Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Sep 1998
Comparative Study[Static instability and dislocation of the 2nd metatarsophalangeal joint. Comparative analysis of 2 different therapeutic modalities].
The authors report the results of instabilities and dislocations treatment of the second metatarsophalangeal joint using two different surgical methods. ⋯ The better the relative length abnormality is corrected, the better is the prognosis after treatment.
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Rev Chir Orthop Reparatrice Appar Mot · May 1998
[Surgery of the spine in Duchenne's muscular dystrophy].
The authors present a retrospective review of 27 patients presenting a Duchenne muscular dystrophy and who were operated for spinal deformity, with special reference to functional result and postoperative evolution of vital capacity. ⋯ Spinal surgery in Duchenne muscular dystrophy has a low morbidity. It allows to keep sitting position to the child and to preserve quality of life. Surgery should be considered as soon as frontal or sagittal collapse of the spine is observed. However surgery does not result in respiratory improvement nor in life duration lengthening.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 1998
Review[Fractures of the tibial pilon. Long-term retrospective study of 51 fractures treated with open reduction and osteosynthesis].
Fracture of the tibial pilon is a rare injury and its treatment remains difficult. The aim of this study was to report the complications and long term results of internal fixation using a technique which respects soft tissues and in which little material was used. ⋯ Analysis and comparison of study reports are difficult because of the absence of consensus in classification system and evaluation methods. The AO-classification, apparently the most objective, will probably be more and more used in the future. Treatment must be adapted to the bony lesion and soft tissue damage. Open reduction and internal fixation must be reserved for a specific group of lesion.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 1998
Case Reports[Plantar dislocation of the tarso-metatarsal articulation (Lisfranc articulation). Apropos of a case].
Plantar fracture-dislocation of the tarso-metatarsal joint (Lisfranc plantar fracture-dislocation) is rather unusual. The authors described a case sustained in a 39 years old man injured in a motorcycle road traffic accident. Mechanism was recognized as plantar hyperflexion combined with an axial foot compression. ⋯ In an additional anatomical study on 8 cadavers, the plantar direction of a fracture-dislocation of the tarso-metatarsal joint was observed when the injury axis followed the scapho-cuneiform joint of the inner border of the foot and the cuboïdo-metatarsal joint on the lateral border, so that both tibialis muscles were fixed on the distal fragment. As tibialis posterior muscle is more powerful, the direction of the dislocation will be plantar. This type of injury is different from plantar fracture-dislocation of the tarso-metatarsal joint secondary to direct load bearing on the dorsum of the foot with severe skin and vessels injuries.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 1998
[C5-C6 and C5-C6-C7 traumatic paralysis of the brachial plexus of the adult caused by supraclavicular lesions].
In C5-C6 and C5-C6-C7 brachial plexus palsies, prognoses was based on the recovery of a useful shoulder and elbow in order to control a normal or partially impaired hand. Treatment was an integrated procedure combining direct nerve surgery and muscle transfers. ⋯ In C5-C6 palsies, elbow flexion is a goal which must be reached in 100 per cent of cases. Prognosis depends of shoulder function. In C5-C6-C7 palsies, results are less good. 6 patients did not recover elbow flexion, no active mobility of the shoulder was observed in 63 per cent of them. The results obtained for elbow flexion are satisfactory if the program does not separate nerve surgery and muscle transfers.