Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2008
Review Comparative Study[Hallux valgus surgery in 2005. Conventional, mini-invasive or percutaneous surgery? Uni- or bilateral? Hospitalisation or one-day surgery?].
There remains a good deal of controversy concerning forefoot surgery. Certain concepts such as conventional procedures, minimally invasive surgery, or percutaneous surgery are promoted because of their specific advantages including rapid recovery and compatibility with a short hospital stay or even outpatient surgery. Nevertheless, in 2005 many questions remain unanswered and highly variable practices have been basically founded on personal experience rather than scientific evidence. ⋯ Statistically, there is very little difference in the short term between the different techniques. A much longer study would be necessary to obtain evidence to guide our practices. While there is certainly no reason to condemn one method or another, surgeons must be careful about the promises given to patients which are generally based on personal experience but not necessarily supported by rigorous scientific data.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2008
Comparative Study[Intramedullary pinning of diaphyseal fractures of both forearm bones in adults: 46 cases].
The goal when treating shaft fractures of the forearm bones is to obtain good bone healing with good preservation of upper limb function. We report a retrospective (1995-2004) consecutive series of patients aged 32 years on average (range 16 to 92 years) who presented 46 shaft fractures of both forearm bones. ⋯ Intramedullary pinning is an attractive alternative for the treatment of shaft fractures involving both forearm bones in adults. Best results are obtained if the fracture (situated outside the 5th sixth) can be stabilized without opening the focus with a single 2.5 mm pin. This method combines the advantages of closed osteosynthesis, that is, a simple nontraumatic procedure decreasing the risk of suppuration, and early return of function, limiting postoperative immobilization. It enables early sturdy bone healing with a low risk of recurrent fracture.
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2008
[Treatment of femoral fracture on previous implants with minimally-invasive surgery and total weight-bearing: benefit of locking plate. Preliminary report].
We report a consecutive prospective series of femoral fractures on previous implants. The purpose was to assess treatment with locking compression plates and total weight-bearing. ⋯ Locking plates have been shown to be an effective treatment for femoral fractures on previous implants allowing a stable fixation sufficient for early weight bearing.
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Traumatic hip dislocation is a rare event in children. Appropriate management remains a subject of debate. The purpose of this study was to investigate the epidemiological, therapeutic features of this situation and the long-term outcome after treatment. ⋯ Traumatic dislocation of the hip joint is rare in very young children, but results from a minimally traumatic event. This suggests the presence of predisposing factors in this category of patients, particularly capsuloligamentary hyperlaxity. After reduction, immobilization can be recommended. Traumatic hip dislocations in children are different from the adult variety due to their rarity, the general absence of associated fractures, easy reduction and better prognosis. The epidemiological and therapeutic features in children older than six years are however similar to those in adults.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 2007
[Total hip arthroplasty after hip arthrodesis performed for septic arthritis].
Revision total hip arthroplasty (THA) after hip arthrodesis is an uncommon and challenging operation. The task would appear to be even more difficult if the arthrodesis was performed because of septic arthritis due to the theoretical risk of recurrent infection. We report our fifteen-year experience. ⋯ An earlier history of infection does not appear to be a contraindication for implantation of a total hip arthroplasty after hip arthrodesis. Despite the long recovery period and the modest gain in joint motion, 80% of patients were satisfied after having had a blocked hip for 36 years on average.