Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
-
Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
Review Case Reports[Atlanto-axial instability in children with trisomy 21: atlanto-axial (C1-C2) or occipito-axial (O-C2) arthrodesis?].
A retrospective study involving seven cases of operated atlantoaxial (C1-C2) instability in patients with Down Syndrome prompted the authors to raise the following question: which kind of arthrodesis is to be performed for these patients? The possibility of an occipito-atlantal (O-C1) instability, is in fact relatively frequent in this condition, as the authors have observed themselves and in a literature survey; this is an argument for performing an occipito-axial (O-C2) arthrodesis. The difficulties met to reduce the C1-C2 luxation, the frequent pseudarthroses (3 cases in our series) and a tetraplegia following a re-operation for non-union are as many other arguments to perform a O-C2 arthrodesis rather than a C1-C2 arthrodesis.
-
Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
Case Reports[Rupture of the pectoralis major muscle: diagnosis and treatment. Apropos of 3 cases].
Rupture of pectoralis major tendon is a rare lesion, often undiagnosed. We present 2 cases of complete rupture and one case of partial rupture. ⋯ We recommend surgical repair of pectoralis major rupture, a lesion that remains symptomatic in the long term. Surgery should be done early, late repairs being technically more difficult and esthetic result less convincing.
-
Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
Review Case Reports[Dislocation of the tibialis posterior tendon].
The authors report a case of traumatic dislocation of the tibialis posterior tendon on the medial malleolus. They describe the treatment applied and made a review of the literature about this rare pathology.
-
Rev Chir Orthop Reparatrice Appar Mot · Jan 1992
[Cotrel-Dubousset instrumentation in the treatment of thoracolumbar and lumbar spine fractures].
Thirty-three thoracolumbar and lumbar spine fractures have been operated on using Cotrel-Dubousset instrumentation. Most were thoracolumbar burst fractures. Regional kyphosis at follow-up was 4 degrees, vertebral kyphosis was 8 degrees. ⋯ This construct with screws varies according to the level (thoraco-lumbar or lumbar); it seems reliable, as compared with other kinds of internal fixation. Restoring the height of the vertebral body is essential and is the key to a good final result. Addition of a postero-lateral fusion and or a brace did not improve the results.
-
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.