Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · May 2004
Review Case Reports[Avulsion fractures of the greater trochanter in children: two cases, review of the literature and proposition for a classification].
Avulsion fractures of the greater trochanter are very rare in children. We report two such cases which led to femoral head necrosis. Based on these two cases and an extensive review of the literature, we discuss the pathophysiology of this complication and propose a new classification system. ⋯ Type 2 avulsion fractures are associated with fracture of the femoral neck with a subsequent risk of femoral head necrosis. Type 3 associates hip dislocation with apophyseal avulsion with, according to the literature, an inevitable progression to head necrosis. The two cases reported look identical with those described by Linhart and Kawenblum illustrate type 3 avulsion fractures of the greater trochanter.
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Rev Chir Orthop Reparatrice Appar Mot · May 2004
Review[Backpack and spinal disease: myth or reality?].
Back pain has become a real public health concern both for adults and children. In general, patients complain of moderate pain. While the topic was long ignored by the scientific community, the number of publications has increased over the last three Years. ⋯ This type of backpack appears to have a limited benefit. Furthermore, the question of mode must not be ignored for children and adolescents. Backpacks with one sack in front and one in back certainly provide better weight distribution but are they acceptable for children and adolescents?
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2003
Review Case Reports[Aneurysmal bone cyst of the spine in children: a 9-year follow-up of 7 cases and review of the literature].
Aneurysmal cyst is an uncommon benign primitive bone tumor generally observed in young subjects, in a spinal localization in 10% of the cases. We report the clinical, radiological, and therapeutic aspects of seven cases of aneurysmal cyst of the spine. ⋯ Aneurysmal bone cysts account for 15% of all primitive tumors of the spine. They are more frequent in the cervical and thoracic spine than in a lumbar or sacral localization. One vertebra is involved in most cases, generally the vertebral body and the posterior arch with an asymmetrical extension to one pedicle in some cases. Neurological complications of variable severity are frequent and can be improved by surgical removal of the tumor. CT scan and MRI are the best exams to analyze the spinal cyst, to show bony walls and liquid-liquid levels suggestive of aneurysmal bone cyst, to evaluate the tumor extension and to search for cord compression. When the CT scan and MRI show characteristic signs of aneurysmal bone cyst of the spine, we do not perform a biopsy systematically if complete removal of the tumor appears possible. Surgical removal with biopsy is the treatment of choice. Reconstruction and stabilization of the spine must be complete using bone graft with or without instrumentation. In case of medullary involvement, decompression must be performed rapidly with the most complete tumor removal as possible. Selective arterial embolization can be used in some localizations or as preparation to surgery. Radiotherapy is contraindicated in children because of the risk of radio-induced tumors.
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Rev Chir Orthop Reparatrice Appar Mot · Jun 2000
Review[Postoperative compressive spinal epidural hematomas. 15 cases and a review of the literature].
In the literature, the frequency of postoperative compressive spinal epidural hematomas (SEH) appearing very low, we conducted the present study to determine the frequency of this complication in their unit and look for causative and predisposing factors. ⋯ Although postoperative SEH is relatively rare, it may have dramatic consequences. In our opinion, reintervention must be performed as soon as possible after the onset of neurologic deficit, the work-up investigations only prolonging the critical surgical delay, which is probably the only alterable prognostic factor.
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Rev Chir Orthop Reparatrice Appar Mot · Jun 2000
Review[Fractures of the shaft of the humerus: systematic plate fixation. Anatomic and functional results in 156 cases and a review of the literature].
Based on our experience with plate fixation of humeral shaft fractures and an analysis of the international literature, we attempted to answer the following questions. What functional outcome and what complications can be expected after surgery? Are the classical complications of open fracture surgery (screw fixation, wiring, plate fixation without compression.) as frequent after plate fixation using the Müller technique? ⋯ Plate fixation according to the Müller technique is a reliable osteosynthesis method with few initial failures or malunions as evidenced by data in the literature. Infection is also rare. Although the radial nerve risk makes this technique rather difficult, excellent functional results can be achieved.