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ABSTRACT: The schwannoma is a benign tumour that can be eradicated; it usually occurs in the peripheral nerves of the upper limb. We report an exceptional localization in the axillary nerve. The diagnosis is based on the typical MRI appearance: in addition, confirmation of the diagnosis has to be made by histological examination. The surgical treatment by resection, taking care to preserve adjacent nerve fibres. This allows recovery without any after-effects since the recurrence rate as well as the potential for malignant transformation of this type of tumour is low.
Chirurgie de la Main 10/2008; 27(5):232-4. · 0.53 Impact Factor
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ABSTRACT: The purpose of this retrospective study was to investigate the contribution of arthroscopic management of moderately stiff elbows resulting from traumatic or degenerative causes.
Elbow arthroscopy was performed in 32 patients with moderately stiff joints; mean preoperative range of motion was 94.8 degrees . Most of the procedures consisted in an anterior approach followed by a posterior approach. Anterior capsulotomy was performed in 5 elbows and joint "cleaning" in the others. The Kashiwagi Outerbridge technique was employed for two elbows.
Mean gain in range of motion was 25 degrees. There was a postoperative loss of range of motion in three cases. There were no intra- or postoperative complications. Eighty percent of patients considered arthroscopy provided an improvement.
Elbow arthroscopy for stiff joint of various causes is a difficult procedure which in our experience has provided a gain in range of motion comparable with other series reported in the literature. Elbow arthroscopy could be a less invasive alternative to open surgery for moderately stiff joints.
Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 07/2007; 93(4):333-8. · 0.37 Impact Factor
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F Kelberine,
F Bonnomet,
R Aswad, R Bleton,
J-P Bonvarlet,
P Clavert,
C Dumontier,
N Graveleau,
P Mansat,
J-L Marmorat,
T Romeo
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ABSTRACT: This symposium of the French Arthroscopic Society is the 2005 state of the art of elbow arthrosocpy in France. A survey reports 499 cases during 2 years with a rate of complication higher than the arthroscopies of other joints (6% of minor and 1% of major complications). The main indication is the removal of loose bodies. They can come from arthritis, chondromatosis, osteochondritis or fracture. The most accurate radiologic examination is an arthroCTscan. The main pronostic factor is the cartilage status. Arthrolysis is the second indication. We performed a retrospective and a prospective studies to compare open and arthroscopic surgery. Results are almost similar with a significant higher improvement in flexion (7 degrees ) in the open group. Open surgery seems more efficient but with a franck loss of motion in the postoperative course. However, in this group elbows were preoperatively stiffer in relation with a trauma event instead of sport related microtrauma in the arthroscopically treated group. Removal of necrotic fragment combined with abrasion in osteochondritis of the capitulum yields to good results with 82% of patients resuming to sports. Long term prognosis is unknown as the joint line is narrowed at a 3 years follow up. Arthroscopy is usefull in synovial diseases as resection of synovial folds or removal of tumors like villonodular synovitis. In the treatment of epicondylitis, the results of our retrospective study are not so good as those reported in the literature. But in our comparative study the results are similar to the open surgery group. The numerous procedures and the different follow up in these two groups did not allow to give statistical analysis. Elbow arthroscopy is a hyper specialty with more and more advanced procedures.
Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 01/2007; 92(8 Suppl):4S31-45. · 0.37 Impact Factor
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ABSTRACT: The success rate for leg replantation has improved with the development of shortening-lengthening protocols. We checked whether this success was maintained long term in five cases of emergency reimplantation. The significant initial shortening of 93 mm, on average, enabled direct internal osteosynthesis, secondary lengthening was initiated swiftly, in the proximal metaphyseal area, and average lengthening was 85 mm. Consolidation was achieved in all cases within normal time periods, with an average inequality in residual length of 8mm. The speed of nerve regeneration was on average 1.926 mm/day, twice faster than usual after simple nerve suturing. At average follow-up of more than 11 years, all patients were walking. We conclude that nerve lengthening stimulates nerve regeneration, and that the results of this protocol, involving extensive initial debridement compensated by secondary lengthening, have enabled the limitations on unilateral leg replantation to be reduced.
