Sami Roukoz | Saint Joseph's University (original) (raw)
Papers by Sami Roukoz
The Egyptian Orthopedic Journal (Print), Dec 31, 2022
The Egyptian Orthopedic Journal (Print), Dec 31, 2022
The journal of bone and joint surgery, Mar 1, 1991
Hand Surgery, Jul 1, 2000
We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant car... more We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included. We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12-80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%). The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic environment of the median nerve and relieves pain.
Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 1998
The authors report a case of osteochondritis dissecans of the trapezium in a 10 year old boy. The... more The authors report a case of osteochondritis dissecans of the trapezium in a 10 year old boy. The main symptom was pain. X-Rays showed osteosclerosis and diminished volume of the trapezium. Magnetic resonance imaging confirmed the diagnosis. At six months, the patient was almost asymptomatic and at one year, X-Rays and the MRI were judged normal. This localisation has never been reported before. The treatment was conservative. Remission was complete.
Annales de chirurgie, 1990
The authors reviewed 200 cases of operated lumbar disk hernias. Hernias of the L4-L5 disk were tw... more The authors reviewed 200 cases of operated lumbar disk hernias. Hernias of the L4-L5 disk were twice as frequent as those of the L5-S1 disk. When clinical examination revealed simultaneous involvement of the L5 and S1 nerve roots, the L4-L5 disk was more frequently responsible (75%). Clinical examination alone was not sufficient to localize the level of the disk hernia and CT scan used for this purpose had a sensitivity of 93.2%. In 20% of cases, the CT scan demonstrated a second asymptomatic lesion. The results of surgical treatment were assessed as 83% good and very good results and 50% complete cures. The authors propose the following recommendations: Look for involvement of the L5 and S1 nerve roots which is suggestive of an L4-L5 hernia; only operate after radiological demonstration of the level of the herniated disk; do not operate on asymptomatic lesions detected by CT scan.
... S Roukoz [1] , A Kahwaji [1] , S Haddad-Zebouni [2] , N Aoun [2] , B Gerbaka [3] , N Attalla ... more ... S Roukoz [1] , A Kahwaji [1] , S Haddad-Zebouni [2] , N Aoun [2] , B Gerbaka [3] , N Attalla [2] [1] Service de Chirurgie ... ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est ...
Journal de Radiologie, 2007
Objectifs Determiner l’apport de l’echographie dans le diagnostic d’une fracture mineure des extr... more Objectifs Determiner l’apport de l’echographie dans le diagnostic d’une fracture mineure des extremites chez l’enfant. Materiels et methodes Cinquante enfants adresses pour radiographie des membres avec suspicion de 53 fractures ont eu une echographie apres la radiographie. Pour la radiographie, nous avons note la presence d’une fracture, d’un epaississement tegumentaire ou l’absence de lesion. Pour l’echographie nous avons note la presence d’une fracture, d’un hematome, ou l’absence de lesion. Resultats Une fracture etait visible a la radiographie et a l’echographie dans 28 cas. Dans 4 cas ou un epaississement tegumentaire etait visible en radiographie, l’echographie a montre une fracture dans 1 cas, un hematome dans 1 cas et etait normale dans 2 cas. Dans 20 cas de radiographie normale, l’echographie a montre une fracture dans 6 cas, un hematome dans 7 cas et etait normale dans 7 cas. Dans un cas de radiographie douteuse, l’echographie etait normale. Conclusion L’echographie a permis de confirmer le diagnostic de fracture dans 7 cas ou elle n’etait pas visible en radiographie et de l’eliminer dans un cas de radiographie douteuse. Elle est cependant operateur dependant et ne peut etre utilisee pour le moment que dans des circonstances particulieres. A l’avenir, elle pourrait remplacer la radiographie dans les traumatismes mineurs.
Hand Surgery, 2000
We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant car... more We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included.We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12–80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%).The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic env...
Annales de Chirurgie de la Main et du Membre Supérieur, 1990
DUBERT T., OBERLIN C., ALNOT J.Y.-Articular nerves of the wrist. Implications on wrist denervatio... more DUBERT T., OBERLIN C., ALNOT J.Y.-Articular nerves of the wrist. Implications on wrist denervation technique. (In French).
