V Mitz's research while affiliated with L'Institut de Chirurgie Orthopedique et Sportive and other places

Publications (99)

Article
Vascular leiomyoma is a benign painful tumour that occurs most frequently in the lower extremity. We report an uncommon case in the hand. Only surgical removal of the tumour allows establishing the diagnosis histologically. A review of the literature confirms the rarity of the tumour in the hand. The purpose of this case report is furthermore to co...
Article
Vascular leiomyoma is a benign painful tumour that occurs most frequently in the lower extremity. We report an uncommon case in the hand. Only surgical removal of the tumour allows establishing the diagnosis histologically. A review of the literature confirms the rarity of the tumour in the hand. The purpose of this case report is furthermore to co...
Article
Reduction of the weight in obese patients is a pre-condition for the aesthetic improvement of obesity or its after effects by plastic surgery. The aim of this study was to evaluate the effectiveness and advantages of gastric banding, using a ring positioned under laparoscopic guidance. Thirty-nine patients with morbid obesity were operated on. For...
Article
Morbid obesity: laparoscopic gastroplasty before plastic surgery.Objectives: Reduction of the weight in obese patients is a pre-condition for the aesthetic improvement of obesity or its after effects by plastic surgery. The aim of this study was to evaluate the effectiveness and advantages of gastric banding, using a ring positioned under laparosco...
Article
The authors report a cases of breast implant infection, 40 years after augmentation mammoplasty. The infection developed 6 weeks after colonoscopy complicated by acute peritonitis due to colonic perforation. Bacteroides fragilis, a usual organism of the gastrointestinal tract flora, was identified in the two septic sites (peritoneal and periprosthe...
Article
The subject of this experimental study is a cylindrical device, with a gauge adjusted to the vessel lumen, which disintegrates in a few minutes. The goal of this device is to increase the reliability of vascular microanastomosis. This study was designed to assess the efficacy and drawbacks of the device. The device is a cylindrical sugar stick, 5 m...
Article
To ameliorate the cervicomental angle, most surgeons suggest different techniques of platysmaplasty. The aim of this anatomic study is to find a simple answer to the following question: Is suturing of the anterior edges of the platysma muscles during platysmaplasty the best procedure to use to obtain the best concave anterior neck angle? Three diff...
Article
Facial fasciitis or non infectious facial retractions are rare and surprising events after a facelift performed at any age. The signs are firm retraction located on one or both sides of the face or neck. They differ from salivary fistula, localised oedema, and limited hematoma, which may be the initial factor responsible for this curious outcome. W...
Article
Based on a series of 74 patients, the authors report their experience of reoperation on unsatisfactory breast implants by the implant replacement technique using silicone prefilled implants. In 92 (57.8%) of the 160 cases, the implant was modified because of a peri-implant capsule, with a satisfactory aesthetic result after only a single operation....
Article
It is difficult to evaluate the medium and long-term results of facelift due to loss to follow-up of a large number of patients. The authors developed a questionnaire which they sent to their patients. 148 patients (143 women and 5 men) answers this questionnaire and 54 patients returned for review. This subjective evaluation of the results neverth...
Article
The thenar flap is a satisfactory reconstruction technique for the treatment of extensive loss of the distal phalanx of the index and middle fingers. As we observed in this series of 20 patients, this flap is reliable and provides tissue that closely matches the missing finger pulp. Flap sensibility is good (average Weber of 6.5 mm). Transferring a...
Article
This study proposes intraarterial in situ thrombolysis for the treatment of microthrombi occurring after tissue crushing. In order to assess the efficacy of the thrombolytic, the authors assayed the serum creatine phosphokinase (CPK) level in the crushed muscle capillary bed. The action of thrombolytics has now been clearly established. In contrast...
Article
The elegance of the cervical region is due to a certain balance between concave and convex surfaces, and is based on the presence of a well-defined cervicomental angle, generally between 90 degrees to 110 degrees. An excessively wide-open cervicomental angle makes the cervical profile inelegant. Numerous surgical techniques can improve this angle....
