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Résumé des communications 通讯摘要
Pub Date : 2008-11-01 DOI: 10.1016/j.rco.2008.07.274
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引用次数: 0
[Abstracts of the 83rd Annual Meeting of the French Society of Surgical Orthopedics and Trauma]. [第83届法国外科骨科与创伤学会年会摘要]。
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引用次数: 0
L’ochronose ou la maladie du cartilage noir 赭骨病或黑软骨病
Pub Date : 2008-11-01 DOI: 10.1016/j.rco.2008.04.011
R. Philippot , C. Coste , E. Lasseur , P. Tramond , J.-C. Rollier , B. Moyen

Nous rapportons deux observations de patients atteints d’ochronose. Cette pathologie autosomique récessive est très rare (1/1 000 000) et secondaire à une enzymopathie. Elle se manifeste d’abord cliniquement par des dépôts noirs au niveau cutanéomuqueux, puis par un ensemble de symptômes, notamment articulaires, conduisant à une arthropathie destructrice des grosses articulations. Sa découverte est souvent tardive, mais son dépistage doit être précoce et, pour les chirurgiens orthopédistes, si possible en préopératoire afin d’éviter tout risque d’endocardite infectieuse dont elle est extrêmement pourvoyeuse. Ces patients nécessitent une prise en charge pluridisciplinaire adaptée, associant des mesures sociales évidentes et un traitement symptomatique. Le traitement médicamenteux en cours de validation semble efficace sur les symptômes articulaires.

We report two cases of ochronosis. This rare disease (1/1,000,000) transmitted by recessive autosomic inheritance results from an enzyme disorder. Clinically, the disease begins by black deposits in connective tissue followed by a group of symptoms, particularly involving the joints, and then destructive joint disease affecting the larger joints. Diagnosis is often established late. Early detection is important, preoperatively if possible, in order to avoid the serious complication of infectious endocarditis. These patients require adapted multidisciplinary care associating social support and symptomatic treatment. Drug therapy is currently under study and appears to provide effective symptom relief.

我们报告了两例赭石病患者的观察结果。这种常染色体隐性病理非常罕见(1/1000000),继发于酶病。它首先在临床上表现为皮肤粘液中的黑色沉积物,然后表现为一系列症状,尤其是关节症状,导致破坏性关节病。它的发现通常很晚,但它的检测应该是早期的,对于整形外科医生来说,如果可能的话,在术前,以避免感染性心内膜炎的任何风险,而感染性心内膜炎是它的主要来源。这些患者需要适当的多学科护理,结合明显的社会措施和对症治疗。正在验证的药物治疗似乎对关节症状有效。我们报告了两例赭石病病例。这种罕见的疾病(1/1000000)由酶紊乱引起的隐性常染色体遗传引起。临床上,该疾病始于结缔组织中的黑沉积,随后出现一组症状,尤其涉及关节,然后是影响更大关节的破坏性关节疾病。诊断通常建立得很晚。为了避免感染性心内膜炎的严重并发症,早期检测非常重要,如果可能的话,在手术前进行。这些患者需要适当的多学科护理,包括社会支持和症状治疗。药物治疗目前正在研究中,似乎能有效缓解症状。
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引用次数: 3
À la mémoire du docteur Olivier Troisier 纪念Olivier Troisier博士
Pub Date : 2008-11-01 DOI: 10.1016/j.rco.2008.06.005
É. Gozlan
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引用次数: 0
Posters électroniques (e-posters) 电子海报(电子海报)
Pub Date : 2008-11-01 DOI: 10.1016/j.rco.2008.07.250
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引用次数: 0
Résultats analytiques chez les sujets non marchant 非行走受试者的分析结果
Pub Date : 2008-10-01 DOI: 10.1016/j.rco.2008.07.270
O. Guyen, J. Béjui-Hugues, J.-P. Carret
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引用次数: 0
Les fractures du col du fémur après 50 ans 50岁后股骨颈骨折
Pub Date : 2008-10-01 DOI: 10.1016/j.rco.2008.06.006
P. Simon , F. Gouin , D. Veillard , P. Laffargue , M. Ehlinger , J.-C. Bel , R. Lopez , P. Beaudet , F. Luickx , V. Molina , L.-E. Pidhorz , N. Bigorre , A. Rochwerger , F. Azam , M.-L. Louis , P. Cottias , S. Hamonic , D. Veillard , F. Vogt , P.-M. Cambas , X. Roussignol

Introduction

Despite many papers and instructional course lectures, therapeutic guidelines are not clearly defined about treatment of femoral neck fractures. The aim of this multicentric French symposium was to prospectively study the results of current therapeutic options in order to propose scientifically proven options.

