Frederic Teboul

Frederic Teboul
International Hand Surgery center, 92 Bd de courcelles, Paris 17, france · Hand and Brachial Plexus Surgery

Hand Surgeon, MD,MS

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83
Publications
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Publications

Publications (83)
Article
In complete digital ring avulsions, amputation is usually carried out when replantation of the avulsed tissue is not an option or has failed. The purpose of this study was to report our experience in treating Urbaniak Class III degloved fingers using an ultra-thinned pedicled groin flap. Sixteen patients from ages 11 to 26 years were included. In a...
Chapter
Full-text available
Restoration of external rotation of the shoulder in adults with partial brachial plexus palsies is challenging. While nerve grafts are possible, nerve transfers are currently the most use method for satisfactory restoration of function. Numerous nerve transfers have been described, although the transfer of the spinal accessory nerve to the suprasca...
Article
Brachial plexus palsy after C8-T1 nerve root injury is rare, but causes a loss of finger flexion and extension, which greatly limits the patient’s grip function. It can benefit from nerve transfers if the diagnosis is made early. Otherwise, tendon transfers may be proposed. Transfers of the extensor carpi radialis longus and brachioradialis to the...
Article
Restoration of shoulder external rotation in partial brachial plexus palsies is a real challenge. The transfer of the spinal accessory nerve to the suprascapular nerve remains the gold standard. This transfer, however, cannot be always performed. Therefore, in these cases, we previously proposed the transfer of the rhomboid nerve to the suprascapul...
Article
L’objectif de notre étude était d’évaluer la fiabilité de l’examen clinique couplé à l’IRM pour déterminer si une ou deux des racines supérieures C5 et C6 sont greffables, dans les paralysies complètes du plexus brachial. Nous avons mené une étude rétrospective avec un recueil de données de 2013 à 2018. Vingt-sept patients ont été inclus. Les critè...
Article
Complete femoral nerve palsies are uncommon but devastating injuries when they are caused by large nerve defects. Direct repair is usually not possible and nerve grafting renders uncertain outcomes. Recent studies proposed different peripheral nerve transfers as treatment strategies for large femoral nerve defects. We report a clinical application...
Article
Elbow flexion is the first goal in upper partial brachial plexus palsy treatment. However, elbow extension is essential for daily living activities. To recover this function, one fascicle of ulnar nerve can be transferred to the branch of the long head of the triceps, but this procedure has been previously published in only two patients. The goal o...
Article
The objective of our study was to evaluate the reliability of clinical examination paired with MRI to determine whether one or both of the superior C5 and C6 roots are graftable in cases of complete brachial plexus palsy. We conducted a retrospective study from 2013 to 2018. Twenty-seven patients who had total brachial plexus palsy and were more th...
Article
Purpose Studies have shown that isolated tenotomy of the long head of the biceps (LHB) improves significantly pain scores, active range of motion and Constant score in elderly patients with massive and irreparable cuff tears with no osteoarthritis. This cadaveric study was performed to assess the feasibility of a tenotomy of the LHB and subacromial...
Article
Full-text available
Introduction One treatment of advanced carpal collapse with osteoarthritis of the midcarpal joint can be proximal row carpectomy (PRC) with pyrocarbon prosthesis implant, replacing the head of the capitate. We report a case of scaphoid nonunion advanced collapse (SNAC) III wrist with intramedullary bone resorption of the capitate. Case Report A 55...
Article
Neuropathies of digital nerves are an infrequent phenomenon and their causes are most often mechanical. A rare cause of acute neuropathy is hourglass-like fascicular constriction of a nerve due to torsion. Although several cases of hourglass-like constriction have been described in the literature, none to our knowledge involved digital nerves. In t...
Article
La préservation de la Bandelette sagittale reste toujours le challenge dans les abords de l’articulation métacarpophalangienne (MP). Nous décrivons une voie simple transtendineuse (T) et indiquée pour toutes les pathologies (G as global for all pathologies) de cette articulation–voie TG. Notre étude rétrospective a inclu 47 MP chez des patients de...
Article
Le premier centre d’office surgery ou de chirurgie de la main en cabinet, hors établissement de santé (clinique, hôpital) a été agréé auprès de notre assureur et de la CPAM (pour certains actes). Nous exposons les étapes, et les résultats concernant les pathologies ciblées. Notre étude prospective inclut à ce jour 52 patients et est toujours en cou...
