Annales de chirurgie
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Annales de chirurgie · Jan 1998
Historical Article[One hundred years of bone surgery in the Lyons Teaching Hospitals (1897-1997)].
Throughout the XIXth century and until 1945, bone surgery focused primarily on correcting deformities in children. The treatment of injury-related bone lesions in adults (compound fractures and dislocations) remained within the province of general surgeons until circa 1970. Lyons played a unique role in the XVIIIth and XIXth centuries, for three reasons. 1) The term "orthopedics" (which means "straight children", or "children to be made straight") was coined in 1743 by an 80-year-old inhabitant of the Saint Nizier parish in Lyons, Nicolas Andry or André, a former dean of the Paris School of Medicine. ⋯ Although societies for surgery of the hip, knee, spine, hand, foot, and so on now exist, meetings of the Lyons Society for Bone Surgery remain useful since new ideas and techniques sometimes stem from experience acquired in other fields. It is worthy of note that in other European countries traumatology is a specialty in itself, which includes visceral and bone traumatology. It can be anticipated that harmonizing the traumatology specialty in Germay and the orthopedic surgery and traumatology specialty in France may raise a number of problems.
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In the nineteenth century, introduction of the first inhaled general anaesthetic (Long, 1842) induced a further search for new types of anaesthesia: carbon dioxide, petroleum ether, derivatives of ethylene, acetone, methyl dichloride, and the study of a new technique-hypnosis. Only chloroform, ether, nitrous oxide were used. Towards the end of the century, ether became the mainstay of inhaled anaesthetics. The other routes of administering anaesthetics (rectal, venous, spinal, local) appeared around 1860.
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Annales de chirurgie · Jan 1998
Historical Article[The origins of the National Academy of Surgery].
The French Academy of Surgery was not created easily largely due to the frequent quarrels between physician and surgeons. Founded in 1731, it experiented many trials and tribulations for three centuries. Disbanded in 1793 by the Convention, it was transformed into Société Nationale in 1843 and only regained the name of Académie in 1935.
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Annales de chirurgie · Jan 1998
[Isolated splenic trauma in adults: value of Resciniti's CT scoring system to define the indications for surgery].
The data of 62 adult patients with isolated blunt splenic trauma were retrospectively analysed to determine the value of a CT score-system in the choice of treatment: nonoperative treatment versus surgical management. 22 patients (35%) without hemodynamic instability presenting with pain localized in the left flank were primarily managed conservatively. 3 of them subsequently required splenectomy. 40 patients (65%) were operated immediately, 32 on the basis of clinical criteria and 8 on the basis of laboratory criteria. 45 patients with no initial haemodynamic disorders were investigated by abdominal CT-scan. Splenic injuries were retrospectively classified according to Resciniti's CT-scoring system. 13 patients had a splenic injury score > or = 5.5. All of them were operated, 11 early and 2 after failure of conservative management. According to our study this score > or = 5.5, which concerns 21% of our patients, can be considered to be an indication for surgery; in this case, a conservative approach should not be at tempted, even in the absence of immediate clinical and laboratory operative criteria.