During his internship, Frédéric Teboul was confronted with an injured hand. This first surgery is for him a revelation and he is immediately passionate about the multi-tissue nature of the hand. Since then, this specialty has not left him, he is now a hand and upper limb surgeon, and a member of the National Academy of Surgery.
The hand: a social organ
For an enthusiast like Doctor Teboul, the hand cannot be reduced to a simple functional organ. It is characterized by its intrinsically social and communicational function. According to Frédéric Teboul, the hand is a symbolic organ of expression just like the face.
Carpal tunnel syndrome: a public health issue
150,000 patients are operated on each year for this common musculoskeletal disorder. A syndrome that affects men and women unevenly since twice as many women undergo these operations each year, in part for hormonal reasons.
Carpal tunnel syndrome is manifested by ants in the hand, bothersome and even very painful, which usually wake up at night.
After a while, the affected people lose sensitivity and strength which can hinder the use of the hand.
For the initial forms, Frédéric Teboul treats this syndrome by infiltration and offers support for the hand using a splint. In the most severe cases, Doctor Teboul operates on his patients either in the open or by endoscopy.
Endoscopy is a method favored by the surgeon because it is micro-invasive and allows the use of only tiny incisions to free the nerve to provide relief to the patient.
Dupuytren’s disease: retraction of the fingers
Doctor Teboul is very familiar with this disease, which is characterized by a progressive and usually painless retraction of the fingers. This disease which mainly affects men causes significant functional discomfort because the curling of the fingers hinders certain gestures.
For Dupuytren’s disease, Dr Teboul uses two different operating methods. The first method practiced by the surgeon is micro-invasive and allows you to break the strap with a needle. Although recovery is almost immediate, recurrence is assured and it is therefore preferable to choose the aponeurectomy in certain cases.
This operation is heavier but makes it possible to remove almost all of the diseased tissue and therefore to reduce recurrences.
Osteoarthritis of the hand: thumb, fingers and wrist
Osteoarthritis is notorious but according to Doctor Teboul we tend to ignore osteoarthritis which affects the hand and in particular that which reaches the base of the thumb (rhizarthrosis).
Frédéric Teboul first tries to treat this type of osteoarthritis by infiltration and in the most painful cases he operates on his patients by installing small prostheses or by performing reconstructive surgery.
The same goes for osteoarthritis of the fingers (often a cause of major aesthetic discomfort) and the wrist.
Hands emergencies: an impressive volume of operations
Of the 21 million emergency room visits over a year, it is estimated that 6 to 12 million passages relate to upper limb trauma. This represents 350,000 hands operated on on average each year, an impressive figure which reflects a substantial volume of work for hand surgeons.
For a specialist surgeon like Doctor Teboul, this represents an average of 10 to 15 daily emergencies.
Towards surgery in an office: a course of care to be developed
Like the Anglo-Saxons, some French hand surgeons tend to want to reduce outpatient operations in favor of surgery in an office.
Doctor Teboul himself performs this type of surgery in order to reduce the patient’s care path and ensure faster recovery. The selection of patients eligible for this type of surgery is subject to strict criteria.
By avoiding hospitalization, patients often go home within an hour of the surgery in the office and can return to near-normal life immediately.
Nerve microsurgery for the paralyzed
Doctor Teboul is recognized for his expertise in the field of nervous microsurgery. His area of expertise is brachial plexus paralysis surgery (motorcycle accidents in 95% of cases). He described new surgical procedures to improve the quality of life of these patients.
By working from regrowth tubes, Dr Teboul manages to operate on an interrupted nerve by placing the tube at both ends of the damaged nerve. This avoids going through a nerve sample in the leg as was practiced for a long time before the discovery of this very encouraging method.
Basic research on stem cells: cure osteoarthritis and tendonitis without operating!
Dr Teboul is also carrying out important fundamental research work using stem cells.
The method consists of taking fatty mass from the patient under local anesthesia in the stomach or thigh, filtering it to extract stem cells.
Once differentiated, we can obtain cartilage, muscle or even tendon cells. This would then make it possible to treat diseases such as osteoarthritis in the long term only by injections, and no longer by surgery.