Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2005
[Recent fractures of the radial head associated with elbow instability treated with floating Judet prosthesis].
Fracture of the radial head associated with elbow instability is infrequent. We report a retrospective series of floating Judet prostheses implanted for comminutive fractures of the radial head associated with elbow laxity caused either by dislocation or rupture of the medial collateral ligaments. ⋯ The floating Judet prosthesis allows optimal adaptation of the implant to anatomy and function. For us, these implants are indispensable when the radial head fracture is associated with elbow instability. The indication for prosthesis may be questionable if the non-fixed fracture is free of associated ligament injury, as suggested by the good long-term reported after simple resection. Rigorous operative technique is crucial, with careful restitution of the radial height. The quality of the result is related to the degree of capsule and ligament injury even after optimal implant positioning. Preventive treatment against periarticular ossification should be systematic.
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Rev Chir Orthop Reparatrice Appar Mot · Jun 2005
[Complications of surgical treatment of spinal deformities: a prospective multicentric study of 3311 patients].
The incidence of complications secondary to surgical treatment of spinal deformations remains imprecise. The purpose of this prospective multicentric observational study was to assess the incidence of intra- and postoperative complications secondary to this type of surgery to detail the observed complications and to identify favoring factors. ⋯ This work enabled us to determine the overall rate of complications after surgical treatment of spinal deformations. Certain risk factors related with complication occurrence were identified, but the heterogeneous nature of the population and the methodology used to identify these factors only allowed detection of trends. A future study by etiological group or focusing on specific complications should allow a more precise analysis of these risk factors. This overall rate of complications should be used to better inform patients and their family about the risks of this type of surgery.
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Rev Chir Orthop Reparatrice Appar Mot · May 2005
Clinical Trial[Tibia nonunion after intramedullar nailing for fracture: decortication and osteosynthesis by medial plating].
Intramedullar nailing is now widely used for fractures of the tibia. Extension of nailing indications to proximal, distal, and comminuted fractures has led to a significant rate of complications. The purpose of this study was to analyze decortication and medial plating for the treatment of tibial nonunion after intramedullary nailing. ⋯ Decortication and medial plating was a safe and efficient treatment for tibia nonunion after failure of intramedullary nailing and allows better reduction and repeated nailing.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2005
[Total hip arthroplasty after treatment of acetabular fracture].
The aim of this retrospective analysis was to examine complications and technical difficulties observed during implantation of total hip arthroplasty (THA) after treatment of an acetabular fracture. ⋯ Despite the high rate of complications, the mid-term results were good, encouraging us to continue this procedure as the first intention treatment using either a press fit cup with or without an autograft, or a cemented cup with a metal ring (Kerboull or Burch-Schneider).
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2005
Comparative Study Clinical Trial[Prevention of heterotopic ossifications in hip arthroplasty: effectiveness of selective Cox-2 inhibitors (celecoxib) versus ketoprofen].
Peri-prosthetic ossifications are a frequent complication of total hip arthroplasty, which, if effective preventive measures are not taken, occur in 60% of patients. Numerous classic antiinflammatory agents have shown their preventive efficacy. New selective Cox-2 inhibitors offer the possibility of reducing the adverse effects of antiinflammatory drugs but remain to be proven effective in this indication. The purpose of this pilot study was to compare the efficacy of celecoxib versus ketoprofen. ⋯ These findings appear to indicate an equivalent efficacy for celecoxib and ketoprofen for the reduction of peri-prosthetic ossifications. Based on these results, a randomized prospective comparative study can be undertaken without risk of losing effective prevention in one group. This prospective study should enable a more precise evaluation of treatment equivalence and quantify any potential gain in morbidity obtained with celecoxib.