Article
The scaphal cartilaginous area is a most suitable anatomic site for cartilaginous graft harvesting. These grafts allow reconstruction of a flat dorsum, or a rounded dome, or alar cartilages or can be used for an extended tip graft. In some cases, both scaphes may be harvested. Raising of the grafts does not leave any sequelae when performed correct...
Article
The authors report their experience of digital pulp reconstruction by free toe pulp transfer. Fifteen patients were treated with the lateral great toe hemipulp. 15 cases of post-traumatic finger tip reconstruction were reviewed including 9 thumbs, 5 index, 2 medius, and one ring finger. There were 6 emergency cases and 9 secondary reconstructions (...
Article
Total scalp avulsion is an uncommon and dramatic accident. Replantation is the only way for acceptable aesthetic final results. However, partial loss of tissue can result, and secondary procedures can be required. A total avulsion of a scalp involving the upper part of the right ear and both eyebrows was replanted after a long delay in our departme...
Article
Directed healing is a therapeutic process that Raymond Vilain conceived as a sequence of: cleaning, granulation and formation of the epidermis. He suggested, to aid healing, the use of sofra-tulle and washing with isotonic solution or tap water, we have added the use of a hair dryer, in order to decrease the exudation from the wound. Such directed...
Article
In 18 cases the authors used a free tissue transfer during the first 24 hours of the treatment of a complex trauma of the upper limb involving osteoarticular and neurovascular loss combined with loss of skin cover. The various flaps include: lateral arm flap (8 cases), latissimus dorsi flap (4 cases), toe to hand transfer (4 cases), radial forearm...
Article
Large open elbow fractures with extensive soft-tissue loss must be treated as an emergency. Vessels and nerves are often alvulsed. One stage reconstruction is very challenging. Ischemia of the distal part of the upper extremity is limited by a synthetic arterial shunt (SAS). After debridement, the authors install the SAS, then the complex procedure...
Article
Total scalp avulsion is an uncommon accident. Three recent cases illustrate our surgical procedure. Small and central hair-bearing avulsed scalps can be treated by secondary scalp expansion (1 case). Large hair-bearing scalp (> 400 cm2) or including aesthetic relief should be treated by microsurgical reimplantation. Venous grafts allow vascular ana...
Article
Los autores relacionan su experiencia de 3 años de utilización del colgajo antebraquial externo en la reconstrucción del miembro superior. Esta serie de 11 casos hace parte de una serie de 22 colgajos utilizados a nivel de los miembros. A nivel de los miembros los colgajos han sido posicionados : 7 veces en la mano, 2 veces en el antebrazo, 2 veces...
Article
The authors report the use of a new polyurethane dressing, studied in 20 patients undergoing breast surgery. Based on objective criteria, this study analyses the contribution of this dressing in the postoperative course.
Article
Since 1989, we have operated 38 patients with breast ptosis with or without hypertrophy according to a technique which leaves a periareolar scar. The principles of this technique are: periareolar skin resection, dissection between the skin and gland over the entire surface of the gland, mastopexy, insertion of an absorbable mesh onto the anterior s...
Article
During the last three years, eleven lateral upper arm flaps were used in the reconstruction of skin defects of the upper limb. These flaps were applied: 7 times on the hand; 2 times on the fore-arm; 2 times on the elbow. Ten flaps had a free transfer, one was vascularised by the distal pedicle. In 4 cases we used an emergency free transfer in the t...
Article
Dix-huit patients ayant présenté une raideur de l'interphalangienne proximale (IPP) en extension ont été traités par téno-arthrolyse dorsale (19 doigts). Les étiologies sont représentées par trois fractures de P1, 2 fractures de P2, 2 sections de l'extenseur au dos de P1, 8 lésions associant fracture et section tendineuse, 2 traumatismes fermés de...