Article
L’implication du patient pour obtenir et retenir l’information préopératoire est très aléatoire. Une fiche expliquant les impératifs juridiques, la problématique de l’assimilation de l’information et la nécessité d’une démarche active pourrait être un moyen d’améliorer sa participation. Étude prospective multicentrique. Une fiche expliquant la prob...
Article
Injuries to the central slip of the extensor mechanism can lead to a Boutonniere deformity with important functional consequences. We report a series of 11 patients treated by lengthening-dorsalizing the lateral bands and tightening the central slip with early mobilization. The average age of the patients was 42 years (14;52). The extension defect...
Article
Introduction The isolated palsies of the flexion of the thumb interphalangeal (IP) joint due to a lesion of the flexor pollicis longus (FPL) are already well described in the direct damage of the tendon of FPL, or as a result of a lesion of the anterior interosseous Nerve (AIN). The aim of our work is to describe the isolated paralysis of the FPL,...
Article
Introduction Paralysis of the suprascapular nerve in upper brachial plexus injuries is most often treated by a nerve transfer from the spinal accessory nerve. We recently described a transfer of the nerve of the rhomboids, branch of the dorsal scapular nerve. An anatomical study proved the transfer was feasible and the diameter of the nerve of the...
Article
Recovery of shoulder function is a real challenge in cases of partial brachial plexus palsy. Currently, in C5–C6 root injuries, transfer of the long head of the triceps brachii branch is done to revive the deltoid muscle. Spinal accessory nerve transfer is typically used for reanimation of the suprascapular nerve. We propose an alternative techniqu...
Article
Nerve injuries are common and can result in significant sensory or motor sequelae often with functional deficit. Nerve damage can range from a simple contusion of the nerve with full recovery to a complete section of the nerve with no recovery in the absence of microsurgical repair. The two currently most used classifications of nerve injuries are...
Article
Paralysis of the suprascapular nerve, in partial injuries of the brachial plexus, most often warrants a nerve transfer. Transfer of the spinal accessory nerve to the suprascapular nerve is performed most often. We propose to directly transfer the nerve of the rhomboid muscles (branch of the dorsal scapular nerve) to the suprascapular nerve in the s...
Article
Full-text available
We present a case of suprascapular nerve idiopathic total palsy lasting for 2 years, with intraoperative finding of suprascapular nerve partial section by the superior transverse scapular ligament. This highlights the importance of early surgical management with an open procedure for suprascapular neuropathy of unknown etiology.
Conference Paper
Full-text available
Nerve transfers: usual and new described by our Team (Goubier and Teboul) as - peripheral transfer (from obturator nerve) on the motor branch of the VL and VM for femoral nerve palsy - Transfer of the rhomboid nerve on the SSN - Transfer of a part of C7 root to the Accessory branch of Spinal nerve for Trapezius palsy
Conference Paper
Full-text available
STPI versus others Treatments ( Litterature Review, and author's Technic)
Article
Full-text available
The long head of the biceps tendon is frequently involved in shoulder pathologies, often in relation to inflammatory or degenerative damage to the rotator cuff. Biceps tenodesis in the bicipital groove and tenotomy are the main treatment options. Tenotomy of the long head of the biceps tendon is a simpler and quicker procedure than tenodesis, and i...
Article
Full-text available
Objectifs .– Lorsque les pertes de substances nerveuses traumatiques n’autorisent pas une suture directe, des artifices de réparation par interposition sont nécessaires. L’objectif de cette étude est d’évaluer l’efficacité et la tolérance des conduits de régénération nerveuse en collagène Revolnerv® (Orthomed SA, Saint-Jeannet, France) dans le trai...
Article
Injuries to the flexor tendons are frequent. Even when correctly treated, they can cause a loss of mobility of the digits secondary to postoperative adhesions. Further, conflicts between the tendon suture and the pulleys can limit the range of motion of the tendon and the flexion of the fingers. We propose a new pulley plasty that permits immediate...
Article
Les lésions sont séparées en avulsions radicellaires médullaires (lésions préganglionnaires) et rupture plus distale (lésion post-ganglionnaire). Les lésions peuvent être associées à des étages radiculaires différents. La myélo-IRM permet le diagnostic des lésions préganglionnaires pouvant exister en l’absence de pseudoméningocèles. Les autres séqu...
Article
Injuries are separated into spinal nerve root avulsions (pre-ganglionic lesions) and more distal rupture (post-ganglionic lesions). The lesions may be associated with different nerve root levels. Spinal MRI is used to diagnose pre-ganglionic lesions, which may be present in the absence of pseudomeningoceles. The other sequences described are used t...
