Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2000
[Risks and results after simultaneous intramedullary nailing in bilateral femoral fractures: a retrospective study of 40 cases].
A retrospective series of 40 patients who underwent simultaneous intramedullary nailings for bilateral femoral shaft fractures was analyzed. The aim of our study was to verify that simultaneous nailing without reaming does not increased risk of fat embolism and to assess clinical and radiological outcome. ⋯ Simultaneous nailing of bilateral femoral shaft fractures can be performed if blood gases remain acceptable and minimal reaming is used.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2000
[Quality of life assessment one year after total hip or knee arthroplasty].
The development of quality of life (QOL) instruments has made it possible to obtain an objective assessment of the impact of surgical procedures taking into consideration the physical, psychological and social aspects of the patient's everyday activities. The aim of this work was to evaluate the short-term and long-term course of QOL after total hip arthroplasty (THA) and total knee arthroplasty (TKA). ⋯ These findings confirm the clear improvement in QOL after THA and TKA, mainly due to physical and psychological dimensions. The QOL measurements allow comparisons with other surgical procedures in other fields. They provide supplementary information, notably concerning pain and are particularly useful in orthopedic surgery. The questionnaires are generally well accepted by the patients, particularly short self-administered questionnaires. They provide useful information on the efficacy of THA and TKA in terms of human and social costs and open new perspectives for analysis of prognostic factors for optimal QOL of operated patients.
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MacFarland fracture is a joint fracture of the ankle in children. The fracture line passes through the medial part of the lower epiphyseal disk of the tibia. Prognosis is dominated by later risk of malalignment and osteoarthritis. MacFarland fracture usually occurs subsequent to adduction trauma. The aim of this study was to analyze prognosis in a retrospective series of children with MacFarland fractures. ⋯ Careful radiologic and clinical surveillance is needed and should be continued to the end of growth (fusion of the tibial cartilage) in children with high risk fractures in order to detect epiphysiodesis early and avoid secondary malalignment. Surgical correction does remain possible and gives good results.
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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.