Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
Review Multicenter Study[Fractures of the anterior rim of the distal part of the tibia. Apropos of a series of 38 cases].
Fracture of the anterior rim of the distal tibia is a rare injury. This fracture seems less serious than other pilon fractures but its treatment is often difficult and didn't give better results. The aim of this study was to describe problem we dealed with and to suggest solutions in order to improve long term results. ⋯ Better results should come from a better analysis of the bone lesions : separation, impaction or mix fracture. This analysis leads to appropriate surgical procedure which give back a stable and anatomic distal tibia. External fixation can be usefull for immobilization ; this can't avoid open reduction and internal fixation of the fracture. Bone grafting can be useful for impaction fracture.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Reconstruction of digital pulp by pulp tissue transfer of the toe. Apropos of 15 cases].
The authors report their experience of digital pulp reconstruction by free toe pulp transfer. Fifteen patients were treated with the lateral great toe hemipulp. ⋯ A wide range of procedures from spontaneous healing to thenar flap, neuro vascular flap or toe pulp transfer can be proposed to treat digital pulp loss. In the case of moderate thumb pulp avulsion and homodigital volar flap can be proposed; if microsurgery is contra-indicated, an hetero-digital flap from the index can be performed. When the other fingers are concerned, a homodigital flap can be proposed for moderate defects. For more important trauma, the thenar flap is convenient to cover the index and the medius pulp. Ring and little fingers can be treated by a reverse digital artery flap or by a cross finger flap. When a toe pulp transfer is indicated we recommend the lateral great toe hemipulp for the thumb and a second or third toe pulp transfer for the other fingers when digital vascular anastomosis are possible. The great toe hemipulp transfer represented a good indication for complete digital pulp loss reconstruction where the thumb is concerned. Performing this reconstruction during the acute phase may improve the management of those trauma by reducing the time needed for cicatrisation and the length of work inability.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Results of posterior lumbar intersomatic fusion in the treatment of isthmic spondylolisthesis. Apropos of 27 cases followed over more than 10 years].
Posterior lumbar interbody fusion (PLIF) as described by Cloward, with laminectomy of the entire separate neural arch in spondylolisthesis, is a difficult operation. The purpose of this study is to evaluate the results of PLIF with autologous bony graft, without reduction or instrumentation in grade I and II spondylolisthesis. ⋯ This study confirms the good results obtained by PLIF with nerve roots decompression in spondylolisthesis. Fusion is stable and does not accelerate degenerative lesion of the upper disc.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
Case Reports[Disruption of the pubic symphysis with overriding impacted symphysis. Apropos of a case].
The authors report one case of overriding impacted symphysis by lateral compression injury of the pelvis. ⋯ This lesion is secondary to lateral compression injury with internal rotation of the right part of the pelvis. It can be classified in type B2 of Tile's classification. It is a rare condition because this mechanism very often leeds to a fracture of the pelvic ring.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Osteosynthesis of tibial valgus osteotomies by goniometric CH-N external fixator].
The authors present technique and results of a new external fixator, the < < goniometric > > external fixator CH-N for osteosynthesis of high tibial osteotomy for arthritic varus knee deformity on 86 kness (75 patients). ⋯ The principle of this special < < goniometri > > external fixator is based on the < < goniometric > > central joint in the frontal plane, this allows to guide the screws during osteotomy in the predesigned position and to control the correction during and after the procedure, in contrary to the others current system either internal or external. Any faulty correction can be modified. With its distal screwing axis, it allows axial dynamization. There are only some but not serious incoveniences due to the application of pins (temporary neuromuscular problems and pin-track infections.