Article
18 patients suffering from PIP stiffness in extension were treated by dorsal teno-arthrolysis. PIP joint stiffness was due to 3 cases of fracture of P1, 2 cases of fracture of P2, 2 cases of extensor tendons, 8 fractures of P1 associated with section of the extensor tendon, 2 cases of PIP closed trauma (1 sprain, 1 dislocation), and 2 crush injurie...
Article
Pulp reconstructions use numerous techniques ranging from simple debridement to local and microsurgical flaps. The authors analyse the various treatments, in which directed healing still retains numerous indications. Local flaps have a definite place, but they are not devoid of risks (iatrogenic stiffness). The indications are presented schematical...
Article
Lors de l'étude de pouces reconstruits par transfert du deuxième orteil, un nouveau test a été mis au point : le « test des 5 allumettesou « Take Five Test . Il s'agit d'un test standardisé de ramassage chronométré et comparatif de cinq objets fins (allumettes), qui permet une évaluation simple, rapide, chiffrée et objective de la dextérité dans le...
Article
El fin de la operación es preservar la sensibilidad pulpar, cada vez que un dedo deber ser amputado. Hemos revisado 9 pacientes que fueron operados según esta técnica, en una serie de 14 pacientes, quienes presentaban crochets, y en quienes una amputación o una artrodesis hiper acortante fueron discutidas. El retroceso de la pulpa permitiendo ajust...
Article
After studying a series of thumbs reconstructed by 2nd toe transfer, we devised a new dexterity test: the "five matches test" or "Take Five Test" (R.S.). This test consists of the standardised timed and comparative pick-up of 5 identical fine objects (matches), permitting a simple and quick evaluation which objectively quantifies dexterity in fine...
Article
The aim of this operation is to preserve the sensitivity whenever when a finger has to be amputated. We have reviewed 9 patients operated according to this technique, out of 14 patients for whom an amputation or a shortening arthrodesis was discussed. The results of pulp recession were most encouraging. The incision were located on both sides of th...
Article
Pulp reconstructions use numerous techniques ranging from simple debridement to local and microsurgical flaps. The authors analyse the various treatments, in which directed healing still retains numerous indications. Local flaps have a definite place, but they are not devoid of risks (iatrogenic stiffness). The indications are presented schematical...
Article
The evaluation of 58 breast reconstructions operated in Boucicaut Hospital demonstrated positive result. The authors review the techniques used for contralateral breast symmetrization. The policy generally adapted has been to perform two sequential operations: 1st step: implantation of a prefilled prosthesis and contralateral breast symmetrization;...
Article
The authors present a foot replantation case at the ankle level followed six months later by a tibial lengthening using the Ilizarov procedure. Performing the aforementioned lengthening following a replantation enables good nervous and vascular sutures, tension-free and ensures a satisfactory result.
Article
The evaluation of 58 breast reconstructions operated in Boucicaut Hospital demonstrated positive result. The authors review the techniques used for contralateral breast symmetrization. The policy generally adapted has been to perform two sequential operations: 1st step: implantation of a prefilled prosthesis and contralateral breast symmetrization;...
Article
Cold sensitivity often occurs after upper limb nerve injuries. 82 patients were reviewed retrospectively with an average follow-up of 42 months. Cold sensitivity occured after 50 % of median nerve injuries and after 75 % of ulnar nerve injuries. Symptoms are localized to the damaged sensory nerve territory, and are related to the level of the lesio...
Article
Cold sensitivity often occurs after upper limb nerve injuries. 82 patients were reviewed retrospectively with an average follow-up of 42 months. Cold sensitivity occurred after 50% of median nerve injuries and after 75% of ulnar nerve injuries. Symptoms are localized to the damaged sensory nerve territory, and are related to the level of the lesion...
Article
The reimplanting activity initiated by Professor Raymond Vilain at Boucicaut Hospital in 1972 allowed emphasizing that, in addition to the reimplantation of a completely severed segment, there existed a parallel activity including microsurgical steps, bone surgery and skin plasties, all of which were gathered under the term of VBS, or Vessels-Bone-...
