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#May 2010
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Ulnar impaction syndrome
Ulno-carpal impaction syndrome is often secondary to the sequels of a fracture of the distal radius.
The inversion of the distal radio-ulnar index with a positive ulnar variance by shortening relative to the radius eventually leads to an abutment between the head of the ulna and the proximal articular face of the lunate. This contact leads to the alteration of the cartilaginous carpal surfaces. There are numerous treatments for the distal radio-ulnar component of malunion of distal radius fracture and the choice of therapy is based on specific evaluation of this joint through a clinical and radiological analysis.
Arthroscopy remains the best diagnostic element in evaluating the seriousness of the ulno-carpal abutment with a direct visualization of the cartilaginous lesions and allowing a precise assessment of the associated lesions, in particular on TFCC or LT ligament. When the inversion of the distal radio-ulnar index is less than or equal to 5mm, the surgical treatment can also be carried out by arthroscopy.
JR Haugstvedt
Lecture
8 years ago
376 views
6 likes
0 comments
10:08
Ulnar impaction syndrome
Ulno-carpal impaction syndrome is often secondary to the sequels of a fracture of the distal radius.
The inversion of the distal radio-ulnar index with a positive ulnar variance by shortening relative to the radius eventually leads to an abutment between the head of the ulna and the proximal articular face of the lunate. This contact leads to the alteration of the cartilaginous carpal surfaces. There are numerous treatments for the distal radio-ulnar component of malunion of distal radius fracture and the choice of therapy is based on specific evaluation of this joint through a clinical and radiological analysis.
Arthroscopy remains the best diagnostic element in evaluating the seriousness of the ulno-carpal abutment with a direct visualization of the cartilaginous lesions and allowing a precise assessment of the associated lesions, in particular on TFCC or LT ligament. When the inversion of the distal radio-ulnar index is less than or equal to 5mm, the surgical treatment can also be carried out by arthroscopy.
Laparoscopic treatment of a chronic mesh infection 4 years after sacral colpopexy
In this video, we present the case of a late infectious complication after abdominal hysterectomy and sacral colpopexy using mesh interposition. We demonstrate the complete laparoscopic removal of the infected mesh, including excision of all the affected surrounding tissue. This is the case of a 57-year-old patient who had a total hysterectomy with bilateral adnexectomy and sacrocolpopexy in 2005. In 2009, she started to complain of an abundant, continuous and smelly vaginal discharge. The microbiological exam revealed a vaginal infection by Proteus mirabilis and the gynecologic examination showed a painful vaginal tumor with a drainage hole.
A Wattiez, S Barata, B Gabriel, J Nassif
Surgical intervention
8 years ago
3950 views
25 likes
0 comments
09:55
Laparoscopic treatment of a chronic mesh infection 4 years after sacral colpopexy
In this video, we present the case of a late infectious complication after abdominal hysterectomy and sacral colpopexy using mesh interposition. We demonstrate the complete laparoscopic removal of the infected mesh, including excision of all the affected surrounding tissue. This is the case of a 57-year-old patient who had a total hysterectomy with bilateral adnexectomy and sacrocolpopexy in 2005. In 2009, she started to complain of an abundant, continuous and smelly vaginal discharge. The microbiological exam revealed a vaginal infection by Proteus mirabilis and the gynecologic examination showed a painful vaginal tumor with a drainage hole.
Laparoscopic Tanner’s gastropexy for acute gastric volvulus
Acute gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach of more than 180 degrees, creating a closed loop obstruction that can result in incarceration and/or strangulation. The most common causes of gastric volvulus in adults are diaphragmatic defects such as paraesophageal hernias. Historically, mortality rates of 30-50% have been reported for acute volvulus, with the major cause of death being strangulation, which can lead to necrosis and perforation. Emergent surgical intervention is indicated for acute gastric volvulus. The laparoscopic treatment requires considerable experience but it has the potential to decrease the morbidity associated with open procedures. In February 2009, a case of an organo-axial gastric volvulus with a giant hiatal hernia was published in WeBSurg. We would like to take advantage of this to present a case with a mesentero-axial type marking the difference of the pathophysiology.
J Torres Bermúdez, S del Valle Ruiz , J Lopez Espejo, G Sánchez de la Villa
Surgical intervention
8 years ago
3743 views
41 likes
0 comments
12:27
Laparoscopic Tanner’s gastropexy for acute gastric volvulus
Acute gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach of more than 180 degrees, creating a closed loop obstruction that can result in incarceration and/or strangulation. The most common causes of gastric volvulus in adults are diaphragmatic defects such as paraesophageal hernias. Historically, mortality rates of 30-50% have been reported for acute volvulus, with the major cause of death being strangulation, which can lead to necrosis and perforation. Emergent surgical intervention is indicated for acute gastric volvulus. The laparoscopic treatment requires considerable experience but it has the potential to decrease the morbidity associated with open procedures. In February 2009, a case of an organo-axial gastric volvulus with a giant hiatal hernia was published in WeBSurg. We would like to take advantage of this to present a case with a mesentero-axial type marking the difference of the pathophysiology.