Injury 10/2006; 37(9):869-76. · 1.98 Impact Factor
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R Bleton,
F J Chaise,
G Chauplannaz,
G Foucher,
M P Lamat,
R Legre,
M P Levy,
F Moutet,
C Oberlin,
M J Ovieve,
P Saffar,
I Chary-Valckenaere
Neurochirurgie 12/2001; 47(5):496-9. · 0.34 Impact Factor
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ABSTRACT: 20 cases of intra-articular fractures of proximal interphalangeal joints were reviewed with a mean follow-up of 3 years 9 months, and a minimum follow-up of 1 year, corresponding to 10 fractures of the head of P1 (7 condylar fractures, 2 supra-intercondylar fractures and 1 diaphyseal fracture with an articular crevice) and 10 fractures of the basis of P2 corresponding to distraction-impaction fractures in 8 cases. The fractures were treated by open reduction and osteosynthesis by screws, mini-screws, or pins, completed by an arthrodesis pin in 3 cases. All fractures were closed, isolated, and too unstable to be treated orthopaedically. Global results were: 14 excellent and good results, 4 moderate results and 2 poor results according to Steel's criteria. No serious early complications were observed. The difficulty of treatment and the duration of rehabilitation are greater in fractures of the base of P2 than for fractures of the head of P1. No statistically significant factor was identified due to the small size of this series, but, the factors of poor prognosis essentially consist of late mobilization and reoperations for failure of percutaneous pinning of a fracture of the basis of P2.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1995; 14(4-5):197-201.
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ABSTRACT: 55 arthroscopies of radio- and midcarpal joints of the wrist were performed for chronic wrist pain with a difficult diagnosis and/or treatment. None of the patients suffered a deterioration and no complications were observed. The results were analysed according to Jackson's and Abe's criteria. In the overall series, arthroscopy was considered to be beneficial for the diagnosis in 80% of cases and for treatment in 49% of cases. Wrist arthroscopy was beneficial in 100% of cases for exact evaluation of the lesions of osteoarthritic wrists or wrists with intracarpal disorganisation and guided the subsequent therapeutic indications. Only 41% of cases obtained a therapeutic benefit from arthroscopy, which nevertheless constituted a useful alternative to surgical operations with a long postoperative course, allowing rapid return to work. Arthroscopy was beneficial for the diagnosis in 66% of chronic painful wrists in which the standard radiological and dynamic assessment was normal, by identifying the anatomical lesions. Arthroscopy was not beneficial in 34% of cases, corresponding to patients with no precise clinical symptoms. Arthroscopy was beneficial for treatment in 54% of cases, with complete cure in the majority of cases.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1993; 12(5):313-25.
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ABSTRACT: Fifty-two cases of nerves injuries involving the sciatic nerve or one of its two main branches (tibialis or peroneal nerve), between the sciatic notch and the knee, were treated by nerve grafts or nerve sutures. 26 cases were injured in the thigh. They were treated by 11 nerve sutures followed by good results in isolated lesions, and 15 nerve grafts. In 9 cases nerve loss was short and fascicular graft was possible. Clear cut injuries had satisfactory results. In 6 cases, nerve loss was extensive (> 10 cm), especially after sciatic nerve disruption following femoral bone fracture. There was not enough nerve graft available to repair the entire sciatic nerve. Tibialis nerve repair was chosen to restore plantar sensitivity. A vascular nerve graft of peroneal nerve could restore plantar sensitivity in all cases. 26 cases were injured around the knee and involved the peroneal nerve. In 12 cases the lesion was clear cut, treated in 10 cases with a short fascicular nerve graft, and in 2 cases by a suture. In most of the cases, results were good, better than that those obtained after tibialis posterior transfer. 14 cases had peroneal nerve disruption after a severe lateral sprain of the knee. Nerve damages were extensive and results were poor. Tendon transfer had to be done quite often.
Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 01/1993; 79(3):205-17. · 0.37 Impact Factor
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ABSTRACT: From 1983 to 1987, 50 adult patients who suffered total palsy of brachial plexus were operated on. The average follow up was 39 months. They suffered severe supra-clavicular lesions of all the roots. All the roots damaged in the scalenic area were grafted, the avulsed ones were not. One root was grafted in 23 patients, two roots in 9 patients, three roots in 5 patients, four roots in 1 patient. No root was grafted in 12 patients. An active flexion of the elbow (over M3+, M4) was recovered in 39 patients (76 per cent). An active adduction of the shoulder (m. pectoralis major) was recovered in 24 patients (48 per cent), and an active abduction (supraspinatus or deltoid) in 13 patients (26 per cent). Twenty seven patients had severe pain before surgery. After grafting, pain decreased in 17 (62 per cent. At follow-up, 31 of the 50 patients had no pain or mild pain. These results justify for the authors nerve repair in total palsy of brachial plexus by supra-clavicular lesions.
Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1992; 78(8):495-504. · 0.37 Impact Factor
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ABSTRACT: The authors after a review of certain elements of the physiology and pathophysiology of the scapho-lunate couple, report a series of 10 patients presenting a post-traumatic scapho-lunate instability stabilized by scapho-lunate bone graft in order to obtain scapho-lunate arthrodesis. The bone fusion was obtained 5 times out of 10, 3 times complete and 2 times by an incomplete bony bridge. In 5 cases, bone fusion was not evident, a fibrous non-union probably occurred which maintained the correction. Nevertheless, the overall results were considered good in 9 out of 10 cases with only one poor result. The outcome with a mean follow-up of 4 years did not show any arthritic changes. The authors consider that scapho-lunate stabilization with an interposed bone graft is a good method which can ensure good stabilization and good clinical results.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1992; 11(2):107-18.
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ABSTRACT: Proximal row carpectomy has precise indications in cases of severe sequelae of scaphoid fractures. This procedure may be indicated either as first-line treatment in a case of advanced pseudarthrosis with osteoarthritis, particularly radio-scaphoid, or secondarily after scaphoid pseudarthrosis has been unsuccessfully treated by other methods. It is essential to make sure that the head of the capitatum and the radial surface of the lunate bone have a satisfactory appearance on plain X-rays, MRI and occasionally arthroscopy. The overall results of this operation which retains wrist movements and which also preserves a good grip strength are very encouraging, as demonstrated by the series of 48 cases of sequelae of scAphoid fractures treated by this technique.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1992; 11(4):269-75.
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ABSTRACT: Sixty-one patients underwent 68 digital pulp amputations involving the distal phalanx (Zone 2 and 3). 46 unipedicular Vankataswami-Subramanian island flaps (VS flap) and 22 bipedicular Moberg-O'Brien flaps (MOB flap) were performed. All distal thumb amputations were treated by MOB flap, whereas all lateral finger distal amputations of the long digits were treated by VS flap. Both flaps were used for the other types of amputation. Four digits developed complications and needed a delayed regularisation. The mean follow-up for the 46 flaps was two years. Pulp reconstruction was satisfactory in all flaps. Sensation was normal or slightly decreased in 66%. Nail dystrophy was considered to be poor in 56% and was attributed to initial trauma and the distal phalanx shortening. 20 degrees of extension deficit was found in 8 patients. We obtained 61 excellent and good results justifying our indications: MOB flap for all types of distal amputation of thumb in zone 2 and 3, VS flap for lateral distal amputations of the long fingers. In transverse amputation of the long fingers, MOB flaps seem to give better results than VS flaps.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1991; 10(5):406-16.
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ABSTRACT: Twelve cases of necrotizing fasciitis or streptococcal cellulitis of the upper limb are reported. Four cases presented with a low grade aggressive for and one case was chronic. Seven fulminating cases resulted in two deaths. These different presentations are in fact different stages of the same disease which is a group A beta-hemolytic streptococcal necrotizing infection of the subcutaneous tissue. It is a medical emergency in which surgery is the main treatment. In cases seen early, surgery helps by making an early diagnosis by showing the typical appearance of the subcutaneous tissue and by isolating organisms in wound culture. In fulminant cases, only extensive surgical debridement can control infection. Delayed or incomplete radical excision may lead to disseminated infection. Infection spreading beyond one upper limb worsens the vital prognosis.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1991; 10(4):286-96.