Article
77 patients with an isolated traumatic ulnar nerve lesion were operated on between 1972 and 1982. 40 patients with more than 18 months of follow-up were reviewed with a new clinical quoting. 37.5 p. cent of satisfactory results were achieved with nerve sutures done in emergency, 56.3 p. cent with secondary nerve grafting. Factors influencing the re...
Article
It would appear to be impossible to compare completely different techniques of mammaplasty performed in very different clinical situations. However, we thought it would be useful to approach the result of mammaplasties from a more "orthopaedic" point of view. Such an approach distinguishes populations of patients with different results and in whom...
Article
We advise dynamic extensor splintage put on as early as possible within the first 6 weeks after the diagnosis of boutonniere deformity. This splintage runs from the dorsal aspect of the hand to the DIP joint which is left free to flex actively. This apparatus is left on for at least six weeks post injury. Sixteen patients have been treated in this...
Article
We advise dynamic extensor splintage put on as early as possible within the first 6 weeks after the diagnosis of boutonniere deformity. This splintage runs from the dorsal aspect of the hand to the DIP joint which is left free to flex actively. This apparatus is left on for at least six weeks post injury. Sixteen patients have been treated in this...
Article
The consequences of postoperative infection at the site of microsurgical repair were studied. The experiment used 60 Wistar rats which were divided into 3 groups of 20 each. The femoral artery, vein, and nerve were transected unilaterally and repaired using microsurgical techniques. Staphylococcus aureus was then inoculated into the wound of group...
Article
This study was undertaken to examine the possibility of using the latissimus dorsi muscular flap, divided in two parts thus covering the surfaces of the heart, and inserting it into the thoracic cavity by means of a segmental resection of the second rib. After cadaver case studies, 15 operations were performed on 5 Beagle dogs. The first group of 5...
Article
Progressive sequential stimulation of a skeletal muscle using trains of 30 Hz impulses with increasing frequencies from 20/min. to 80/min. within 3 months, allowed us to obtain in goats a transformation of the fast twitch glycolytic muscular fibers into fatigue resistant slow twitch oxidative muscular fibers. The conditioned muscle can be used in t...
Article
The full picture of functional ulnar deficiency, following suture or grafting, was studied and analyzed by two of the authors, who followed this series of patients on a long-term basis. The patients were tested using sphygmometric rubber bulbs in other to determine the overall closing force of the hand (making a fist), and the force of the pinch be...
Article
The full picture of functional ulnar deficiency, following suture or grafting, was studied and analyzed by two of the authors, who followed this series of patients on a long-term basis. The patients were tested using sphygmometric rubber bulbs in other to determine the overall closing force of the hand (making a fist), and the force of the pinch be...
Article
Total reimplantation of rats' legs by microsurgical techniques is a useful means of creating experimental lymphedema. The phenomenon follows a cyclic course which lasts for about 3 weeks after surgery. In order to follow the evolution of the lymphedema quantitatively, precise measurements were carried out by indirect isotopic lymphography using rhe...
Article
The median nerve compressed in the carpal tunnel can be released by an incision in the "line of life", a natural fold along the axis of the third metacarpal bone. By sectioning the carpal tunnel in the palm of the hand, on the cubital side of the median nerve, division of the external branch and of the sensory cutaneous rami of the nerve can be avo...
Article
Though retromuscular implantation of mammary prosthesis for breast reconstruction presents certain advantages, a retrospective study of the results of 56 such prostheses implanted in 38 patients demonstrated certain complications related to this procedure. These included: ectopy, secondary migration, poor aesthetic appearance during muscle contract...
Article
The groin flap, first described by McGregor, has proved its usefulness. The height of the scar can be reduced by two variants, which the authors call the slip flap and the string flap. The slip flap is easily concealed, even by low panties, and is centered on an afferent branch of the superficial iliac circumflex artery proximally in the groin, 5 c...
