Publications by authors named "I Auquit-Auckbur"

64 Publications

Innervation of digital joints: an anatomical overview.

Surg Radiol Anat 2021 May 6. Epub 2021 May 6.

Department of Orthopedic Surgery, Rouen University Hospital, Rouen, France.

Introduction: The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints.

Materials And Methods: A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalangeal (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber.

Results: In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC.

Discussion And Conclusion: Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source.
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http://dx.doi.org/10.1007/s00276-021-02754-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101085PMC
May 2021

[Dorsal skin defect: What solutions exist?]

Ann Chir Plast Esthet 2021 Apr 28;66(2):184-192. Epub 2020 Sep 28.

Service de chirurgie plastique, hôpital Jacques-Monod, 29, avenue Pierre-Mendès-France, 76290 Montivilliers, France.

Dorsal subcutaneous or cutaneous defects can be of multiple origin: tumor, congenital malformation, trauma, chronic radiodermitis ulceration, parting of sutures or spine surgery infection, pressure sore, etc. Wound healing of these defects can be really difficult to obtain with simple processes, such as direct sutures or skingrafts, and often implies skin flap surgery. The rarity of recipients vessels from the dorsal area makes free flaps surgery harduous. Various local or locoregional back cover solutions are available: muscular or musculocutaneous flaps (latissimus dorsi, trapezius muscle, spinal muscles, gluteus maximus), perforator flaps (DICAP, DLICAP, SCAP and IGAP…), random flaps. These flaps are really useful and must be mastered in order to propose the best-suited cover solution for each patient after a precise evaluation of their medical and clinical background. Our study, based on the Literature and some clinical cases, aims to draw up a complete table of local, locoregional and microsurgical coverage solutions by anatomical area for median and paramedian back wound defects and thus to produce a decisional algorithm facilitating our care.
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http://dx.doi.org/10.1016/j.anplas.2020.07.002DOI Listing
April 2021

Nostril Surgery: Indications, Surgical Procedures and Outcomes-A Systematic Review of Published Cases.

Aesthetic Plast Surg 2020 12 18;44(6):2219-2229. Epub 2020 Aug 18.

Department of Plastic, Reconstructive and Aesthetic Surgery, Hopital Privé de L'Estuaire, 505 Rue Irène Joliot Curie, 76620, Le Havre, France.

Introduction: To achieve adequate nasal proportions, nostril surgery can be a complementary technique useful in facial surgery. To help surgeons with the decision to realize nostril surgery, we conducted a systematic review to summarize reported cases on surgical procedures with a specific interest on indications, surgical procedures and postoperative outcomes. A therapeutic algorithm is also proposed.

Method: We carried out this review in accordance with the PRISMA criteria. Twenty-two eligible studies were identified using Medical databases, including 1599 patients. A qualitative and quantitative analysis was carried out.

Discussion: Excision techniques were realized on 728 patients (45.5%), followed by cinching sutures on 642 patients (40%) and combined techniques: excision techniques with flap advancement techniques in 189 cases (12%), excision techniques with flap advancement techniques and cinching suture in 40 patients (2.5%). When excessive alar flaring was present, alar wedge resection was preferred in the 92% of followed by alar and sill resection. Cinching sutures were realized when excessive alar flaring was associated with a vertical alar axis, in cases of wide alar base, of associated orthognathic surgery. When excessive alar flaring was associated with wide alar bases, indications changed basing on the associated deformities. In 795 patients, nostril surgery was conducted simultaneously with rhinoplasty.

Conclusion: Nostril surgery through excision techniques, cinching sutures or flaps advancement techniques, reveals good outcomes and can be complementary to rhinoplasty or orthognathic surgery. Through this systematic review, we tried to orient surgeons to find the best treatment for nostril base surgery.

Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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http://dx.doi.org/10.1007/s00266-020-01911-yDOI Listing
December 2020

Coverage losses of substance in the shoulder.

Ann Chir Plast Esthet 2020 Nov 14;65(5-6):570-588. Epub 2020 Aug 14.

Plastic and reconstructive hand surgery unit, CHU de Rouen, 3rd floor Pavillon DEVE, 1, rue de Germont, 76031 Rouen cedex, France.

Losses of substance of the shoulder are less common than elsewhere in the upper limb. They arise essentially from tumors (sarcomas), infectious diseases (hidradenitis) or traumatic events, (burns). The objectives of reconstruction depend on whether the losses of substance are located on the curve of the shoulder or in the axillary area. There exist numerous regional solutions, including perforator, propeller, pedicled and free flaps. The donor region may be the thorax (latissimus dorsi, serratus anterior), the back (trapezium, scapular or subscapular flaps, occipito-cervico-thoracic flap), the anterior surface of the thorax (pectoralis major or minor, supraclavicular, perforators of the acromiothoracic artery, delto-pectoral flap) or arm (brachial lateral or medial). Multitissular reconstructions are also possible in regional and pedicled form, as well as microanastomosed flaps in exceptional conditions.
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http://dx.doi.org/10.1016/j.anplas.2020.06.008DOI Listing
November 2020

Finger joint denervation in hand osteoarthritis: Indications, surgical techniques and outcomes. A systematic review of published cases.

Hand Surg Rehabil 2020 09 20;39(4):239-250. Epub 2020 Mar 20.

Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, 1, rue de Germont, 76000 Rouen, France.

In cases of osteoarthritis with preserved motion, joint denervation can be an effective alternative to arthroplasty or arthrodesis to reduce joint-related pain. Although denervation is a standardized procedure for wrist osteoarthritis, it is used sparingly for finger joints. We conducted a systematic review to summarize reported cases of finger joint denervation in hand osteoarthritis with a specific focus on surgical procedures and postoperative outcomes. PubMed, Cochrane and Science Direct databases were searched from 1998 to 2019 and 13 relevant articles were selected. Three hundred and twenty-five denervations were conducted on 291 patients. Distal interphalangeal (DIP) joint denervation was performed through a dorsal approach; 83% of patients were satisfied with the surgery and complications occurred in 58%. Proximal interphalangeal (PIP) joint denervation was performed through a palmar approach; 90% of patients were satisfied with the surgery; complications were observed in 14%. Good results were observed in 95% of patients who underwent metacarpophalangeal (MCP) joint denervation; complications were observed in 26%; denervation was carried out with dorsal and palmar approaches in all cases. Denervation of the trapeziometacarpal (TMC) joint was achieved through the Wagner approach (61%), multiple incisions (26%), or dorsal approach (13%); satisfaction rate was 91%, with a 6% complication rate. Finger joint denervation in hand osteoarthritis is a simple and effective procedure, providing satisfactory pain relief. Good results are reported in all studies, especially for PIP and TMC joint denervation. Further investigations should be conducted on DIP and MCP joint denervation.
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http://dx.doi.org/10.1016/j.hansur.2020.02.005DOI Listing
September 2020