Article
Femoral nerve lesions are uncommon, but very distressing at the functional level because of the absence of knee locking mechanism by the quadriceps muscle. We propose here a new neurotization procedure of obturator nerve motor branches to the motor portion of the femoral nerve in the thigh. This study was conducted on five cadavers. The motor porti...
Article
Scapholunate ligament injuries may lead to scapholunate instability and wrist osteoarthritis. Many surgical techniques have been described to repair these injuries. The goal of our study is to assess the clinical results after capsulodesis with the scaphotriquetral ligament for scapholunate instabilities. Twenty-eight patients, 22 men and six women...
Article
Restoring elbow flexion remains the first step in the management of total palsy of the brachial plexus. Non avulsed upper roots may be grafted on the musculocutaneous nerve. When this nerve is entirely grafted, some motor fibres regenerate within the sensory fibres quota. Aiming potential utilization of these lost motor fibres, we attempted suturin...
Article
Scapholunate dissociation or scaphoid pseudarthrosis may lead to osteoarthritis of the wrist. When osteoarthritis affects the midcarpal joint, proximal row carpectomy is no longer possible and only 4 corners fusion or capitolunate arthrodesis may be indicated. However, in some cases, osteoarthritis or bone necrosis may involve the lunatum, making p...
Article
Restoration of flexion in the elbow is the priority in the management of brachial plexus injuries. Current techniques of reconstructions, combining both nerve grafting and nerve transfer, allow more extensive repair, with additional targets: shoulder, elbow extension, hand. The transfer of intercostal nerves onto the nerve of the triceps long head...
Article
Brachial plexus surgery constitutes a long and complex procedure. The aim of our study is to assess the interest of having a double operating team throughout the duration of this surgery. Seventeen patients with brachial plexus palsy underwent surgery operated by a double team. The operating time corresponding to each step of the procedure and the...
Article
In total brachial plexus palsy, fingers flexion restoration is a real challenge. Nerve surgery can generally restore shoulder abduction and elbow flexion. However, results of nerve grafts or nerve transfers are generally poor for hand function. As a matter of fact, the long distance between nerve sutures and terminal nerve branches in muscles decre...
Article
Thirteen patients were operated on for hand palsies in cases of C7 to T1 or C8, T1 root avulsions. Finger flexion and intrinsic function were paralyzed in all patients. Finger extension was paralyzed in 12 patients. Wrist flexion and extension were present in all patients. Tendon transfers were performed to restore the different functions. The exte...
Article
Brachial plexus trauma is a rare condition in children except for obstetrical lesions, for which nerve grafting is generally proposed. Two children (9 and 12 years old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored. Nerve tr...
Article
The distally based sural neurocutaneous flap is technically simple and characterised by limited morbidity. It is one of the therapeutic alternatives for the coverage of small ormiddle-sized soft-tissue loss in the distal third of the leg, at the level of the ankle and of the heel. This flap is based on a retrograde flux originating from the superfi...
Article
Losses of skin substance of the dorsal face of the hand occasionally justify resorting to cover flaps when the noble elements (bones, tendons) are whether damaged or exposed. Few flaps allow filling in these losses of substance. Among those, which do, posterior interosseous reverse flap is indicated in some cases. We will present the technique and...
Article
Fingertip amputation injuries require an emergency reconstruction. There are a lot of techniques of reconstruction. Its goals are to cover the terminal phalanx, providing good padding, preserving useful sensation, preventing hook nail deformity as well as the morbidity of the donor site. The approach to the choice of the surgical reconstruction pro...
Article
Restoration of elbow flexion is the first goal in brachial plexus injuries. The current procedures using nerve grafts and nerve transfers authorize more extensive repairs, with different possible targets: shoulder, elbow extension, and hand. Elbow extension is important to stabilize the elbow without the contralateral hand and allows achieving a us...
Article
In C5, C6, or C5-to-C7 root injuries, many surgical procedures have been proposed to restore active elbow flexion. Nerve grafts or nerve transfers are the main techniques being carried out. The transfer of ulnar nerve fascicles to the biceps branch of the musculocutaneous nerve is currently proposed to restore active elbow flexion. Recovery of bice...
Article
Scapholunate dissociation or scaphoid pseudarthrosis may lead to wrist osteoarthritis. When osteoarthritis concerns the midcarpal joint, proximal row carpectomy is not possible. Only 4-corner or capitolunate arthrodesis may be indicated. In this procedure, pseudarthrosis was frequently described in literature. However, in these series, fixation was...
Article
Fingertip tissue loss is frequent. It often requires a reconstruction with a flap in case of exposure of the distal phalanx. We will present the technique of reconstruction by means of a local pedicle flap described by Atasoy. It is a local bipedicled flap harvested from the fingertip. The incision is triangular or volar without exceeding the palma...