Journal De Radiologie, 1999
Nous rapportons deux cas d'osteomyelite multifocale recurrente. Dans les deux cas, l'IRM ... more Nous rapportons deux cas d'osteomyelite multifocale recurrente. Dans les deux cas, l'IRM a montre des lesions asymptomatiques concomitantes que la scintigraphie n'a pas pu detecter. Les lesions asymptomatiques detectees a l'IRM, siegeaient chez un patient sur le cotyle et chez l'autre patient au niveau de l'extremite inferieure du femur. A l'encontre des publications precedentes, l'IRM a ete plus sensible que la scintigraphie dans ces deux cas.
Hand Surgery and Rehabilitation
Lebanese Medical Journal, 2021
EFORT open reviews, May 1, 2022
• Congenital scoliosis (CS) is a spinal deformity resulting from underlying spinal malformations ... more • Congenital scoliosis (CS) is a spinal deformity resulting from underlying spinal malformations with an incidence of 0.5-1/1000 births. • CS makes up 10% of scoliotic deformities, of which 25% do not progress, 25% progress mildly and 50% need treatment depending on the age, curve characteristics and magnitude and type of anomaly. • CS is associated with non-vertebral anomalies (genitourinary, musculoskeletal, cardiac, ribs anomalies, etc.) and intraspinal anomalies (syrinx and tethered cord). • Imaging should include whole spine X-rays, CT scanner with reconstruction to better delineate the vertebral anomalies and MRI to visualize the neural elements. • Treatment of CS in the majority of cases is non-surgical and relies on fusion techniques (in situ fusion and hemiepiphysiodeis), resection techniques (hemiverterba resection), and growth-friendly techniques (distraction and instrumentation without fusion).
Journal of Hand Surgery (European Volume), 2008
The intention of this prospective study was to evaluate the role of the musculocutaneous and radi... more The intention of this prospective study was to evaluate the role of the musculocutaneous and radial nerves in elbow flexion and forearm supination. The study included 29 patients having loco-regional anaesthesia for minor hand surgery. Elbow flexion and forearm supination forces were evaluated before and after an isolated musculocutaneous nerve block in one group and an isolated radial nerve block in another group. The results showed that the biceps tendon is responsible for 47% of the forearm supination force and the combination of brachioradialis and the supinator for 64% of this force. It showed also that the musculocutaneous and radial nerves contribute by 42% and 27.5%, respectively, to the flexion force of the elbow. These results are intended to help surgeons in decision making when treating chronic biceps tendon rupture, in repair of traumatic brachial plexus neuropathy and in using tendon transfers, such as the Steindler transfer, around the elbow.
Lebanese Medical Journal
Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator ... more Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear. This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis. Evaluation was done using the Constant score, visual analog scale for satisfaction and quality of life. Twenty patients met the inclusion criteria. Three patients were lost to follow-up. The remaining (9 males and 8 females) had a mean follow-up period of 40.5 months. The mean age at surgery was 61.3 years. Thirty-five percent of patients were involved in heavy labor while the lesions affected the dominant side in 70% of the cases. Mean preoperative Constant score was 40.8 and increased to 78.8 (p < 0.05) wi...
Lebanese Medical Journal
To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric... more To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma. Fifty children with 53 suspected fractures were referred for upper and/or lower limbs X-rays, followed by ultrasound. On radiography, we noted presence of fracture, of soft tissue thickening, or absence of any lesion. On ultrasound, we noted presence of fracture, of soft tissue lesion, or absence of lesions. A fracture was seen on both examinations in 25 patients with 28 fractures.In 4 patients where only soft tissue thickening was seen on radiography, ultrasound showed fracture in 1 patient, hematoma in 1 patient and was normal in 2 patients. In another patient with a doubtful diagnosis of fracture on radiography, ultrasound was normal. In 20 patients with normal X-rays, ultrasound showed fracture in 6 patients, hematoma in 7 patients and was normal in 7 patients. Ultrasound was helpful as an adjunct to radiography, it yielded additional bone (7/50 patients) and soft tissue (8/...
