Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2000
Review[Tibial fracture with intact fibula treated by reamed nailing].
The main difficulties encountered in the orthopedic treatment of leg fractures with intact fibula are reduction of the tibial and an unusually high rate of varus unions and non-unions. The aim of this retrospective study was to assess the outcome after reamed nailing of tibial fractures with an intact fibula. ⋯ Nailing is a reliable technique for the treatment of tibial fractures with an intact fibula. Weight bearing should be encouraged as early as possible. The indication for a locked nail depends on the anatomic type of the tibial fracture and its localization. Immediate weight bearing should be recommended. Strict surveillance allows dynamization with fibulotomy in case of late consolidation. Prospective randomized studies comparing nailing with other therapeutic methods are needed to confirm these data.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 1999
Review[Repair of cartilage defects. Technical aspects].
Efficacious treatment of chondral and osteochondral defects of the weight bearing surfaces represents a real challenge for the orthopaedic surgeon. Treatment options for full thickness cartilage defects are discussed in this paper. Poor biomechanical characteristics of the reparative fibrocartilage promoted by "traditional resurfacing techniques" provide only moderate clinical outcome in the treatment of such lesions. ⋯ There are less experiences with the clinical use of periosteal and perichondrial resurfacing techniques and biomaterials. Beside the promising early and medium term results of these methods the authors express that a successful treatment of the full-thickness cartilage damages of the weight bearing surfaces depends not only the way of the cartilage repair but on the treatment of the underlying cause as well. According to this statement for an effective treatment of full thickness defects on the weight bearing surfaces requires careful patient selection, complex operative plan and well organized treatment course.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 1999
[Retrospective study of 23 arthrolyses of the elbow for post-traumatic stiffness: result predicting factors].
The goal of the study was to determine the results of elbow arthrolysis for post-traumatic stiffness, and to identify factors governing the result of that procedure. ⋯ The range of motion obtained after arthrolysis performed because of elbow post-traumatic contracture is mainly related to preoperative stiffness. By comparing with postoperative range of motion, a loss of 5 degrees to 10 degrees can be predicted.
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Rev Chir Orthop Reparatrice Appar Mot · Nov 1999
[Zone I and II flexor tendon laceration in children].
The goals of this study is to determine the effect of post-operative management as optimun period of post-operative immobilization, type of immobilization and importance of early mobilization program in zone I and II flexor tendon laceration in children. ⋯ Primary flexor tendon repairs in children in this series achieved satisfactory functional results in comparison with adults. There is however, in the very young, some widely differing results since the necessity of post operative care was not fully appreciated. Immobilization with a short splint should be avoided because of greater complication rate as rupture, especially in very young. We found no benefit of early passive mobilization protocols. Immobilization should not be extend beyond 4 weeks because of deterioration of final functional result.
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Rev Chir Orthop Reparatrice Appar Mot · Nov 1999
[Associated fracture of the posteromedial tubercle and the lateral process of the talus: a case report. Contribution of computed tomography].
Fracture of lateral process of the talus is an uncommon injury, fracture of the posteromedial tubercle of the talus is quite rare, and association of the two lesions is not reported previously. We report a case of an associated fracture of posteromedial tubercle an lateral process of the talus. ⋯ The fracture of the posteromedial tubercle was treated by internal fixation, through a posteromedial approach. At 12 months follow-up the patient was able to walk without pain and radiographic result was excellent (no avascular necrosis of the tubercle and no Arthrosis of subtalar joint).