Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Dec 2006
Case Reports[Deep benign fibrous histiocytoma: a case report].
Bening fibrous histiocytoma is one of the most frequent benign tumors. Most tumors are found in the skin, particularly on the limbs. Tumor size is usually small. ⋯ Most deep tumors occur in the subcutaneous tissue. Deep locations in other organs have also been reported. We report a case and discuss the pathological and clinical aspects of this rare tumor.
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Rev Chir Orthop Reparatrice Appar Mot · Nov 2006
[One-stage reconstruction of the two cruciate ligaments with a single autogenous graft from the extensor system: techniques and results of 25 chronic cases].
Chronic tears of both cruciate ligaments are rarely encountered. Management practices have varied. One-stage reconstruction of both ligaments using arthroscopically implanted allografts was proposed starting in 1996 for such chronic laxity but only 44 cases have been reported in six papers mixed in with recent cases raising very different problems. Treatments using allografts or autogenous grafts or both implanted arthroscopically have often been combined with open surgery. We report a retrospective analysis of 25 knees treated with the same technique from 1983 to 2004: reconstruction with a single transplant taken from the extensor system. ⋯ Classically, one or other of the cruciate ligaments is repaired, sometimes both, but in a two-stage procedure associating two different methods and autogenous tendon grafts. One-stage reconstruction of both cruciate ligaments with a single autogenous graft and a wide approach has not led to any complications. One-stage reconstruction using this technique has several advantages: one anterior incision, single transplant which also enables lateral plasty, short immobilization time with rapid rehabilitation.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2006
[Grammont reversed prosthesis for acute complex fracture of the proximal humerus in an elderly population with 5 to 12 years follow-up].
Aim of this retrospective study was to analyze outcome in 23 cases of Delta III reverse ball-and-socket total shoulder prosthesis for acute complex fractures of the proximal humerus in an elderly population with poor bone quality. In such a population, this procedure could escape the difficulties of a reliable and efficient refixation of the tubercles. ⋯ For acute complex fractures of the proximal humerus in elderly subjects with poor bone quality, when an efficient and reliable re-fixation of the tubercles is difficult or impossible, reverse ball-and-socket shoulder prosthesis is a possible alternative providing good functional outcome except for rotations but with the risk of inferior scapular notching. Although not problematic in the mid term, these notches may contribute to glenoid loosening with bone loss in the long-term. Nevertheless, this procedure seems to improve the status of patients with such fractures.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2006
[Bipolar shoulder prosthesis for rheumatoid arthritis with irreparable rotator cuff tear: results after 5 years' follow-up].
The goal of this study was to assess the clinical and radiological outcome of bipolar shoulder prosthesis in twelve shoulders with rheumatoid arthritis (RA) and irreparable rotator cuff tears. ⋯ Some massive tears involving the subscapularis tendon can lead to anterior recurrence after bipolar shoulder prosthesis. They might be a limit to the procedure and require a reversed shoulder prosthesis or a glenohumeral arthrodesis.
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Meniscal lesion does not mean meniscectomy and this is particularly true for the lateral meniscus. The reputation of mildness of the meniscectomy is usurped. The rate of joint space narrowing after lateral meniscectomy is of 40% at a follow-up of 13 years compared to 28% for the medial meniscus (symposium SFA 1996). ⋯ They should be early diagnosed (MRI). Treatment options are various: abstention, meniscectomy, and repair. Painful post lateral meniscectomy syndrome may be treated by a new surgical option: meniscal allograft.