Article
Patients must be informed of the benefits and risks before any surgical procedure. This information must be clear, honest, specific and complete in order that the patient can give his or her informed consent. This information has to be given face to face, however paper may be used to emphasize certain points and aid retention of information. We stu...
Article
In C7 to T1 or C8, T1 root avulsion palsies, restoration of finger active extension is not possible. Only tenodesis may restore hand opening in active wrist flexion. Many techniques have been described to restore this motion. In routine techniques, extensor tendons are fixed on radius or sutured on dorsal retinaculum. However, in these procedures,...
Article
Scapho-trapezio-trapezoid arthrodesis was originally performed for the treatment of scapho-lunate instability. However, only a few publications have described this technique for treatment of osteoarthritis of the scapho-trapezio-trapezoid (STT) joint. The purpose of this paper is to analyze the results of triscaphoid arthrodesis for STT osteoarthri...
Article
Scapho-trapezio-trapezoid arthrodesis was originally performed for the treatment of scapho-lunate instability. However, only a few publications have described this technique for treatment of osteoarthritis of the scapho-trapezio-trapezoid (STT) joint. The purpose of this paper is to analyze the results of triscaphoid arthrodesis for STT osteoarthri...
Article
In order to rescue elbow flexion after complete accidental avulsion of one brachial plexus, seven patients underwent a neurotization of the biceps with fibers from the contralateral C7 root. The C7 fibers used for the graft belonged to the pyramidal pathway, which descends from the cerebral hemisphere ipsilateral to the damaged plexus, and which co...
Article
Injury to the spinal accessory nerve in the posterior cervical triangle leads to paralysis of the trapezius muscle. The aim of this study was to determine the indications for nerve repair or reconstructive surgery according to the etiology, the duration of the preoperative delay, and specific patient characteristics. Of twenty-seven patients with a...
Article
An immunocompromised 29-year-old man presented with a Ralstonia pickettii osteomyelitis affecting the trapezium bone. The patient underwent two surgical debridement stages, including trapezectomy and long-term drainage. The type of the contaminant organism and the trapezium localization make this observation atypical.
Article
An immunocompromised 29-year-old man presented with a Ralstonia pickettii osteomyelitis affecting the trapezium bone. The patient underwent two surgical debridement stages, including trapezectomy and long-term drainage. The type of the contaminant organism and the trapezium localization make this observation atypical.
Article
The transfer of one or more ulnar nerve fascicles to the nerve to the biceps can restore elbow flexion in patients with upper brachial plexus palsy. The purposes of the present retrospective study were to evaluate the results of this procedure, to measure the delay in reinnervation of the biceps muscle, and to define the indications for a secondary...
Article
Palsies affecting elbow flexion result in major disability and therefore warrant routine surgical treatment, even in patients with permanent hand paralysis. When elbow flexion is good, restoring extension which is a classic priority in tetraplegic patients is also extremely useful to patients with peripheral palsies. When the time since the injury...
Article
Paralysis of the serratus anterior may lead to severe disability. Many surgical options are available, from soft-tissue procedures to scapulothoracic fusion. We report the results of 10 consecutive scapulothoracic fusions in 10 patients (7 men and 3 women) treated between 1980 and 1997. The mean age at surgery was 39 years (range, 22-57 years). Par...
Article
The acoustic behavior of cancellous bone with regard to its complex poroelastic nature has been investigated. The existence of two longitudinal modes of propagation is demonstrated in both bovine and human cancellous bone. Failure to take into account the presence of these two waves may result in inaccurate material characterization. Acoustic wave...
Article
The aim of our paper is to assess the functional results and specific difficulties encountered in the treatment of desmoid tumors located near the brachial plexus. Seven patients with a desmoid tumor in this region were followed for at least 2 years (average 59 months). All patients were managed operatively. The resection was marginal in 6 patients...
Article
The aim of our paper is to assess the functional results and specific difficulties encountered in the treatment of desmoid tumors located near the brachial plexus. Seven patients with a desmoid tumor in this region were followed for at least 2 years (average 59 months). All patients were managed operatively. The resection was marginal in 6 patients...
Conference Paper
It is now commonly accepted that the spatial architecture as well as the multiphasic nature of a medium strongly influence the propagation of ultrasonic waves. Using a model-based approach, the propagation of acoustic waves in spongy bone tissues was analyzed within the framework of the Biot's theory. Both theoretical analysis and experimental test...

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