Réanimations, F-35033, Rennes, France
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Langlais F, Belot N, Thomazeau H, Huten D, Lambotte JC, Dreano T. Tumeurs malignes osseuses du genou : exérèse et reconstruction. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0246-0467(05)41445-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Langlais F, Lambotte JC, Thomazeau H, Dreano T. [Wear and loosening of prostheses]. Chirurgie 1997; 122:232-6. [PMID: 9297911] [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: 02/05/2023]
Abstract
In 1996, the outcome of any total joint replacement is loosening, occurring usually about 20 years after implantation. Loosening is not a mechanical failure of the bone-implant junction but the consequence of the osteolysis of the periprosthetic bone. It is due to an inflammatory pannus, a tissue constituted by macrophages, which are activated by wear particules originated by the articulating surfaces. The authors showed that this osteolysis is close from that observed with other inflammatory diseases and that it can be obtained with wear particules of many biomaterials, the polyethylene (PE) being the most common in clinical conditions. Several trends in order to reduce polyethylene wear or to replace PE by other materials are presented. Future improvements of the duration of joint prostheses depend on laboratories including surgeons involved in basic research: they are a mandatory link between the engineer and the biologist who study the mechanical and the biological aspects of the wear and of the fixation of biomaterials.
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Affiliation(s)
- F Langlais
- CCA, Laboratoire Biomécanique et Biomatériaux, Faculté de Médecine de Rennes
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