Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Femoral reconstruction with endosteal bone allografts protected by a metallic mesh in reoperation of total hip prosthesis. 19 cases with an average follow-up of 83 months].
To assess after 83 months of follow-up, the results of 19 femoral revisions carried out according to an original method combining a cemented stem and bone reconstruction by means of impacted-morcelized bone allograft protected by a titanium mesh. ⋯ Satisfactory functional and radiographic results were obtained with this method after 5 to 10 years of follow-up instead of severe preoperative femoral bone stock impairement. Likewise, we observed only one recurrence of loosening diagnosed with the help of digitized X-ray examination. Only one significant (> 3.5 mm) femoral stem migration was detected. Radiographic features of femoral reconstruction were observed but without histologic proof of graft integration. This method uses a longer stem than the "Exeter", but avoids a high rate of femoral stem migration and appears compatible with femoral bone reconstruction.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Anterior spinal fusion by thoracoscopy. A non-traumatic technique].
Video assisted thoracic surgery (VATS) is a new modality which allows visualization of, and access to the intrathoracic organs without thoracotomy. Recently, this technique has been used for anterior thoracic spine approach to perform surgery which previously required standard postero-lateral thoracotomy. The authors report their initial experience of anterior spinal fusion using thoracoscopy and give a detailed description of their surgical procedure. ⋯ This original technique demonstrates that thoracoscopy for anterior thoracic surgery is better for the patients, reducing surgical trauma of the chest wall and to the lung parenchyma (in term of post operative comfort, sh
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Prevention of hemorrhagic complications in the lateral retinacular section of the patella. A study of the lateral arteries of the knee applied to the prevention of knee hemarthrosis].
Arthroscopic lateral retinacular release is one of the most employed procedures for patellar chondromalacia. A literature review show a complication rate of 10 to 18 p. 100 of postoperative hemarthrosis. This work aims to study the vessels anatomy of the lateral side of the knee in order to find anatomical landmarks allowing to avoid or coagulate them. ⋯ Following this anatomical study, we suggest, as a supplementary precaution, a selective hemostasis of the lateral superior genicular vessels through a small incision associated with the location of the lateral inferior genicular vessels by cutaneous transillumination.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
Review[Proximal femoral fractures in patients over 75 years. Vital and functional prognosis of a cohort of 78 patients followed during 2.5 years].
The purpose of this study was to highlight factors influencing vital and functional prognosis at 2.5 years of elderly people being treated for a proximal femoral fracture. ⋯ Therapeutic choices can only be guided by assessments of patients' vital and functional prognosis. A sophisticated or even expensive device should be demanded for patients with favorable prognosis. For patients with precarious functional and vital prognosis, priority should be given to less invasive techniques with immediate walking. The cost of the device should be correlated with patient's functional investment.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Severe motor weakness associated with lumbar spinal stenosis. A retrospective study of a series of 61 patients].
Severe motor weakness is a rather infrequent symptom in the course of lumbar stenosis. The objectives of this study are three fold: describe the motor deficit, evaluate the prognosis factors and determine the type of stenosis the most likely to be complicated by motor loss. ⋯ No study dealing specifically with the postoperative outcome of motor deficit caused by lumbar stenosis has been published. However the rate of motor recovery (complete or partial) disclosed in our series is comparable with that found in other series dealing more generally with the overall post-surgery outcome. At our last follow-up, 82 per cent of our patients were considered as having an excellent or good result. It can be concluded that the existence of a motor deficit is not a major pejorative factor of the overall final functional result. Motor weakness is more frequently observed in elderly patients, in cases with degenerative spondylolisthesis, or when a discal herniation is associated with a bony compression. Chances of recovery are better, when the deficit is monoradicular, when the stenosis is focal, or associated with a discal herniation and when the patient is relatively young.