Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1995
Case Reports[Fractures of the tibial tuberosity associated with avulsion of the patellar ligament in adolescents].
Avulsion fracture of the tibial tuberosity is considered as a relatively uncommon adolescent injury. The avulsion of the patellar ligament may occur as part of the injury. Two cases of sixteen year old boys with this kind of injury have been reported. Fractures are described using Ogden et al. classification : type I is an avulsion fracture of the most distal portion of the ossification center of the tubercle ; type II, an upward angulation of the lip fragment ; type III, a fracture of the lip fragment with propagation of the fracture-line into the knee joint. Each type is subdivised into A (no comminution) and B (comminution). Frankl et al. in 1990 address the possibility that patellar ligament avulsion may occur as part of the injury (type C). ⋯ Avulsion fracture of the tibial tuberosity is rare. When conservative treatment is indicated, it is important to search an avulsion of the patellar ligament. When such an injury is suspected, lateral radiographs of the knee should be made in flexion as well as in extension. We believe that treatment should include open reduction and internal fixation associated with a protect tension band allowing early rehabilitation.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1995
Case Reports[Recent post-traumatic luxation of the trapeziometacarpal joint. Apropos of 8 cases].
Eight cases of acute traumatic dislocation of the trapezio-metacarpal joint treated by percutaneous pinning without ligamentoplasty are reported in order to evaluate this method. ⋯ Closed reduction followed by stabilization by percutaneous pinning gives good results in the treatment of acute traumatic dislocation of the trapezio-metacarpal joint. It finds its limits with patients with degenerative changes on the initial radiographs, and in this case ligamentous reconstruction, arthrodesis or arthroplasty might be advocated.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1995
[Multifascicular intramedullary nailing of the forearm].
Purpose of the study was to present the advantages of intramedullary nailing of long bones for treatment of fractures of the forearm. These advantages are 1) preserving the fracture-hematoma and 2) non exposure of bone. This technique is based on the technique of bundle nailing developed by Hackethal (1959). ⋯ In conclusion with our confined spectrum of indications Hackenthal nailing is a low-risk method, which leads to rotational stability and early bone healing.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1995
[Treatment of Morton neuroma by neurectomy. Apropos of 43 cases].
Morton's neuroma is a frequent cause of metatarsalgia. Its diagnosis is clinical but progress in medical imaging: ultrasound, evoked potentials and above all MRI allows an improvement of para-clinical diagnosis. ⋯ Morton's neuroma is located essentially in the third interdigital space. Neurectomy is a simple operation that often leads to recovery.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1995
Case Reports[Femoral head necrosis after intramedullary nailing of the femur in adults].
An avascular necrosis of the femoral head occurred after intra-medullary nailing of a femoral diaphyseal fracture. This complication may be related to the posterior situation of the proximal insertion hole just posterior to the trochanteric notch and piriformis fossa as demonstrated by the CT scan. This situation of the nail may cause injury to posterior branch of the circonflex artery at the time of rod insertion. Even if it appears exceptional in adult patients with intra-medullary nailing, this potential complication and the anatomy of the superior extremity of the femur should be known.