Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Osteosynthesis of internal malleolar fracture by staplers].
Rigid medial and lateral fixation should stabilize the syndesmosis without further additional supplementation. We used Titanium staples for medial malleolar fixation. ⋯ Titanium staple is easy to use in medial malleolar fractures excluding anterior rim fractures.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Long-term outcome at adjacent levels of lumbar arthrodesis].
Posterolateral lumbar fusion is commonly recognized to have a significant effect upon the more proximal unfused segments. Wether these effects are clinically significant remains unclear. Long term studies with standardized follow-up are scarce. ⋯ Degenerative changes were significantly more frequent in group III's patients. However, no significant correlation was found between the roentgenographic findings and the final functional results and only 8 patients required a new surgery. These results may suggest that posterolateral fusion accelerates the development of degenerative changes in adjacent discs if the fusion is performed on a degenerative spine.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
Comparative Study[Biomechanical comparative study of three types of osteosynthesis in the treatment of supra and intercondylar fractures of the humerus in adults].
Supra and intercondylar fractures are the most common fractures of the distal end of the humerus in adult. An osteosynthesis consisting of a plate is the treatment of choice. But location and type of plate always remain open for debate. The authors present the results of an in vitro biomechanical study, which compared the stiffness of three types of osteosynthesis commonly used in these fractures. ⋯ In spite of the progress of the material and the accuracy of the indications, the treatment of supra and intercondylar fractures of the distal end of the humerus is always a difficult problem. The devices have to be as stable as possible to allow an early motion. The best one should be placed on both sides of the distal humerus, because of the sagittal cyclic forces it undergoes, but this location is anatomically impossible. Our study concludes that the device using the Lambda plate i
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Surgical treatment of ruptures of the Achilles tendon. Apropos of 42 cases treated by Bosworth's technique].
There is no consensus on the treatment of acute ruptures of the Achilles tendon. We have chosen surgical technique with early muscle stimulation. This study analyses possibilities of functional recovery and complications in Athletes. ⋯ A rigid and stable reconstruction, allowing early weightbearing without equinus position seems to be a rational treatment for Achilles tendon rupture in athletes.
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All intramedullary femoral surgery entails embolic phenomena which explain peroperative collapses formally known as bone cement implantation syndrome, as well as perioperative fat embolism syndromes. Locally, the bigger the cavity is, the higher the number of accidents: 2.5-5 per cent for GUEPAR hinged-knee prosthesis, 1.75 per cent for total hip arthroplasty with long stem, and 0.1 per cent during classic THA with cement limited to the metaphysis. Anomalies in bone vascularization also increase risk: 10.5-13 per cent during prophylactic nailing for shaft metastases, 1-11.5 per cent during hemiarthroplasty cemented in osteoporotic bone of femoral neck fractures, and only 0.1 per cent during THA implanted because of arthrosis. ⋯ Preventive treatment is surgical as there is an inverse relation between embolic marrow and marrow eliminated by large volume washes (which is often more effective than draining). Cement indications in older patients as well as the choice of fixation techniques in femoral fractures must take into account the cardio-pulmonary condition of the patient. Resuscitation procedures dealing with these complications end in the patient's death in half of the cases.