The Egyptian Orthopedic Journal (Print), Dec 31, 2022
The Egyptian Orthopedic Journal (Print), Dec 31, 2022
The journal of bone and joint surgery, Mar 1, 1991
Hand Surgery, Jul 1, 2000
We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant car... more We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included. We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12-80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%). The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic environment of the median nerve and relieves pain.
Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 1998
The authors report a case of osteochondritis dissecans of the trapezium in a 10 year old boy. The... more The authors report a case of osteochondritis dissecans of the trapezium in a 10 year old boy. The main symptom was pain. X-Rays showed osteosclerosis and diminished volume of the trapezium. Magnetic resonance imaging confirmed the diagnosis. At six months, the patient was almost asymptomatic and at one year, X-Rays and the MRI were judged normal. This localisation has never been reported before. The treatment was conservative. Remission was complete.
Annales de chirurgie, 1990
The authors reviewed 200 cases of operated lumbar disk hernias. Hernias of the L4-L5 disk were tw... more The authors reviewed 200 cases of operated lumbar disk hernias. Hernias of the L4-L5 disk were twice as frequent as those of the L5-S1 disk. When clinical examination revealed simultaneous involvement of the L5 and S1 nerve roots, the L4-L5 disk was more frequently responsible (75%). Clinical examination alone was not sufficient to localize the level of the disk hernia and CT scan used for this purpose had a sensitivity of 93.2%. In 20% of cases, the CT scan demonstrated a second asymptomatic lesion. The results of surgical treatment were assessed as 83% good and very good results and 50% complete cures. The authors propose the following recommendations: Look for involvement of the L5 and S1 nerve roots which is suggestive of an L4-L5 hernia; only operate after radiological demonstration of the level of the herniated disk; do not operate on asymptomatic lesions detected by CT scan.
... S Roukoz [1] , A Kahwaji [1] , S Haddad-Zebouni [2] , N Aoun [2] , B Gerbaka [3] , N Attalla ... more ... S Roukoz [1] , A Kahwaji [1] , S Haddad-Zebouni [2] , N Aoun [2] , B Gerbaka [3] , N Attalla [2] [1] Service de Chirurgie ... ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est ...
Journal de Radiologie, 2007
Objectifs Determiner l’apport de l’echographie dans le diagnostic d’une fracture mineure des extr... more Objectifs Determiner l’apport de l’echographie dans le diagnostic d’une fracture mineure des extremites chez l’enfant. Materiels et methodes Cinquante enfants adresses pour radiographie des membres avec suspicion de 53 fractures ont eu une echographie apres la radiographie. Pour la radiographie, nous avons note la presence d’une fracture, d’un epaississement tegumentaire ou l’absence de lesion. Pour l’echographie nous avons note la presence d’une fracture, d’un hematome, ou l’absence de lesion. Resultats Une fracture etait visible a la radiographie et a l’echographie dans 28 cas. Dans 4 cas ou un epaississement tegumentaire etait visible en radiographie, l’echographie a montre une fracture dans 1 cas, un hematome dans 1 cas et etait normale dans 2 cas. Dans 20 cas de radiographie normale, l’echographie a montre une fracture dans 6 cas, un hematome dans 7 cas et etait normale dans 7 cas. Dans un cas de radiographie douteuse, l’echographie etait normale. Conclusion L’echographie a permis de confirmer le diagnostic de fracture dans 7 cas ou elle n’etait pas visible en radiographie et de l’eliminer dans un cas de radiographie douteuse. Elle est cependant operateur dependant et ne peut etre utilisee pour le moment que dans des circonstances particulieres. A l’avenir, elle pourrait remplacer la radiographie dans les traumatismes mineurs.
Hand Surgery, 2000
We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant car... more We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included.We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12–80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%).The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic env...
Annales de Chirurgie de la Main et du Membre Supérieur, 1990
DUBERT T., OBERLIN C., ALNOT J.Y.-Articular nerves of the wrist. Implications on wrist denervatio... more DUBERT T., OBERLIN C., ALNOT J.Y.-Articular nerves of the wrist. Implications on wrist denervation technique. (In French).
