Thierry Christen's research while affiliated with Lausanne University Hospital and other places

Publications (25)

Article
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We investigated the role of three-dimensional (3-D) CT in the diagnosis and management of four bipartite scaphoids in three patients. We computed the volume ratio, moment of inertia ratio and direction vector from the centroid of the scaphoid to the os centrale carpi. We found that the os centrale carpi was always smaller than the scaphoid and show...
Article
Full-text available
Background: Metacarpal nonunion is a rare condition. The osteogenic capacity of periosteal free flap was investigated in five patients with metacarpal nonunion and impaired bone vascularization. Patients and methods: Surgery was performed between 64 and 499 days after the initial bone osteosynthesis. The average age was 27.6 (range 16-32) years....
Article
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Background: Ulnar nerve compression at the elbow level is the second-most common entrapment neuropathy. The aim of this study was to use shear-wave elastography for the quantification of ulnar nerve elasticity in patients after ulnar nerve decompression with anterior transposition and in the contralateral non-operative side. Method: Eleven patie...
Article
Biomimicry consists in imitating nature to solve complex human problems. The hand surgeon usually tries to copy and recreate the structure-to-function and function-to-control relationships of the native tissues after damage. With its exceptional structure and biomechanics, the flexor digitorum superficialis (FDS) has been an important source of ins...
Article
Full-text available
Purpose The flexor carpi radialis brevis (FCRB) is a supernumerary musculotendinous structure of the wrist that has been the focus of some interest in the last decade. While its anatomy is well known, its in vivo function remains unknown as it has never been studied. Methods Eleven cases of FCRB underwent a multimodal ultrasound consisting of B-mo...
Article
Purpose The spiral oblique retinacular ligament (SORL) procedure acts as a dynamic tenodesis to restore distal interphalangeal joint (DIP) extension and restrain proximal interphalangeal hyperextension. Despite the ingenious technique based on the oblique retinacular ligament anatomy, obtaining strong internal fixation remains an issue during the S...
Article
The choice of the donor tendon in tendon reconstruction of the hand theoretically influences the results of the surgery because of the interactions of its structure with the healing process. The objective of our study was to specify the surgical bases of vascularized extensor indicis proprius (EIP) in tendon reconstruction of the hand and to presen...
Article
PURPOSE : Recently, local anaesthesia has become popular among hand surgeons. We hypothesized that using the ‘’wide awake local anaesthesia, no tourniquet’’ (WALANT) approach would result in lower global costs and in an increase of the operating room's efficiency. METHODS : All cases of carpal tunnel and trigger finger releases performed over 2016...
Article
Flexor carpi radialis brevis (FCRB) is a supernumerary musculo-tendinous structure of the wrist, often discovered incidentally during imaging, surgical procedure, or cadaveric dissection. Five cases (three patients) with FCRB were reported and underwent a multimodal ultrasound consisting of B-mode US, Doppler US and Shear Wave Elastography. Examina...
Article
Full-text available
Wide awake local anesthesia no tourniquet (WALANT) hand surgery is a rapidly growing in popularity. WALANT has been used by hand surgeons when operating on bones, tendons, ligaments, nerve entrapments. We offer a case report of the first case in the literature describing WALANT technique when performing trapeziometacarpal joint arthroplasty with pr...
Poster
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Metacarpal nonunion after closed fracture is uncommon. Tough atrophic and hypovascular nonunions happen mostly in transverse diaphyseal fractures. It usually occurs after bone loss or expansive removal of the periost. Patients with this condition often present with persistant pain, loss of motion, or loss of strength. Clinical and surgical handling...
Article
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. ME...
Article
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Closed tendon avulsion of both flexor tendons in the same finger is an extremely rare condition. We encountered the case of a patient who presented a rupture of the flexor digitorum profundus in zone 1 and flexor digitorum superficialis in zone 3 in the little finger. This occurrence has not been reported previously. We hereby present our case, mak...
Article
Background: Ulnar nerve decompression at the elbow traditionally requires regional or general anesthesia. We wished to assess the feasibility of performing ulnar nerve decompression and transposition at the elbow under local anesthesia. Methods: We examined retrospectively the charts of 50 consecutive patients having undergone ulnar nerve entrap...
Article
Full-text available
Management of musculoskeletal tumours usually begins with the appearance of a lump or bump, or the onset of unspecific symptoms. A poor initial work-up, a faulty biopsy or an inadequate resection may have a severe impact on the prognosis, including re-interventions, amputation, local recurrence or systemic spread of the disease. The patient with a...
Article
Thumb hypoplasia treatment requires considering every component of the maldevelopment. Types II and IIIA hypoplasia share common features such as first web space narrowing, hypoplasia or absence of thenar muscles and metacarpophalangeal joint instability. Many surgical techniques to correct the malformation have been described. We report our surgic...
Article
The surgical handling of central cleft hands may involve various procedures to restore acceptable function. Stabilization of the merged cleft is usually achieved through reconstruction of the intermetacarpal ligament. However, no attention has been paid to the agenesis of the metacarpophalangeal collateral ligaments adjacent to the cleft, which is...
Article
Deep burn assessment made by clinical evaluation has an accuracy varying between 60% and 80% and will determine if a burn injury will need tangential excision and skin grafting or if it will be able to heal spontaneously. Laser Doppler Imaging (LDI) techniques allow an improved burn depth assessment but their use is limited by the time-consuming im...
Article
Full-text available
Posterior chest wall defects are frequently encountered after excision of tumors as a result of trauma or in the setting of wound dehiscence after spine surgery. Various pedicled fasciocutaneous and musculocutaneous flaps have been described for the coverage of these wounds. The advent of perforator flaps has allowed the preservation of muscle func...

