Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2002
[Total hip arthroplasty without cement in children and adolescents: 17 cases].
Hip disease can produce major pain and functional disorders in children who should benefit from total hip arthroplasty. We report our experience with total hip prostheses implanted without cement in children. ⋯ The question on whether or not total hip arthroplasty should be performed early in these children to avoid osteotomies which could alter the longevity of a future prosthesis remains open. Custom-made stems inserted without cement have provided satisfactory results in our experience. To date, follow-up is too short to compare our results with those obtained by others using cemented stems.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2002
[Reconstruction-arthrodesis of the first metatarsophalangeal joint iatrogenic bone defects].
Arthrodesis-reconstruction for metatarsophanlangeal bone defects of the great toe after hallux valgus or hallux rigidus is rarely performed and only a few series are found in the literature. In these series, retarded bone fusion, skin rupture, and interphalangeal intolerance (both clinically and radiologically) have been frequent. The purpose of this work was to determine what parameters contribute to minimizing these postoperative risks. ⋯ Correct position of the arthrodesis is essential to alleviate transfer metatarsalgia. A moderate lengthening of the great toe can minimize the risk of skin rupture. In order to preserve the interphalangeal joint, the position of the arthrodesis must be precise both in the sagittal and horizontal plane, leaving sufficient valgus and avoiding the need for temporary interphalangeal pinning.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2002
[Systematic circumferential (360 degree) decompression treatment of major arthrotic cervical stenosis].
Worsening and irreducible evolution of neural involvement in cervical stenosis requires cord decompression. Different techniques have been proposed. We associated a dual posterior then anterior approach to achieve 360 degrees decompression. We evaluated results on the basis of neurological and mechanical outcome. ⋯ 360 degrees arthrodesis for severe cervical canal stenosis provides a satisfactory solution to mechanical problems and substantial neurological improvement. Fusion is regularly obtained without complementary anterior instrumentation. Neurological improvement is correlated with disease duration and the degree of deficit at onset. Anteroposterior decompression and 360 degrees fusion provide cure for all the components of stenotic disease. The dual approach is indicated in severe cases with cord involvement as recognized by myleopathic clinical manifestations and on the MRI.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2002
[Total hip arthroplasty and femoral head osteonecrosis in renal transplant recipients].
Osteonecrosis of the femoral head is reported in a very variable proportion of renal transplant recipients. When these patients require total hip arthroplasty (THA), immunosuppression and poor bone quality increase the risk of aseptic loosening and infection. In the literature, functional outcome has been satisfactory although rates of early and late complications have varied greatly. The purpose of our work was to determine the long-term outcome in a series of renal graft recipients who underwent THA for osteonecrosis of the femoral head. ⋯ THA enables good functional outcome for renal transplant recipients suffering from osteonecrosis of the femoral head, but at the cost of a high risk of early and long-term complications not always reported in the literature.