[Evaluation of the cervicothoracobrachial outlet and results of conservative treatment]. / Evaluation du syndrome de la traversée cervico-thoracobrachiale et résultats du traitement conservateur.

A thorough evaluation of the thoracic outlet patient assists the therapist in determining the neurologic and vascular components, but exact localization and pathologic structures are difficult to recognize. According to Walsh, separating compressive TOS from entrapment TOS is essential to proper treatment. Compressive versus entrapment TOS is stated throughout assessment: etiology, symptomatology, associated pathologies and results of provocative maneuvers, including the Plexus Brachial Tension Test popularized by Butler. Improvement following the various protocols of standard treatment varies from 50 to 90%. In entrapment TOS, utilization of peripheral nerve mobilization techniques to restore nerve gliding mobility could improve the results of conservative treatment.

[The axial orientation of the phalanges following the curling up of the fingers]. / L'orientation axiale des phalanges consécutive à l'enroulement des doigts.

This study follows and modestly completes those by Dubousset and Kapandji concerning the phenomena of axial (or longitudinal) rotation of the phalanges combined with flexion-extension of the fingers. Our analysis of the orientation of axial rotation of the skeletal elements of the digital chain, in relation to each other and during digito-palmar flexion was supported by simple observation, impressions in silicone paste, study of anatomical preparations, three-dimensional computed tomography. The index finger and middle finger tend to supinate. The ring finger undergoes virtually no rotation and the distal end of the little finger tends to pronate. These phenomena, essential for good adaptation to grip and fine manipulation must be taken into account by rehabilitation physicians when the amplitude of these movements are limited by immobilisation or disease.