Article
The authors report 20 cases of reimplantation of upper limbs going from the axilla to the wrist, and excluding digital reimplantations. They have also excluded from this series the 25 most recent cases. Only the oldest cases of the series are reported, with an average time lapse of 43.2 months. The study was essentially on the functional recuperati...
Article
The authors describe the treatment which they recommend for fractures of the fifth metacarpal. After a brief description of fractures of the proximal end of the diaphysis and of the head of the bone, they study in detail fractures of the neck of the fifth metacarpal. They found that conservative treatment is not very successful but that internal fi...
Article
Thorn-off thumb replantation is very challenging. Although formerly contraindicated, this sort of replantation should be attempted today with a precise technique. A clinical case illustrates the necessity for long venous grafting in order to repair both arterial and venous circuits. Other repairs, such as tendon transfer, nerve grafting, skin graft...
Article
The authors present an original external fixation of the skeleton, using pins and orthopedic cement. This technique has the advantage of being non-expansive and using the usual surgical material, which is available in every operating room. The authors used it in 26 cases, but good indications for external fixation represent only 7% of severe open t...
Article
In the presence of peripheral nerve damage, the only acceptable procedure is suture without tension, carried out under excellent conditions of fascicular approximation. In the case of loss of substance, immediate or secondary suture should never be performed. In the experience of "S.O.S. Main" secondary suture has led to the most disastrous results...
Article
Defined by severe injuries of several digital structures and by lesions of several axes, complex hand injuries raise numerous problems of management. The activity of the unit "S.O.S. Hand-Reimplantation" of the Boucicaut Hospital petmitted us to determine the various clinical and socio-professional aspects. In the first part of this article, a stat...
Article
Peribuccal burns produce deformities associating cicatrical patches and retractile adhesions with resulting: downward attraction of the buccal commissure and subsequent difficulty in smiling with the mouth closed; reduction in the size of the open mouth because of laterobuccal adhesions which produce a peribuccal gag; backward, and often asymmetric...
Article
Our clinical experience favors the use of long autologous venous micrografts any time excessive tension is noted along the anastomotic line or in case of a short pedicle in a free flap. The technical problems of harvesting and interposition of these long micrografts are presented.
Article
Antibiotic therapy for paronychia has seen its day. It is indicated only rarely and justified only when on the day following infection or during the next few days there are signs of regional or systemic spread. The surgical treatment of infections of the hand is not difficult but should be known, if not learned. A paronychia which has been opened b...
Article
A technique for a flap used as a pure vascular adjunct that does not impringe of the sensitivity of the donor finger, has been propounded by the authors for the management of sole digital arteritis or painful stumps after digital amputations owing to lesser vascular supply, in other words conditions requiring only appropriate vascular supply. The l...
Article
The analytic and overall functions of reimplanted fingers should be judged according to a scale in order to determine the indications for reimplantation. Objective criteria are defined which take into consideration various functions, the number of operations and the duration of the total work incapacity. The authors conclude that certain indication...
Article
Surgery of dorsal articular wounds of the interphalangeal joints of the fingers, as an emergency, raises difficult problems. The conservation of satisfactory joint movements depends mainly on the quality of the dorsal skin repair. The authors discuss their main indications, and emphasise the concept of complete repair on one stage by qualified surg...
Article
Basing themselves on recent dissection work as well as conventional descriptions, the authors have made some technical suggestions aiming at compensating the postoperative loss of sensitivity of the ear lobe. Since the terminal ramifications of the auricular branch of the superficial cervical plexus, located within the subcutaneous plane, not deepe...

