Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jun 2002
[Fresh fractures of the radial head: results with the Judet prosthesis].
Communitive fractures of the radial head are a therapeutic challenge when fixation is not possible. Secondary sequelae including ulnar valgus, ascension of the radius, osteoporosis of the humeral condyle and biomechanical impairment of the elbow cannot be avoided with resection or the Swanson prosthesis. The Judet prosthesis, with its floating cup, is a technically attractive solution, but the question is whether it can avoid the secondary effects observed with resection or the Swanson prosthesis. ⋯ Our results with the Judet prosthesis were much better than those reported in the literature for resection and Swanson prosthesis.
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Rev Chir Orthop Reparatrice Appar Mot · May 2002
[Correlation between osteoporosis and types of fractures of the proximal femur: clinical and X-Ray study of 284 cases].
Proximal femoral fractures are the most severe medical and social consequence of osteoporosis. The bone loss in the proximal femur can be assessed with the Singh Index, which represents a cheap and reproducible method and which quantifies the osteoporosis on a 1-6 scale. The purpose of the study is to correlate the Singh Index with the anatomical forms of fracture (extra and intracapsular) in a series of patients. ⋯ In this series patients with extracapsular proximal femur fractures show a lower Singh Index compared to the intracapsular types (p=0.03). The choice for the type of osteosynthesis or arthroplasty should take into account the mechanical solidity of the femur.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2002
Comparative Study Clinical Trial[Anterior cruciate ligament reconstruction: patellar tendon autograft versus four-strand hamstring tendon autografts. A comparative study at one year follow-up].
The purpose of our study was to compare outcome at one year after anterior cruciate ligament reconstruction for chronic laxity using the patellar tendon autograft or four-strand hamstring tendon autografts. ⋯ These two surgical techniques provide good functional outcome at one year with better control of laxity with patellar tendon autografts and better relief of pain with four-strand hamstrings autografts. Longer follow-up would be useful to assess laxity long after hamstring reconstruction. We compared the type of transplant and the fixation method together as a single unity, but progress in four-strand hamstring autograft fixation will certainly allow even more optimal results and improved correction of laxity. In our opinion, the patellar tendon autograft remains the gold standard for high-performance athletes practicing a contact-pivot sport, but both types of ACL reconstruction are most useful. We select patients for four-strand hamstring tendon reconstruction as a function of age, sex, and type of sports activities.
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2002
[Femoral shaft fractures in the elderly treated by intramedullary nailing].
Little work has been devoted to femoral shaft fractures in the elderly, contrasting with the data available for proximal neck or trochanteric fractures. The purpose of this study was to determine the epidemiological and clinical features of femoral shaft fractures in the elderly from a retrospective series of 58 patients who underwent locked intramedullary nailing procedures with Grosse and Kempf (GK) or long gamma (GL) nails. ⋯ The general and functional prognosis of femoral shaft fractures in the elderly is the same as for proximal fractures. These diaphyseal fractures can be individualized due to their characteristic mechanical and anatomic features: composite fracture with a rotation element involving the distal portion of the trochanter and the proximal quarter of the diaphysis. Several types of ostheosynthesis have been proposed for fixation. Locked intramedullary nailing has been found to be effective despite the difficulty in reduction, especially for particularly proximal fractures. There is a risk of iterative fracture in the transition zones between the femoral component and the osteoporotic bone.