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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors have reviewed 194 malleolar fractures. 164 cases were treated conservatively. Less of half of them led to satisfactory results. 44 cases were operated on either primitively or after failure of conservative treatment. 29 satisfactory results were noted on 33 cases reviewed after a one year (or more) follow-up. Both foci were systematically approached, including the cases where a ruptured fragment existed in place of the malleolar fracture. Important third posterior fragments were fixed by a postero-lateral approach in prone position. Usually the lateral malleoli were fixed by screwing or plating or wiring. Medial malleoli were fixed by screwing or wiring. In some cases, collapse of the tibial roof had to be treated by grafting. The authors emphasize the importance of a fair repair of such lesions which should be recognized by tomographs. Indications are detailed. In any case, treatment should be applied in emergency for avoiding early blisters.
Rev Chir Orthop Reparatrice Appar Mot
PMID:[Bimalleolar fractures and their equivalents]. 13 21

Nineteen patients have had an arthroplasty of the semilunar by Swanson's prosthesis at stage III of Kienbock's disease. They have been reviewed after an average period of 4 years. The clinical evaluation finds 14 good and excellent results, two fair and 3 poor ones. Its analysis shows a persistence of a non limiting pain 15 times; a fair muscular strength which reaches 65 per cent of the strength of the healthy side and articular amplitudes reduced by 36 per cent of the normal amplitude. Radiologically, the study of the wrist as a whole shows that the prosthetic implantation avoids the aggravation of the collapse of the wrist, whereas its cubital sliding increases by about 15 per cent. The analysis of the evolutive mode of the wrist shows a subluxation of the scaphoid which leads 15 times to a scaphoradial arthrosis; 17 times were observed lytic signs which in 4 cases have evoked a synovitis. It seems therefore that the clinical results are favourable more than 3 times out of 4, but radiological signs of osteoarticular degeneration show the necessity to stabilize the external column of the wrist, in order to avoid the deterioration of the Swanson's implants.
Rev Chir Orthop Reparatrice Appar Mot 1989
PMID:[Limitations of replacing the semilunar with a Swanson's implant]. 268 15

The authors have followed 140 patients with sickle cell disease anemia (101 cases) or related hemoglobinopathies (39 cases). Among them hip involvement was noted in 55 (104 hips). Forty three times the hip involvement occurred in childhood and twelve times in adult life. When the necrosis appeared in childhood (84 hips) the average age was twelve. The deformity involved the femoral head (coxa plana, coxa magna) as well as the neck (short neck, coxa vara). After an average follow-up of nineteen years, clinical and radiological examinations evidenced 64 functional impairments and 25 arthrosis, 10 of which have already been operated on. The necrosis appearing during adult life (20 hips) had the same outcome as idiopathic necroses, leading rapidly to arthrosis after collapse of the sequestrum. It seems that the etiology of the necroses is linked to rheologic disorders, the deformity of the red cells causing arteriolar thromboses. In this series the hip disease was correlated with sickle cell retinopathy as defined after angiography. On the contrary there was no correlation with the severity of anemia, its treatment, the ethnical origin of the patient.
Rev Chir Orthop Reparatrice Appar Mot 1989
PMID:[Natural history of hip necrosis in sickle cell disease. Apropos of 104 necroses]. 269 46

Sixty spinal metastases have been treated surgically. In 22 cases a posterior approach was made with decompression laminectomy and internal fixation. In 38 others an anterior approach was made to resect the vertebral body and replace it by cement. In the thoracic and lumbar spines, internal fixation after a posterior approach led to secondary displacement in five cases out of nine. In contrast, spines approached anteriorly remain stable. The results were analysed after a follow-up period ranging from six months to four years. In most of the cases there was a dramatic improvement in spinal and radicular pain. Twenty-three cases had neurological impairment and in 15 of them this was improved, sometimes with complete recovery. The authors consider that surgery is indicated in metastasis of the vertebral body with collapse of the vertebra and bony compression of the spinal canal. In these cases radiotherapy is relatively ineffective. In contrast the results obtained after surgery in cases with epidural involvement are not better than those obtained by radiotherapy. Surgery should therefore be used only in radioresistant tumours.
Rev Chir Orthop Reparatrice Appar Mot 1985
PMID:[Treatment of secondary cancer of the spine]. 408 62

Ninety spinal metastases were treated by plating using a posterior approach. Fifty were thoracic or thoraco-lumbar, 11 in the upper cervical spine, 14 in the lower cervical spine and fifteen in the lumbar spine. Surgical fixation was followed by radiotherapy, chemotherapy or hormone therapy, when indicated. In the upper cervical region a special plate was screwed into the occiput. In the lower cervical spine fixation was accompanied by anterior vertebrectomy at the same procedure. In the entire series good stability was obtained in nine out of ten cases. Mortality during the first post-operative months was about 10 to 15 p. 100 dependent on the level. Two thirds of the patients gained some benefit from the operation. Cases with paraplegia and loss of independence had less favourable results than others. The ideal indications are threatened collapse of vertebrae, recent neurological impairment of severe pain resistant to conservative treatment.
Rev Chir Orthop Reparatrice Appar Mot 1985
PMID:[Surgical treatment of spinal metastases by stabilization using posterior plates screwed into the vertebral pedicles]. 408 63

