Entrapment of the suprascapular nerve.

Operative release for entrapment of the suprascapular nerve was carried out in 35 patients. They were assessed at an average of 30 months (12 to 98) after operation using the functional shoulder score devised by Constant and Murley. The average age at the time of surgery was 40 years (17 to 67). Entrapment was due to injury in ten patients and no cause was found in three; 34 had diffuse posterolateral shoulder pain. The strength of abduction was reduced in all the patients. The average Constant score, unadjusted for age or gender, before operative release was 47% (28 to 53). In 25 of the patients both the supraspinatus and infraspinatus muscles were atrophied and seven had isolated atrophy of the infraspinatus muscle. The average conduction time from Erb's point to the supraspinatus muscle and to the infraspinatus muscle was 5.7 ms (2.8 to 12.8) and 7.4 ms (3.4 to 13.4), respectively. In two patients MRI revealed a ganglion in the infraspinatus fossa and, in another, a complete rupture of the rotator cuff. The average time from the onset of symptoms to operation was ten months (3 to 36). A posterior approach was advocated. The average Constant score, after operative release, unadjusted for age or gender was 77% (35 to 91). The overall result was excellent in ten of the patients, very good in seven, good in 14, fair in two, and poor in two. The symptomatic and functional outcome in our series confirmed the usefulness and safety of operative decompression for entrapment of the suprascapular nerve.

Peroneal nerve entrapment.

Sixty patients (sixty-two limbs) who had entrapment of the peroneal nerve were managed with operative decompression, and the results were evaluated after an average duration of follow-up of forty-two months (range, twenty-five to 162 months). The entrapment was postural in five patients, dynamic in two (one of whom had bilateral entrapment), and idiopathic in fifty-three (one of whom had bilateral entrapment). Fifty-eight patients (including the two who had bilateral entrapment) had a positive Tinel sign. Twenty-two patients (including the two who had bilateral entrapment) had sensory symptoms only, and thirty-eight had both sensory and motor symptoms. Electrophysiological studies were performed for all patients in order to confirm the diagnosis. Sensory deficits were confirmed on the basis of a marked decrease in the amplitude of sensory potentials, and motor deficits were confirmed on the basis of decreased nerve-conduction velocities. The common peroneal nerve was decompressed by division of both edges of the fibular fibrous arch. The average time from the onset of symptoms to the operation was fourteen months (range, one to 120 months), primarily because of delayed referrals. Twelve of the twenty-two patients who had had only sensory symptoms preoperatively had complete recovery by the time of the latest follow-up. The average delay from the onset of symptoms to the operation was thirty months (range, six to eighty-six months) for the ten patients (eleven limbs) who did not have full recovery compared with nine months (range, four to thirty-six months) for the twelve patients (thirteen limbs) who did. The postoperative recovery of motor function, as determined with use of the grading system of the Medical Research Council, was good for thirty-three (87 per cent) of the thirty-eight patients who had had both sensory and motor symptoms preoperatively. All seven patients who had peroneal nerve entrapment of known etiology had improvement postoperatively. We recommend operative decompression when symptoms persist or recovery remains incomplete for three to four months, provided that the diagnosis has been confirmed with electrophysiological studies.

[Common fibular nerve lesions. Etiology and treatment. Apropos of 146 cases with surgical treatment]. / Les lésions du nerf fibulaire commun: approche étiologique et thérapeutique. A propos de 146 cas traités chirurgicalement.

PURPOSE OF THE STUDY: Common peroneal nerve lesion on the lateral aspect of the knee is one of the most frequent neurologic injury of the lower limb. We reported the results of surgical procedure for each etiological group. MATERIAL AND METHODS: In the peroneal nerve entrapment group, we individualised 62 fibular tunnel syndroms (55 idiopathic, 4 postural, 3 dynamic), and 16 external compression. Traumatic causes were represented by 22 varus injuries of the knee and by 11 fractures, 16 iatrogenic lesions, 2 wounds, 5 wound sequelae, 2 contusions and 1 burn. Tumoral group was represented by 7 intraneural ganglionic cyst and 2 extraneural tumour (1 exostosis and 1 chondromatosis of the proximal tibio fibular joint). All patients underwent surgical procedure. Neurolysis was performed when the nerve was in continuity. Suture or nerve grafting was performed in the other cases. In the case of intraneural ganglionic cyst, a complete tumoral excision was realised. RESULTS: Eighty-three per cent of excellent and good results were obtained for the fibular tunnel syndrom, 62.5 per cent for external compression, 36 per cent for varus injury of the knee, 78 per cent for the other traumatic causes and 89 per cent for tumoral lesions. DISCUSSION: This report confirms that the result depends on the etiology of the common peroneal nerve lesion. We propose surgical treatment within 2 to 4 months for the patients without clinical and electrophysiological improvement. If there is doubt on the continuity of the nerve, we propose an earlier surgical treatment. Our results were in general satisfactory except when a nerve graft was necessary furthermore if it was a traction injury and if the length of the graft was longer than 6 centimeters.

Ascorbic acid increases synaptosomal potassium-induced dopamine release.

On synaptosomes prepared from striata of mice, increasing concentrations of ascorbic acid (from 0.01 mM to 0.5 mM) did not modify the 3H-dopamine uptake. However, at the 0.1 mM concentration, ascorbic acid increased the potassium-induced release of 3H-dopamine by synaptosomes previously loaded with the amine. This effect was dependent on the presence of Ca2+ in the superfusion medium and was not shared by dehydroascorbic acid (from 1 mM to 0.01 mM). This effect of ascorbic acid, which occurs in the range of its endogenous concentrations, suggests that it is a putative modulator of dopaminergic transmission.

[Ulnar nerve palsy after percutaneous crossed pinning of supracondylar fractures of the humerus in children]. / Les paralysies cubitales après embrochage percutané en croix des fractures supracondyliennes de l'humérus de l'enfant.

Five ulnar palsies with spontaneous improvement, from the medial percutaneous pinning, have been analysed out of thirty two displaced supracondylar fractures of the humerus. These findings allow us to discuss this technique, despite the advantages provided by the mechanical stability of this fixation.

Semi-log model for interpreting the results of swabbing surfaces naturally contaminated.

Two mathematical models for depicting microbial depletions during six consecutive swabbings of refrigerated tank wall and teat skin were tested. Although a second degree polynomial equation gave a better adjustment of the data, a first degree equation was preferred to calculate the total numbers of micro-organisms possibly retrieved from surfaces by swabbing. This model was used for estimating the level of milk contamination by teat skin.