Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Four part valgus impacted fractures of the upper extremity of humerus: ilium graft reconstruction. Apropos of 8 cases].
We present the results of an original technique for reconstruction of valgus-impacted humeral head using autologous iliac bone. ⋯ This specific type of displaced four-part fracture of the proximal humerus which consists of valgus impaction of the head fragment without lateral displacement has a rate of avascular necrosis lower than that of other displaced four-part fractures. Blood supply of the articular segment is maintained via the periosteum extending to the medial part of the anatomic humeral neck. These data authorized the authors to propose a new conservative treatment for four-part valgus impacted proximal humeral fractures.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[A new method of osteosynthesis in proximal humeral fractures: a new internal fixation device. Apropos of 17 cases followed over more than 2 years].
The authors describe a new internal fixation device, and report on 17 proximal humeral fractures managed with this technique. ⋯ Except for the fracture-dislocations our device confers several major benefits. The humeral head is preserved. Typical problems associated with joint replacement (dislocations, loosening, glenoid degeneration) are avoided. Humeral head conservation enhances healing of the tuberosities. Fixation could always be obtained, regardless of the complexity of the fracture pattern. An hemiarthroplasty (e.g. in case of avascular necrosis) is possible by the modular design of the device.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Arthrodesis of the shoulder for post-traumatic palsy of the brachial plexus. Analysis of a series of 18 cases].
In case of severe traction injuries of the supraclavicular brachial plexus in adult, the functional results of direct shoulder nerve repair are less predictable than those of the elbow. Furthermore, the surgical management of the remaining flail shoulder is still controversial. The post-operative results and the indication for shoulder arthrodesis are evaluated in this study. ⋯ Gleno-humeral arthrodesis is a reliable method for restoring shoulder function in case of brachial plexus sequellae lesion, giving more strength, but less external rotation than shoulder nerve repair.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Surgery of the upper cervical spine in rheumatoid arthritis. Indications and results apropos of 28 cases].
The goal of this study was to precise indications and surgical techniques for stabilisation with or without decompression of the upper cervical spine instability in rheumatoid arthritis. ⋯ Occipito-cervical arthrodesis is necessary as soon as the patient presents neurological signs. When there is an anterior dislocation associated with vertical dislocation, if there is posterior dislocation in case of osteoporosis of the posterior C1-C2 arc, or destabilisation of the lower cervical spine. C1-C2 arthrodesis is suggested when there is no important neurological signs, when displacement is limited to a pure anterior dislocation and in young patient with good bone quality.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1996
[Osteosynthesis of tibial valgus osteotomies by goniometric CH-N external fixator].
The authors present technique and results of a new external fixator, the < < goniometric > > external fixator CH-N for osteosynthesis of high tibial osteotomy for arthritic varus knee deformity on 86 kness (75 patients). ⋯ The principle of this special < < goniometri > > external fixator is based on the < < goniometric > > central joint in the frontal plane, this allows to guide the screws during osteotomy in the predesigned position and to control the correction during and after the procedure, in contrary to the others current system either internal or external. Any faulty correction can be modified. With its distal screwing axis, it allows axial dynamization. There are only some but not serious incoveniences due to the application of pins (temporary neuromuscular problems and pin-track infections.