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ABSTRACT: Sarcoidosis without bone involvement or sarcoid dactylitis, is a very unusual cause of flexor synovitis. Our reported patient initially presented with chronic arthralgia of the knees and ankles. The initial diagnosis of rheumatoid arthritis was incorrect. A surgical flexor synovectomy was performed to release painful compression of the median nerve due to the synovitis. The correct diagnosis was suggested by the histopathological examination showing noncaseating epithelioid granulomas. The diagnosis was confirmed by the association of a negative tuberculin test and raised angiotensin converting enzyme. No recurrence of synovitis occurred after surgical excision and colchicine therapy but arthralgia persisted.
Annales de Chirurgie de la Main et du Membre Supérieur 02/1991; 10(4):360-3.
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ABSTRACT: The authors after a review of certain elements of the physiology and pathophysiology of the scapho-lunate couple, report a series of 10 patients presenting a post-traumatic scapho-lunate instability stabilized by scapholunate bone graft in order to obtain scapholunate arthrodesis. The bone fusion was obtained 5 times out of 10, 3 times complete and 2 times by an incomplete bony bridge. In 5 cases, bone fusion was not evident, a fibrous nonunion probably occurred which maintained the correction. Nevertheless, the overall results were considered good in 9 out of 10 cases with only one poor result. The outcome with a mean follow-up of 4 years did not show any arthritic changes. The authors consider that scapholunate stabilization with an interposed bone graft is a good method which can ensure good stabilization and good clinical results.ResumenLos autores después de haber realizado una revisión de algunos de los puntos basicos de la fisiología y de la unidad escafo lunar de la fisiopatología relacionan una serie de 10 pacientes que presentaban una inestabilidad post traumática estabilizada mediante un injerto cortico espongioso escafo lunar a fin de obtener una artrodesis escafo lunar. La fusion ósea se obtuvo solo en 5 casos de 10, tres veces de manera total y en dos ocasiones una artrodesis parcial. En 5 casos la fusión no se produjo pero existía una pseudo artrosis cerrada con un tejido fibroso que mantenia la correción. De todas maneras los resultados globales son considerados como buenos en 9 oportunidades sobre 10 con un solo resultado mediocre. La evolución con un seguimiento promedio de 4 años no ha mostrado ninguna evolución hacia la artrosis. La estabilización escafolunar con un injerto óseo cortico espongioso interpuesto constituye para los autores un método del cusal desean destacar sus ventajas puesto que permite obtener una estabilidad satisfactoria y unos buenos resultados clínicos.
Annales de Chirurgie de la Main et du Membre Supérieur.
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ABSTRACT: Sarcoidosis without bone involvment or sarcoid dactylitis, is a very unusual cause of flexor synovitis. Our reported patient initially presented with chronic arthralgia of the knees and ankles. The initial diagnosis of rheumatoid arthritis was incorrect. A surgical flexor synovectomy was performed to release painful compression of the median nerve due to the synovitis. The correct diagnosis was suggested by the histopathological examination showing noncaseating epithelioid granulomas. The diagnosis was confirmed by the association of a negative tuberculin test and raised angiotensin converting enzyme. No recurrence of synovitis occurred after surgical excision and colchicine therapy but arthralgia persisted.ResumenLas sinovitis aisladas de la mano de orígen sarcoidósico, sin alteración ósea, que no entran en el cuadro de la dactilia sarcoidósica, son excepcionales. Los casos presentados mostraban en primer lugar artralgias crónicas esencialmente de rodillas y tobillos. El diagnóstico inicial y erroneo, fue el de la poliartritis reumatoidea sero-negativa. Una sinovitis de los tendones flexores de los dedos, responsable de un síndrome irritativo del nervio mediano, requirio una sinovectomía quirúrgica. El examen anatomopatológico orienta el diagnóstico, poniendo en evidencia lesiones foliculares, sin necrosis caseosa. El diagnostico fue confirmado por la asociación de una anergia tuberculínica y un aumento de la enzima de conversión de la angiotensina. La sinovitis no ha recidivado tras sinovectomía, y tratamiento con colchicina, pero las poliartralgias han persistido.
Annales de Chirurgie de la Main et du Membre Supérieur 10(4):360-363.
