Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Value of orthopedic treatment of distal fractures of the forearm in children. Apropos of 152 cases].
Distal forearm fractures in children are frequent. Management is conservative except in rare cases which will be discussed. ⋯ Close reduction is possible for fractures with large displacement but must be done perfectly and the cast must be adapted. If instability, irreducibility and/or incorrect reduction exist, management must include posterolateral and intrafocal percutaneous pinning, especially in older children. While rare, this indication must be known.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Osteochondral fractures of the external femoral condyle after traumatic patellar dislocation during physical exercise in children].
Nineteen osteochondral fractures of the lateral femoral condyle associated with acute traumatic patellar dislocation resulting from sport injury in children were studied. The purpose of this study was to specify clinical and radiological features. ⋯ Lateral femoral condyle osteochondral fractures are associated with nearly one third of traumatic patellar dislocation resulting from sport injury in children. A detailed radiographic examination can help diagnosis. Treatment depends on the delay after injury, the size and location of the fracture.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Conservative treatment of stress fractures of the tarsal navicular in athletes].
The purpose of the study was to propose an algorhythm for nonoperative treatment of partial tarsal navicular stress fractures in athletes, based on the results of the authors prospective research, conducted in 17 athletes. ⋯ If clinical indication of tarsal navicular stress fracture is confirmed by a positive bone-scan, a CT or MRI exploration is required to distinguish stress reaction from stress fracture. In partial tarsal navicular stress fractures, immobilisation in a short-leg cast with nonweightbearing for 6 to 8 weeks depending of the magnitude of the fracture is required. This is followed by a treatment consisting of 4 two-weeks stages which clinically monitored. The previous phase can be repeated for another two weeks, depending of clinical findings. This algorhythm of nonoperative treatment of partial tarsal navicular stress fractures allowed in all athletes a return to competitive activity.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Treatment of complex bicondylar fractures of the tibial plateau by semi-circular anterior diaphyseal-epiphyseal plate].
One third of all tibial plateau fractures are bicondylar, and some of them have posterior separation and metaphyseal comminution. In these cases, it may be difficult to reconstruct at the same time tibial axis, bone continuity and articular surface. The authors propose a new method for the treatment of these fractures. ⋯ Complex bicondylar fractures are one of the most difficult fractures to treat. Identification of the lesions should be envisioned before operation and especially the separated posterior fragments. The peroperative extension combined with the anterior approach with ATT elevation provided a complete view of intra articular fracture and correction of the axis. The semi-circular anterior plate allowed the fixation of all the fragments, and furthermore, the original procedure using temporary pins to guide the definitive plate has avoided to loose the reduction.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Reconstruction of digital pulp by pulp tissue transfer of the toe. Apropos of 15 cases].
The authors report their experience of digital pulp reconstruction by free toe pulp transfer. Fifteen patients were treated with the lateral great toe hemipulp. ⋯ A wide range of procedures from spontaneous healing to thenar flap, neuro vascular flap or toe pulp transfer can be proposed to treat digital pulp loss. In the case of moderate thumb pulp avulsion and homodigital volar flap can be proposed; if microsurgery is contra-indicated, an hetero-digital flap from the index can be performed. When the other fingers are concerned, a homodigital flap can be proposed for moderate defects. For more important trauma, the thenar flap is convenient to cover the index and the medius pulp. Ring and little fingers can be treated by a reverse digital artery flap or by a cross finger flap. When a toe pulp transfer is indicated we recommend the lateral great toe hemipulp for the thumb and a second or third toe pulp transfer for the other fingers when digital vascular anastomosis are possible. The great toe hemipulp transfer represented a good indication for complete digital pulp loss reconstruction where the thumb is concerned. Performing this reconstruction during the acute phase may improve the management of those trauma by reducing the time needed for cicatrisation and the length of work inability.