Annales de chirurgie
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Annales de chirurgie · Jan 1994
[Open fractures caused by gunshot in civilian practice. Apropos of 31 cases].
The authors report their experience of the treatment of 31 gunshot open fractures in civilian practice. The fractures, comminuted in two thirds of cases, were produced by various fire-arms. ⋯ The were also 7 cases of delayed union, 3 mal unions and 7 cases of joint stiffness. To improve the prognosis of these lesions, the authors emphasize that surgeons must be familiar with ballistic wounds and carry out an early initial and appropriate treatment.
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A prospective study was conducted to determine the best position of patients undergoing esophageal hiatus surgery. Three positions were compared: 1) use of a cushion; 2) use of the operating table block, and 3) the ordinary supine position. ⋯ The angle determined by the xiphoid process and a horizontal line passing through the hiatas area was 14 degrees and 8 degrees, more when the cushion and the block were used, respectively, as compared with the supine position (p < 0.01). We recommend the use of the cushion in hiatal surgery, affording better exposure and therefore a more comfortable approach to the hiatal area as compared with the supine position.
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This article is a review of recent data concerning: plexus and peripheral nerve blocks for the upper and lower limbs, intravenous regional anesthesia, and medullary, epidural and spinal anaesthesia. We have focused on the advantages and disadvantages of each technique which should be taken into account for their selection. Regional anaesthesia techniques are not without risks, and advantages are perhaps not as obvious now as was reported in the past, especially in the case of medullary spinal or peridural anaesthesia.
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The authors report one case of bilateral traumatic dislocation of the testes. A rapid analysis of literature enable to emphasize the usual mechanism (motorcycle accident), different anatomic types and therapeutic behaviour; immediate closed reduction and more often, surgical orchidopexy.
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Annales de chirurgie · Jan 1993
Case Reports[Para-hiatal gastric strangulation after Toupet's operation].
An exceptional case of incarcerated para-hiatal hernia with gastric necrosis, developing 7 years a Toupet procedure, is reported. To our knowledge, this is the first reported case of this complication after a surgical anti-reflux procedure without diaphragmatic counter incision. The mechanism, diagnostic difficulties and treatment are discussed.