Citations

... Elle permet un gain de la capacité de l'avancement du lambeau de 3 à 6 mm, elle permet une restauration esthétique et fonctionnelle de la pulpe. Actuellement, les lambeaux d'Atazoy et de Kutler sont, malgré leur simplicité de réalisation, abandonnés par plusieurs auteurs [9,10] laissant la place aux autres techniques de reconstruction pulpaire, particulièrement le LIPH qui malgré ses inconvénients : la raideur de l'interphalangienne distale, et le risque accru de nécrose postopératoire, rapportés par certains auteurs [10,[14][15][16], ce que nous avons observé dans un seul cas. Le LIPH reste une indication de choix devant les larges pertes de substance pulpaires en sifflet palmaire ou latérale, et cela grâce à son avancement important parfois au prix d'une cicatrice hypertrophique. ...
... The question is then to evaluate such a complex criteria. The Take Five test [26] provide an answer to that question. It is, indeed, a very simple test which has been proved to be reliable (the variability in the same person between two trials is small). ...
... One such is the use of interposition vascular grafts (IVG), both in primary cases and in secondary salvage procedures. Nonetheless, IVG use has been associated with a high failure rate [1][2][3][4] and as such surgeons have remained hesitant to adopt its use. Still IVG have always remained a viable option for the skilled microsurgeon in difficult situations and recent studies have shown encouraging outcomes. ...
... All of the reports about lengthening of salvaged extremities recommend extensive debridement of the necrosed tissues and adequate shortening. [2][3][4][5][6][7][8][9] A shortened upper extremity often leads to poor aesthetic results, while it does not affect functional recovery. On the other hand, a shortened lower limb leads to a substantially impaired locomotor function because of limping. ...
... The idea of proceeding to breast reconstruction with a preestablished drawing realized by the plastic surgeon originates from our concern to avoid a breast reconstruction after a Halsted incision mastectomy [1][2][3][4] The latter would already condemn the result either shape wise or because of the scar quality. ...
... Les lésions du nerf ulnaire sont fréquentes et entraînent des conséquences fonctionnelles majeures sur la pince pollicidigitale et le verrouillage de la prise. Après une lésion du nerf ulnaire, le déficit fonctionnel moteur est ressenti par le patient comme plus gênant que le déficit sensitif [1]. Généralement, les plaies et pertes de substance du nerf ulnaire au niveau de l'avant-bras sont suturées ou greffées. ...
... Recovery of sensory function, power grip and a global functional score, evaluated by the disabilities of the arm, shoulder and hand questionnaire (DASH), seem to be favourable prognostic factors after treated median and ulnar nerve injuries [14], but few studies have been dedicated to the relevance of cold sensitivity. Previous data indicate that cold sensitivity may be more frequent after an ulnar nerve injury than after a median nerve injury [17]. Outcome and presence of cold sensitivity after surgically treated hand and nerve injuries or disorders can be evaluated by patient related outcome measurements (PROMs) [18][19][20]. ...
... Where treatments are described, they are markedly variant and based on small-scale retrospective case studies [14][15][16] or expert opinion pieces. [17][18][19][20][21][22][23][24][25][26] Proposed interventions range from immediate movement within a short arc movement framework 14 to full-time extension splinting for up to eight weeks. 19,21 Closed CS injuries had been historically managed in our unit by following clinical guidelines that were nonspecific in terms of splinting time frames, progression of movement and managing poorer outcomes, primarily due to the lack of evidence described above. ...
... Studies revealing great plasticity of biochemical and histological changes of electrically stimulated skeletal muscles were of essential importance for this form of treatment. Training a skeletal muscle according to a suitable protocol of electrical stimulation leads to a number of changes in the structure and cytoarchitecture of the fibers of skeletal muscle as well as its enzymatic activity and metabolism [30][31][32][33]. ...
... For cardiac repair, especially following myocardial ischemia, MSCs provide an attractive potential therapeutic approach (17). Latissimus dorsi muscle flaps, preconditioned by long term pacing for subsequent use in cardioplasty, undergo cardiac-like differentiation (18). Differentiation to a cardiomyocytic lineage must include gap junction formation, which should, in turn, improve cell engraftment (19) and reduce the risk of arrythmogenic events (20). ...