Forty cases of unstable fracture of the distal end of the radius were treated by distraction and fixation using a Hoffmann external fixator. Most of the fractures were both epiphyseal and metaphyseal. They were followed up for between 6 months and 4 years. The anatomical and functional results were generally good; the range of movement of the wrist and its strength were satisfactory. However 4 instances of secondary collapse of the bone could probably have been avoided by a cancellous bone graft. Two severe algodystrophies were observed.
Rev Chir Orthop Reparatrice Appar Mot 1983
PMID:[Treatment of unstable fractures of the wrist using Hoffmann's external fixator. Study of a series of 40 cases]. 623 87

This study concerned how perceived depth collapses after asymptotic depth is reached and the information specifying depth is abruptly removed. The stimuli were random-dot, computer-generated three-dimensional objects and the depth information was motion parallax. Motion parallax was removed in two ways. In the first method, the depth of all object points was reassigned to zero, simulating a disk. In the second method, a rotation of the object was introduced in such a way that a degenerate case of motion parallax was produced. The results showed that judgments of depth slowly collapsed once motion parallax was removed. Over-all, judgments of depth required about the same duration to collapse as was required for the judgments to build up to asymptotic levels (about 750 msec.). Finally, depth collapsed more slowly when the motion parallax was removed by redefining the object as a disk than when removed using the other method.
Percept Mot Skills 1995 Feb
PMID:Perceptual collapse of three-dimensional structure from motion parallax. 762 85

From November 1988 to December 1990, 15 four-bone fusions (capitalum-lunatum-triquetrum-hamatum) were performed in our department. 3 cases were lost at follow-up, so we here describe 12 cases reviewed for a clinical and radiologic evaluation. Etiologies were as follows: advanced scapholunate dissociation: 5 cases; advanced pseudarthrosis of the scaphoid: 6 cases; ulnar midcarpal instability: 1 case. Follow-up averaged 18.8 months with a range of 6 to 29 months. Pain was significantly lessened: 9 patients had either no pain, pain influenced only by weather, or pain after sustained effort. Results for strength were average. Joint motion was severely restricted, with individual variations among patients. Remaining joint motion was of little use, and some activities of daily living were thus hampered. Pre and postoperative radiologic analysis of the carpus showed that repositioning the proximal row into the distal row of bones was not necessary. In order to obtain a good result, it suffices to stabilize the existing carpal collapse without attempting to restore carpal height. Study of this short series showed the efficacy of this arthrodesis as regards to pain although it significantly decreased the range of motion.
Rev Chir Orthop Reparatrice Appar Mot 1993
PMID:[Arthrodesis of 4 bones of the wrist. Study of 12 follow-up cases]. 806 97

The authors report a case of massive osteolysis of the spine in an eighteen years old boy presenting a T9 collapse without neurological symptoms associated to a right chylothorax which disappeared after 5 days of drainage. MRI showed an increased signal on T1 and T2 weighted sequences. An orthopaedic treatment with a cast was decided as a first attempt. Because on increasing pain and kyphosis, surgery was considered, with posterior segmental fixation with Hartshill rectangle from T4 to L5. The result was satisfactory after 6 months of follow-UP. The vanished bone disease is a rare affection of unknown aetiology. 132 cases were published, 20 with spinal localization. The prognosis is uncertain with a mortality of 16 per cent. The treatment of bony lesions is difficult. Spinal localizations are best treated by segmental fixation extended on normal vertebrae.
Rev Chir Orthop Reparatrice Appar Mot 1999 Mar
PMID:[Spinal localization of Gorham's syndrome. Case report]. 1032 71

Carpal instability with scapho-lunate dissociation is still attributed to rupture of the so-called scapho-lunate ligament. Actually, this structure is not a ligament but a loose capsule allowing very different flexion of the scaphoid (92 degrees) and the lunate (20 degrees). As reconstruction of the scapho-lunate "ligament" has often been less than satisfactory we searched for another technique. Sections of the scapho-lunate "ligament" on cadaver specimens never produce scapho-lunate dissociation. This dissociation can not occur because the scaphoid is maintained in the radial facette. It was observed that the only way to produce scapho-lunate dissociation is to section the scapho-trapezo-trapezoid ligament allowing flexion of the scaphoid and dorsal dislocation out of the radial facette. The scapho-trapezo-trapezoid ligament is not well known and is not described in anatomy text books because it is hidden by the flexor carpi radialis tendon. It is confluent with the scaphoid and the trapezoid. This produces a radial (scapho-trapezoid) column which acts like a true external pillar maintaining the height of the carpus and preventing carpal collapse. Finally, dissociation of the proximal pole from the semi-lunate can only occur by posterior displacement. After experimenting the technique on cadaver specimens, we developed a reconstruction method for the palmar scapho-trapezoid ligament using a band of the flexor carpi radialis tendon, applied in 38 patients. The flexor carpi radialis band measured 7 cm and was left attached to the base of the second metacarpal then passed in a tunnel bored anteriorly to posteriorly in the distal pole of the scaphoid. The band was then drawn dorsally while maintaining the scaphoid in place, and sutured to the postero-ulnar border of the radius. The height of the carpus was restored as was scaphoid movement over the lunate. The reduction persisted at mid- and long-term and prevented carpal collapse and joint destruction. Among the 38 operated patients, 33 remained pain free and 5 complained of minor pain under stressful conditions. All were satisfied. Anatomic research and clinical experience has demonstrated that the scapho-trapezoidal ligament is the key to scapho-lunate dissociation and its correction. Currently, this operation is the only way to achieve easy and persistent correction of carpal instability with scapho-lunate dissociation.
Rev Chir Orthop Reparatrice Appar Mot 2003 Apr
PMID:[Carpal instability with scapho-lunate dissociation treated using the flexor carpi radialis and scaphoid-trapezoid ligament repair: foundations, technique and results of preliminary series]. 1284 59


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