Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
Case Reports[Instability and misdiagnosed or neglected dislocations of the upper cervical spine in children. Apropos of 20 cases].
Neglected instabilities or luxations of the upper cervical spine in children are rare if one discards conditions such as chondrodysplasia, Down Syndrome or others, were the spine is known to be at high risk of instability. We have studied twenty cases of neglected luxations and the delay in diagnosis is explained either by the asymptomatic character of some of these lesions, or by the difficulty in diagnosis. At the occipito-atlantal level we have reviewed: an instability in translation which required an occipito-axial fusion; two compensatory counter occipito-atlantal luxation of an atlanto-axial rotatory fixation. ⋯ Their diagnosis was made on routine X-rays, but the complete or incomplete aspect of the luxation, as well as its fixed aspect, was best appreciated with dynamic CT scan. Their treatment was always started with collar neck or halo traction in order to obtain, reduction of the dislocation, or at least the disparition of the torticollis and the head straight up on shoulders. The stability of the spine was achieved with a minerva cast jacket, halo cast or spine fusion depending on the case.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
[Plexus nerve blocks for postoperative analgesia after orthopedic surgery of the lower limbs].
In our institution, plexus nerves blocks have been performed in seventy patients after lower limb surgery. The technique is considered as simple and reliable. The administration of a 0.375 per cent bupivacaine epinephrine containing solution allows to obtain analgesia longer than 15 hours in 45 p. 100 of the patients, devoided of side effects. Lower limb plexus nerves blocks appear as an efficient technique for postoperative analgesia following orthopaedic surgery.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1991
Review[Arthroscopy of the shoulder with the patient in beach-chair position].
The authors describe a technique of arthroscopy in the "beach chair" position, that they have exclusively used since 1989. The classical setting in lateral decubitus takes a long time and can be the cause of complications especially neurological due to the traction. ⋯ Another advantage is the quick and easy setting; the locoregional anesthesia is easy to use, it is possible to practice an open surgery without changing the setting. All these advantages lead the authors to propose this position for all arthroscopy of the shoulder whether diagnostic or therapeutic.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1990
[Traumatic C1-C2 luxation in children. Prognostic study and therapeutic indications apropos of 13 cases].
The authors reviewed the cases of 13 children with C1-C2 traumatic dislocations. A particular interest was given to the elements which seemed to have an influence on the conservative treatment. ⋯ Pure rotatory dislocations generally occurring after a slight trauma healed thanks to a strict and necessarily early immobilization. On the contrary anterior dislocations due to violent traumas and all C1-C2 dislocations which treatments were delayed required an arthrodesis.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1990
[Posterior sternoclavicular luxation. Apropos of 6 cases].
The authors have reviewed six retro-sternal dislocations of the clavicle. The indirect mechanism of this dislocation was in 3 cases, due to sport accidents (rugby). ⋯ The surgical reduction revealed lesions of the meniscus which were found in 3 cases out of 6 and allowed one to realize a plastic operation using the tendon of the subclavian muscle (4 times out of 6) in order to stabilize by sternoclavicular joint, as well in recent injuries as in old ones. The results were satisfactory.