Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Ipsilateral fractures of the femoral and tibial diaphyses].
Simultaneous ipsilateral femoral and tibial fractures cause a floating knee. Treatment of such patients is complicated by fat-embolism syndrome (12 per cent), local soft tissue damage, ipsilateral knee ligament tear (5 to 39 per cent) and delayed shortening or torsional deformity. Our study aimed to determine the frequency of complaints about the knee and to study the causes of malunion. ⋯ Simultaneous ipsilaterla femoral and tibial fracture, or so called floating knee, occurs in patients who are involved in a high-velocity injury. Knee instability is however the major cause of poor results.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Treatment of pseudarthrosis of the clavicle by bone plate with screw fixation and autologous spongiosa graft].
The authors review and evaluate the operative treatment of mid-shaft clavicular non-union by compression plate osteosynthesis and most frequently by decortication and autogenous bone grafting. ⋯ Symptomatic non-union of the mid-shaft clavicular is a rare complication, mainly after non-operative treatment (11 cases in 12 years in our series). Factors responsible for non-union are the initial high velocity injury, the cominution, the overlapping and great displacement, the paucity of cancellous bone at this site and the trapezius interposition. Internal fixation by compression plating, decortication and bone grafting in atrophic non-union often encountered is a safe reliable method allowing uncomplicated healing and acceptable functional results.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Selective indications of skull radiography after head injury in children].
Skull X-rays are systematically performed on children after head injuries in most hospitals. However, the discovery of a skull fracture as an isolated finding rarely warrants intervention. In february 1994, we stopped performing systematical skull X-rays in children after head injuries. We report the results of this experience. ⋯ Routine skull X-rays after head trauma are not justified either for financial or radioprotection reasons. In this study, more than half of the children were less than five years old and ran a higher risk of irradiation.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Value of combined spinal and epidural anesthesia in the management of peroperative analgesia in prosthetic surgery of the lower limb. Prospective study of 68 cases].
Efficient peri-operative analgesia is more comfortable, allows earlier mobilisation and better functional results for lower limb arthroplasties. We report our 60 cases prospective study of combined spinal and epidural anesthesia, and expose interests of this technique to control peri-operative pain. ⋯ The results indicate that combined spinal and epidural anesthesia for the management of peri-operative pain provide an excellent pain control with a daily morphine injection. For lower limb arthroplasties, visual analogue scale is always inferior or equal to 2 and satisfaction mark equal to 1.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Extra osseous tumors of the spine in children and adolescents. Spinal complications].
The delay in diagnosis of spinal tumors is not rare. The chief complaint may include pain, walking disability, and spinal or limb deformities. The purpose of our study is to analyze the spinal deformities associated with non osseous intraspinal tumors, to assess the complications of treatment, and to set out a preventive protocol. ⋯ Diagnosis of intraspinal tumors in children and adolescents should be done early, and laminoarthrectomy should be replaced by osteoplastic laminotomy.