Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Severe motor weakness associated with lumbar spinal stenosis. A retrospective study of a series of 61 patients].
Severe motor weakness is a rather infrequent symptom in the course of lumbar stenosis. The objectives of this study are three fold: describe the motor deficit, evaluate the prognosis factors and determine the type of stenosis the most likely to be complicated by motor loss. ⋯ No study dealing specifically with the postoperative outcome of motor deficit caused by lumbar stenosis has been published. However the rate of motor recovery (complete or partial) disclosed in our series is comparable with that found in other series dealing more generally with the overall post-surgery outcome. At our last follow-up, 82 per cent of our patients were considered as having an excellent or good result. It can be concluded that the existence of a motor deficit is not a major pejorative factor of the overall final functional result. Motor weakness is more frequently observed in elderly patients, in cases with degenerative spondylolisthesis, or when a discal herniation is associated with a bony compression. Chances of recovery are better, when the deficit is monoradicular, when the stenosis is focal, or associated with a discal herniation and when the patient is relatively young.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
Case Reports[A propos of an unusual case of lumbar-pelvic dislocation in a suicidal jumper].
We report a particular case of lombo-pelvic dislocation in a suicidal jumper, characterized by a distal sacral fracture associated with bilateral fractures of both iliac wings. To our knowledge, it has yet not been described. ⋯ We have described a particular type of transverse fracture of the pelvis, which, in our mind, should be put in the same category as type 2 transverse fractures of the sacrum described by Roy Camille and al, in the suicidal jumper. Since there is no compression of sacral roots into the sacral canal, prolonged bedrest is likely to be the better treatment.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Osteosynthesis of internal malleolar fracture by staplers].
Rigid medial and lateral fixation should stabilize the syndesmosis without further additional supplementation. We used Titanium staples for medial malleolar fixation. ⋯ Titanium staple is easy to use in medial malleolar fractures excluding anterior rim fractures.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[A prospective study of the outcome of anterior laxity of the knee after anterior cruciate ligament reconstruction with procedures using two different patellar tendon grafting methods].
The aim of this study was to evaluate postoperative evolution of anterior laxity, in order to know at what time the elongation of the reconstructed anterior cruciate ligament (ACL) begins to develop after surgery, and if there were any correlations with recuperation of knee flexion or extension. The second purpose of this study was to compare two series of patients operated on by two different procedures for a long standing ACL rupture. ⋯ Evolution of laxity is more favourable in group I with bone-to-bone ligament fixation. Recovering early and complete flexion and extension is not prejudicial for the ligament. Laxity developed between 3 and 6 months and less between 6 and 12 months. KT-1000 is able to detect laxity during early postoperative period. Dynamic radiographs are more precise to control laxity year after year. Informations concerning the two compartments of the knee are of great interest to compare different procedures and to improve new surgical techniques.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Long-term outcome at adjacent levels of lumbar arthrodesis].
Posterolateral lumbar fusion is commonly recognized to have a significant effect upon the more proximal unfused segments. Wether these effects are clinically significant remains unclear. Long term studies with standardized follow-up are scarce. ⋯ Degenerative changes were significantly more frequent in group III's patients. However, no significant correlation was found between the roentgenographic findings and the final functional results and only 8 patients required a new surgery. These results may suggest that posterolateral fusion accelerates the development of degenerative changes in adjacent discs if the fusion is performed on a degenerative spine.