Citations

... SWE confirmed the anterior location of the ulnar nerve relative to the rotation axis of the elbow, with a decreased tension in the ulnar nerve during elbow flexion: the values of the shear elastic modulus in the ulnar nerve decreased from 107.2 to 79.1 kPa with elbow flexion. These shear elastic modulus values were comparable to those recently reported in patients before and after anterior transposition of the ulnar nerve [5]. Due to the absence of extrinsic compression factors in this anterior nerve location, excessive friction and stretching are other potential mechanisms to consider. ...
... Innervation of the FCRB is provided by the anterior interosseous nerve, and feeding is supplied by the radial artery 5,13,14 . The FCRB is a striated skeletal muscle and plays a role in voluntary wrist flexion 15 . 16 found a presence of the FCRB of 1.7% among 225 cadavers, and Mimura et al. 14 calculated a ratio of 1.6% based on the MR images of 379 people with carpal tunnel syndrome. ...
... Following implementation of this pathway, the authors demonstrated a 31% reduction in total costs and 34% reduction in total time spent by patients at the facility, with no changes in quality of outcomes or patient experience [21]. Other studies have also demonstrated greater operative throughput and workflow efficiencies with the incorporation of WALANT [15,22]. ...
... 41 Similarly positive analgesic results were reported with olecranon fracture plating, hand fracture fixation, 42 wrist arthroscopy for triangular fibrocartilaginous complex repair, 43 and trapeziometacarpal joint prosthesis implantation. [42][43][44] Repair of an ulna shaft fracture has also been performed under WALANT with the addition of a periosteal nerve block. 45 ...
... 8 Transposition of a neuroma, as in our study, is frequently used as a surgical technique during re-operation. 8,17 Relief of pain and outcome after re-operation have been discussed in the literature and indicate that no one method is more effective than another. 17 From a global view of neuroma treatment, pain improves by surgery, but the present regression analysis did not identify any specific risk factors for a re-operation. ...
... Já as injúrias no tendão flexor superficial dos dedos são incomuns, mais frequentemente afetando o dedo anelar ou médio 5 . A lesão fechada de ambos os tendões é rara, tendo sido descritos somente nove casos na literatura desde 1984 6 . ...
... Roberti et al performed a retrospective study of patients undergoing ulnar nerve transposition during CuTS surgery. 14 In this study, when GA and LA were compared, VAS scores of the GA group were about twice those of the LA group 7 days postoperatively. Our concern, the difference in immediate postoperative pain, was reflected in the number of opioid injections during hospitalization. ...
... Diese Tumorerkrankungen stellen sehr hohe Anforderungen an die Diagnostik und Therapie. Dies ist einerseits auf die Seltenheit der Tumoren, andererseits darauf zurückzuführen, dass eine möglichst frühe Diagnose und adäquate Therapie nur mithilfe einer effektiven Interdisziplinarität erreicht werden kann [3][4][5][6]. Die Tumoren des muskuloskelettalen Systems treten bei Erwachsenen sehr selten auf [7][8][9][10][11]. Nur ein Anteil von 1% der Tumorerkrankungen im Erwachsenenalter stellen maligne Knochentumoren dar [8,12,16]. ...
... 21 For type 2 and 3A thumbs, opposition transfer, with either abductor digiti minimi 22,23 or flexor digitorum superficialis (FDS), is utilized for this functional augmentation. 24 Current literature is limited to small case series, revealing positive patient-reported outcomes for both techniques. 21,25 Yet, there is a slightly better trend in outcome and lower revision rate in FDS opposition transfer than abductor digiti minimi transfer. ...
... Other researchers also determined cut-off perfusion values, which varied between 200 PU and 300 PU. However, they used it to distinguish superficial partial-thickness from deep partial-thickness or full-thickness burns in the standard LDI diagnostic procedure for assessing an undebrided wound [25][26][27][28][29][30]. LDI is regarded as an effective aid to clinical judgment when considering the excision of burns with indeterminate depth [31,32]. ...