Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jun 2002
[Reposition flap techniques in fingertip amputations: 6 cases].
The purpose of this study was to evaluate an alternative procedure for amputations distal to the distal interphalangeal joint: the reposition flap. ⋯ Fingertip amputations have been widely reported. Methods have varied from directed scarring to partial toe transfer. These situations present two types of challenge: insensitivity of the volar aspect or an overly sensitive pulp; cosmetic presentation and function of the dorsal aspect due to the complex role of the nail. Distal reimplantation remains the best technique, but the reposition flap offers an interesting alternative in case of failure or for patients who do not accept finger shortening. The advantage of the reposition flap is that it preserves finger length and the nail. Work stoppage and intolerance to cold can be an inconvenience due to the long time required for wound healing.
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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
[Thoracic scoliosis: exothoracic and endothoracic deformations and the spinal penetration index].
We reviewed retrospectively our patients with thoracic lordoscoliosis and conducted a conceptual analysis of the patients with airway compression and atelectasia due to anterior protrusion of the vertebral bodies in order to describe the pathological conditions involved and the management methods used. Our goal was to develop a new concept for quantifying thoracic deformation. The individual cases discussed here have been reported earlier, but this is the first series analysis to date. ⋯ The spinal penetration index is an important morphological index of thoracic anatomy that measures the real volume of the functional thoracic cavities and which must be differentiated from vital capacity which measures both volume and function. This index can be used for pre- post-operative comparisons and constitutes a first step in 3-D assessment of thoracic spine deformations. It can also be used to classify spinal deformations and to make general recommendations concerning the management of both endothoracic humps and exothoracic rib humps.