Journal De Radiologie, 1999
Nous rapportons deux cas d'osteomyelite multifocale recurrente. Dans les deux cas, l'IRM ... more Nous rapportons deux cas d'osteomyelite multifocale recurrente. Dans les deux cas, l'IRM a montre des lesions asymptomatiques concomitantes que la scintigraphie n'a pas pu detecter. Les lesions asymptomatiques detectees a l'IRM, siegeaient chez un patient sur le cotyle et chez l'autre patient au niveau de l'extremite inferieure du femur. A l'encontre des publications precedentes, l'IRM a ete plus sensible que la scintigraphie dans ces deux cas.
Hand Surgery and Rehabilitation
Lebanese Medical Journal, 2021
EFORT open reviews, May 1, 2022
• Congenital scoliosis (CS) is a spinal deformity resulting from underlying spinal malformations ... more • Congenital scoliosis (CS) is a spinal deformity resulting from underlying spinal malformations with an incidence of 0.5-1/1000 births. • CS makes up 10% of scoliotic deformities, of which 25% do not progress, 25% progress mildly and 50% need treatment depending on the age, curve characteristics and magnitude and type of anomaly. • CS is associated with non-vertebral anomalies (genitourinary, musculoskeletal, cardiac, ribs anomalies, etc.) and intraspinal anomalies (syrinx and tethered cord). • Imaging should include whole spine X-rays, CT scanner with reconstruction to better delineate the vertebral anomalies and MRI to visualize the neural elements. • Treatment of CS in the majority of cases is non-surgical and relies on fusion techniques (in situ fusion and hemiepiphysiodeis), resection techniques (hemiverterba resection), and growth-friendly techniques (distraction and instrumentation without fusion).
Journal of Hand Surgery (European Volume), 2008
The intention of this prospective study was to evaluate the role of the musculocutaneous and radi... more The intention of this prospective study was to evaluate the role of the musculocutaneous and radial nerves in elbow flexion and forearm supination. The study included 29 patients having loco-regional anaesthesia for minor hand surgery. Elbow flexion and forearm supination forces were evaluated before and after an isolated musculocutaneous nerve block in one group and an isolated radial nerve block in another group. The results showed that the biceps tendon is responsible for 47% of the forearm supination force and the combination of brachioradialis and the supinator for 64% of this force. It showed also that the musculocutaneous and radial nerves contribute by 42% and 27.5%, respectively, to the flexion force of the elbow. These results are intended to help surgeons in decision making when treating chronic biceps tendon rupture, in repair of traumatic brachial plexus neuropathy and in using tendon transfers, such as the Steindler transfer, around the elbow.
Lebanese Medical Journal
Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator ... more Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear. This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis. Evaluation was done using the Constant score, visual analog scale for satisfaction and quality of life. Twenty patients met the inclusion criteria. Three patients were lost to follow-up. The remaining (9 males and 8 females) had a mean follow-up period of 40.5 months. The mean age at surgery was 61.3 years. Thirty-five percent of patients were involved in heavy labor while the lesions affected the dominant side in 70% of the cases. Mean preoperative Constant score was 40.8 and increased to 78.8 (p < 0.05) wi...
Lebanese Medical Journal
To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric... more To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma. Fifty children with 53 suspected fractures were referred for upper and/or lower limbs X-rays, followed by ultrasound. On radiography, we noted presence of fracture, of soft tissue thickening, or absence of any lesion. On ultrasound, we noted presence of fracture, of soft tissue lesion, or absence of lesions. A fracture was seen on both examinations in 25 patients with 28 fractures.In 4 patients where only soft tissue thickening was seen on radiography, ultrasound showed fracture in 1 patient, hematoma in 1 patient and was normal in 2 patients. In another patient with a doubtful diagnosis of fracture on radiography, ultrasound was normal. In 20 patients with normal X-rays, ultrasound showed fracture in 6 patients, hematoma in 7 patients and was normal in 7 patients. Ultrasound was helpful as an adjunct to radiography, it yielded additional bone (7/50 patients) and soft tissue (8/...