Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2006
Clinical Trial[Retrograde locked nailing of humeral shaft fractures: a prospective study of 58 cases].
Appropriate treatment for humeral shaft fractures remains a debated issue. Among the classical osteosynthesis techniques proposed, closed nailing was adapted to the humerus rather late, using the anterograde method. Use of retrograde nailing, which spares the rotator cuff, is more recent. The purpose of this study was to report outcome in 58 humeral shaft fractures in adults treated using the universal humeral nail between January 2000 and December 2003. ⋯ Retrograde insertion of this nail facilitates treatment of humeral shaft fractures by allowing immediate joint motion and the advantages of closed reduction: no infection, no late bone healing requiring conversion to another method of fixation. The residual technical problems concern proximal nailing and nail introduction.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 2005
Randomized Controlled Trial Comparative Study[Pertrochanteric fractures: a randomized prospective study comparing dynamic screw plate and intramedullary fixation].
The objective of this study was to compare the dynamic hip screw (Synthes) and intramedullary fixation (Targon PF, Aesculap) for the treatment of pertrochanteric fractures in terms of stability, complications and cost effectiveness. ⋯ Data in the literature report an advantage for intramedullary nailing, particularly a mechanical advantage, for the treatment of pertrochanteric fractures. Our findings show that good results are obtained with the screw-plate fixation using the DHS with less blood loss and at a lower cost.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2005
Case Reports[Scapulohumeral arthrodesis for non-neurological shoulder: a study of 8 cases].
Scapulohumeral arthrodesis is mainly used for the treatment of sequelar injury after brachial plexus palsy. Indications are however controversial and limited to patients with non-neurological shoulders. We report a series of eight shoulder arthrodeses performed on non-neurological shoulders in order to determine and detail the current role of this procedure. ⋯ Shoulder arthrodesis is more than a salvage method to reduce pain and gain stability. The objective should be to recover useful function (hand-mouth, hand-perineum, brachio-thoracic function). It should be used when prosthetic arthroplasty is not possible (infectious arthritis, advanced degenerative disease in young subjects, loss of glenoid bone stock, failure after treatment of multidirectional instability with degenerative disease). Shoulder arthrodesis still has rare indications because of the predictability of sustained outcome.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2005
Clinical Trial[Impaction posterior wedge osteotomy for the treatment of postsurgical flatback: 22 cases].
There is increasing interest in sagittal balance as an important element when planning treatment of spinal deformations. Posture disorders, particularly flatback, can be observed after surgical treatment of scoliosis. The frequency of flat back syndrome has increased with the development of spinal surgery. ⋯ The literature on osteotomy for the treatment of flat back is sparse. Our series of subtraction osteotomy is the largest reported to date. Preoperative and intraoperative planning remain a topic of debate and require further study.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2005
[Single-plane external fixation of fresh fractures of the femur: critical analysis of 53 cases].
External fixation has not been widely used for femoral fractures and few series are reported in the literature. External fixation is generally reserved for severe open fractures, for vessel injury or multiple trauma with life threatening. We present a retrospective analysis of a serie treated in a single center in order to detail the indications of this fixation technique. ⋯ External fixation remains the only solution to stabilize certain open diaphyseal fractures or for patients with life-threatening multiple injuries. This techniques allows control of the other traumatic lesions while waiting for internal fixation. For fractures of the distal femur, external fixation can only be advocated for metaphyseodiaphyseal fractures with an intact or reconstructed epiphyseal portion.