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ABSTRACT: Sixty-one patients underwent 68 digital pulp amputations involving the distal phalanx (Zone 2 and 3). 46 unipedicular Vankataswami-Subramanian island flaps (VS flap) and 22 bipedicular Moberg-O'Brien flaps (MOB flap) were performed. All distal thumb amputations were treated by MOB flap, whereas all lateral finger distal amputations of the long digits were treated by VS flap. Both flaps were used for the other types of amputation. Four digits developed complications and needed a delayed regularisation. The mean follow-up for the 46 flaps was two years. Pulp reconstruction was satisfactory in all flaps. Sensation was normal or slightly decreased in 66 %. Nail dystrophy was considered to be poor in 56 % and was attributed to initial trauma and the distal phalanx shortening. 20° of extension deficit was found in 8 patients. We obtained 61 excellent and good results justifying our indications : MOB flap for all types of distal amputation of thumb in zone 2 and 3, VS flap for lateral distal amputations of the long fingers. In transverse amputation of the long fingers, MOB flaps seem to give better results than VS flaps.ResumenSesenta y ocho colgajos en 61 pacientes (46 colgajos de Vankataswami-Subramanian (VS), 22 colgajos llamados de « Moberg-O'Brien(MOB) fueron efectuados por una amputación traumática de la tercera falange con exposición ósea en zonas 2 y 3. A título prospectivo, las indicaciones fueron, para el pulgar el MOB, y para los biseles laterales de los dedos largos el VS. Para los otros tipos de amputaciones de los dedos largos, los dos colgajos fueron utilizados. Sólo se presentaron cuatro complicaciones severas que requirieron una regularización secundaria, 46 colgajos fueron controlados con un seguimiento promedio de 2 años. El recubrimiento fue satisfactorio en todos los casos revisados. La sensibilidad se presentó como normal o ligeramente disminuida en 66 % de los pacientes. La distrofia ungueal frecuente (56 %) parece relacionada con el trumatismo inicial y al déficit de longitud del esqueleto restante. Además un flexum de la IFP en promedio de 20° se encontró en 8 pacientes. Obtuvimos 61 % de buenos y muy buenos resultados confirmándonos en nuestras indicaciones de utilización del MOB para todos los tipos de amputación de la última falange en zonas 2 y 3 a nivel del pulgar, y del VS en las amputaciones en bisel lateral de los dedos largos. En las amputaciones de los dedos largos en guillotina, el MOB parece dar mejores resultados que el VS.
Annales de Chirurgie de la Main et du Membre Supérieur 10(5):406-416.
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ABSTRACT: Proximal row carpectomy has precise indications in cases of severe sequelae of scaphoid fractures. This procedure may be indicated either as first-line treatment in a case of advanced pseudarthrosis with osteoarthritis, particularly radio-scaphoid, or secondarily after scaphoid pseudarthrosis has been unsuccessfully treated by other methods. It is essential to make sure that the head of the capitatum and the radial surface of the lunate bone have a satisfactory appearance on plain X-rays, MRI and occasionally arthroscopy. The overall results of this operation which retains wrist movements and which also preserves a good grip strength are very encouraging, as demonstrated by the series of 48 cases of sequelae of scaphoid fractures treated by this technique.ResumenLa resección de la hilera proximal de los huesos del carpo tiene indicaciones precisas en las secuelas graves de la fracturas del escafoides. Esta indicación puede pensarse de primera intención si se está ante el caso de una pseudoartrosis avanzada con artrosis, especialmente radio escafoidea, o de manera secundaria cuando la pseudoartrosis del escafoide ha sido tratada mediante diferentes métodos. Un punto esencial es el hecho de asegurarse que la cabeza del hueso grande y la superficie radial del semilunar presenten un aspecto satisfactorio, en las radiografías de rutina, en el IRM y a veces mediante artroscopia. Los resultados globales de esta intervención que conserva la movilidad de la muñeca y que finalmente conserva una buena fuerza de prensión son completamente estimulantes como lo muestra la serie de 48 secuelas de fracturas del escafoide tratadas mediante esta técnica.
Annales de Chirurgie de la Main et du Membre Supérieur 11(4):269-275.
