Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Femoral reconstruction with endosteal bone allografts protected by a metallic mesh in reoperation of total hip prosthesis. 19 cases with an average follow-up of 83 months].
To assess after 83 months of follow-up, the results of 19 femoral revisions carried out according to an original method combining a cemented stem and bone reconstruction by means of impacted-morcelized bone allograft protected by a titanium mesh. ⋯ Satisfactory functional and radiographic results were obtained with this method after 5 to 10 years of follow-up instead of severe preoperative femoral bone stock impairement. Likewise, we observed only one recurrence of loosening diagnosed with the help of digitized X-ray examination. Only one significant (> 3.5 mm) femoral stem migration was detected. Radiographic features of femoral reconstruction were observed but without histologic proof of graft integration. This method uses a longer stem than the "Exeter", but avoids a high rate of femoral stem migration and appears compatible with femoral bone reconstruction.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Value of orthopedic treatment of distal fractures of the forearm in children. Apropos of 152 cases].
Distal forearm fractures in children are frequent. Management is conservative except in rare cases which will be discussed. ⋯ Close reduction is possible for fractures with large displacement but must be done perfectly and the cast must be adapted. If instability, irreducibility and/or incorrect reduction exist, management must include posterolateral and intrafocal percutaneous pinning, especially in older children. While rare, this indication must be known.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Treatment of complex bicondylar fractures of the tibial plateau by semi-circular anterior diaphyseal-epiphyseal plate].
One third of all tibial plateau fractures are bicondylar, and some of them have posterior separation and metaphyseal comminution. In these cases, it may be difficult to reconstruct at the same time tibial axis, bone continuity and articular surface. The authors propose a new method for the treatment of these fractures. ⋯ Complex bicondylar fractures are one of the most difficult fractures to treat. Identification of the lesions should be envisioned before operation and especially the separated posterior fragments. The peroperative extension combined with the anterior approach with ATT elevation provided a complete view of intra articular fracture and correction of the axis. The semi-circular anterior plate allowed the fixation of all the fragments, and furthermore, the original procedure using temporary pins to guide the definitive plate has avoided to loose the reduction.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Anterior spinal fusion by thoracoscopy. A non-traumatic technique].
Video assisted thoracic surgery (VATS) is a new modality which allows visualization of, and access to the intrathoracic organs without thoracotomy. Recently, this technique has been used for anterior thoracic spine approach to perform surgery which previously required standard postero-lateral thoracotomy. The authors report their initial experience of anterior spinal fusion using thoracoscopy and give a detailed description of their surgical procedure. ⋯ This original technique demonstrates that thoracoscopy for anterior thoracic surgery is better for the patients, reducing surgical trauma of the chest wall and to the lung parenchyma (in term of post operative comfort, sh
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Value of combined spinal and epidural anesthesia in the management of peroperative analgesia in prosthetic surgery of the lower limb. Prospective study of 68 cases].
Efficient peri-operative analgesia is more comfortable, allows earlier mobilisation and better functional results for lower limb arthroplasties. We report our 60 cases prospective study of combined spinal and epidural anesthesia, and expose interests of this technique to control peri-operative pain. ⋯ The results indicate that combined spinal and epidural anesthesia for the management of peri-operative pain provide an excellent pain control with a daily morphine injection. For lower limb arthroplasties, visual analogue scale is always inferior or equal to 2 and satisfaction mark equal to 1.