Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2007
Multicenter Study[The floating knee: a retrospective analysis of 172 cases].
A retrospective multicentric observational study of 172 floating knee injuries is reviewed. According Fraser's classification 71.5% of the cases are type I and the repartition of the type II in the 3 subgroups is as follow: II A 8.2%, II B 11.6%, et II C 8.7%. At least one of the fractures was open in 69.2% of the patients. ⋯ According the functional score of Karlström and Olerud, 23 patients were rated as excellent, 38 as good, 35 as fair and 20 as bad. The contributing factors influencing bad functional outcome are the age, a type II lesion, a femoral fracture located at the distal third, and an open fracture. The IM using a single knee incision does not show in this series better results but the shortening of the operating time was highly significant.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2007
[Reconstruction of long bone defects with a vascularized fibular graft after tumor resection in children and adolescents: thirteen cases with 50-month follow-up].
The vascularized fibular graft is a widely used technique for the reconstruction of long bone defects after tumor resection. Complications are not uncommon despite the presence of a good vascular supply. We report our experience with long bone reconstructions in children and adolescents after resection of primary malignant bone tumors. ⋯ Long bone reconstruction using an autologous vascularized fibular graft is a reliable technique providing satisfactory functional results. Complications can be prevented by making solid fixation and using a corticocancellous graft creating a favorable osteoinducing environment. A massive allograft is another solution providing good immediate mechanical stability.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2007
[Can the postoperative pain level be predicted preoperatively?].
We searched for factors present preoperatively which could be used to predict the intensity of postoperative pain. ⋯ Significant postoperative pain can be expected in the following situations: pain after prior surgery, presence of chronic pain sustained for more than six months, intense preoperative pain, state of depression.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2007
Comparative Study[Low accuracy of the anterior pelvic plane to guide the position of the cup with imageless computer assistance: variation of position in 106 patients].
The anterior pelvic plane, also called the Lewinnek plane, is commonly used as the reference plane to guide imageless computer assisted surgery for total hip arthroplasty (THA) because this plane is considered to be globally vertical in the standing position. To our knowledge, no study has evaluated this hypothesis or the potential variations in orientation as a function of gender, position of the subject, or THA insertion. The purpose of this work was to examine these different hypotheses in a radio-clinical study. ⋯ Variations in the orientation of the anterior pelvic plane in relation to the vertical would suggest that this plane is not a reliable reference. To our knowledge, there is no reliable reference which can be easily identified during the operation which would take into account variations in the position of the pelvis. We thus believe it would be preferable to attempt to operate without a reference plane, relying on a more kinematic approach to guide computer-assisted implantation of the THA cup.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2007
Case Reports[Bizarre parosteal osteochondromatous proliferation (Nora's lesion): two cases].
The lesion Nora described in 1983 as a bizarre parosteal osteochondromatous proliferation (BPOP) is a member of a group of osteocartilaginous surface lesions. BPOP is infrequent but new cases are regularly reported. We report two new cases with an unusual localization (ilion and distal humerus) and unusual size (9 cm for the iliac lesion). In light of these cases and reports in the literature, the main differential diagnoses of BPOP are exostosis and parosteal osteosarcoma.