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ABSTRACT: Twelve cases of necrotizing fasciitis or streptococcal cellulitis of the upper limb are reported. Four cases presented with a low grade aggressive form and one case was chronic. Seven fulminating cases resulted in two deaths. These different presentations are in fact different stages of the same disease which is a group A beta-hemolytic streptococcal necrotizing infection of the subcutaneous tissue. It is a medical emergency in which surgery is the main treatment. In cases seen early, surgery helps by making an early diagnosis by showing the typical appearance of the subcutaneous tissue and by isolating organisms in wound culture. In fulminant cases, only extensive surgical debridement can control infection. Delayed or incomplete radical excision may lead to disseminated infection. Infection spreading beyond one upper limb worsens the vital prognosis.ResumenDoce casos de fasceitis necrotizante o celulitis estreptocócia del miembro superior se relacionan. En seis casos, se trataba de un cuadro clínico poco agresivo, y en un caso de una presentación crónica. Siete pacientes presentaron un cuadro fulminante, de los cuales 2 murieron. Estos diferentes cuadros clínicos, representan de hecho, los mismos estadios evolutivos de una misma enfermedad, la infección necrotizante del tejido celular subcutáneo por el estreptococo beta-hemolítico del grupo A. Se trata de una urgencia médico-quirúrgica y la cirugía ocupa una posición predominante. Las formas vistas precozmente, o poco agresivas, permiten hacer un diagnóstico precoz por el aspecto de las lesiones del tejido celular demostrandose el germen con gran fiabilidad. En las formas fulminantes, solo un debridamiento quirúrgico extenso de todos los tejidos necróticos permite controlar la infección. Las actitudes quirúrgicas poco agresivas, o diferidas, que dejan los tejidos necróticos infectados, permiten la propagación de la infección. La diseminación de la infección mas alla del miembro superior ponen rapidamente en juego el pronóstico vital.
Annales de Chirurgie de la Main et du Membre Supérieur 10(4):285-.
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ABSTRACT: 55 arthroscopies of radio- and midcarpal joints of the wrist were performed for chronic wrist pain with a difficult diagnosis and/or treatment. None of the patients suffered a deterioration and no complications were observed. The results were analysed according to Jackson's and Abe's criteria. In the overall series, arthroscopy was considered to be beneficial for the diagnosis in 80 % of cases and for treatment in 49 % of cases. Wrist arthroscopy was beneficial in 100 % of cases for exact evaluation of the lesions of osteoarthritic wrists or wrists with intracarpal disorganisation and guided the subsequent therapeutic indications. Only 41 % of cases obtained a therapeutic benefit from arthroscopy, which nevertheless constituted a useful alternative to surgical operations with a long postoperative course, allowing rapid return to work. Arthroscopy was beneficial for the diagnosis in 66 % of chronic painful wrists in which the standard radiological and dynamic assessment was normal, by identifying the anatomical lesions. Arthroscopy was not beneficial in 34 % of cases, corresponding to patients with no precise clinical symptoms. Arthroscopy was beneficial for treatment in 54 % of cases, with complete cure in the majority of cases.ResumenCincuenta y cinco artroscopias de las articulaciones radio y medio carpiana de la muñeca fueron efectuadas a causa de dolores crónicos de la muñeca de diagnóstico y/o tratamiento difícil. Ningún paciente se empeoró y no hubo ninguna complicación. Los resultados fueron analizados según los criterios de Jackson y Abe. En toda la serie, se consideró que la artroscopia había resultado benéfica desde el punto de vista diagnóstico en 80 % de los casos y desde el punto de vista terapéutico en 49 % de los casos. La artroscopia de la muñeca presenta un valor en 100 % de los casos en el sentido de la evalución exacta de las lesiones de la muñeca con alteraciones artrósicas o que presentan una desorganización intra carpiana y además ha guiado las indicaciones terapéuticas ulteriores. Solo 41 % de estos casos obtuvieron un beneficio terapéutico de la artroscopia, lo que sin embargo representa una alternativa interesante a ciertas cirugías con un largo seguimiento post operatorio, lo que permite una reincorporación más rápida al trabajo. La artroscopia fue benéfica desde el punto de vista terapéutico en 66 % de las muñecas que se presentan con un dolor crónico permitiendo determinar las lesiones anatómicas. La artroscopia no aportó ningún beneficio en 34 % de los casos que correspondía a pacientes quienes no presentaban un signo clínico de localización preciso. La artroscopia fue útil desde el punto de vista terapéutico en 54 % de los casos, con una mejoría completa en la mayoría de los casos.
Annales de Chirurgie de la Main et du Membre Supérieur 12(5):313-325.