Material and methods

Three prospective studies were carried out in order to answer to these questions: (1) is it possible with anatomical reduction and stable fixation to lower the non union and osteonecrosis rate? (2) is functional treatment of Garden 1 fractures successful in more than 65 years patients? (3) what criteria are useful to choose the kind of arthroplasty for more than 65 years patients?

Results

For the 64 patients between 50 and 65 years old included in the first study, 44 ORIF and 17 prostheses were performed. No open reduction was performed in this series despite a 34% malreduction rate. The risk for displacement after functional treatment of Garden 1 fractures is 31%.

For patients over 65 years old, almost fractures are treated in this series by an arthroplasty. The one-year mortality rate after displaced femoral neck fracture was 17%. Functional results were better in total hip prosthesis group than in bipolar or unipolar group. Non cemented stems were not safer than cemented ones in frail patients.

Discussion and conclusions

For young patients, ORIF should be the treatment of choice: the initial displacement and its effects on the femoral head vascularisation, the quality of reduction and fixation are the two most significant factors for good outcome. For Garden 1, fractures in patients 65 years old or more, it is proposed to performed an internal fixation despite in two thirds of the cases, it should be unnecessary because non identification of predictive factors of failure. For patients over 65 years old, the type of arthroplasty to perform in displaced fractures is to be chosen according to the preoperative mobility and comorbidities. Because of acetabular erosion with long-term follow-up, it is clearly indicated to perform total hip replacement for patients with life expectancy of 10 years or more. For frail patients, unipolar arthroplasty is the best option. The place for bipolar or uncemented implants is not yet well-defined and more prospective trials are needed. In this multicentric study, results appear quite different in terms of mortality, or functional status. These differences seem to be related to technical choice, geriatric care, nutritional consideration or surgical organisation, all factors that may be of major importance for prognostic.

尽管有许多论文和教学课程,但股骨颈骨折的治疗指南并没有明确的定义。这次多中心法国研讨会的目的是前瞻性研究当前治疗方案的结果,以提出科学证明的方案。材料和方法为了回答以下问题,我们进行了三项前瞻性研究:(1)解剖复位和稳定固定是否有可能降低骨不愈合和骨坏死的发生率?(2)对于年龄大于65岁的Garden 1型骨折患者,功能治疗是否成功?(3) 65岁以上患者选择关节置换术的标准是什么?结果在第一项研究中纳入的64例50 - 65岁患者中,44例行ORIF, 17例行假体。尽管有34%的复位不良率,但在该系列中未进行切开复位。Garden 1型骨折功能治疗后发生移位的风险为31%。对于65岁以上的患者,几乎所有的骨折都是通过关节置换术来治疗的。移位性股骨颈骨折后1年死亡率为17%。全髋关节假体组功能结果优于双极组和单极组。在体弱患者中,非骨水泥支架并不比骨水泥支架更安全。讨论与结论对于年轻患者,ORIF应该是治疗的选择:初始移位及其对股骨头血管的影响,复位和固定的质量是获得良好结果的两个最重要的因素。对于Garden 1, 65岁及以上患者的骨折,建议进行内固定,尽管在三分之二的病例中,由于无法识别失败的预测因素,应该没有必要进行内固定。对于65岁以上的患者,应根据术前活动能力和合并症选择移位性骨折的关节置换类型。由于长期随访发现髋臼糜烂,对于预期寿命在10年及以上的患者,明确建议行全髋关节置换术。对于身体虚弱的病人,单极关节置换术是最好的选择。双相或非胶结植入物的应用尚不明确,需要更多的前瞻性试验。在这项多中心研究中,在死亡率或功能状态方面的结果似乎大相径庭。这些差异似乎与技术选择、老年护理、营养考虑或手术组织有关,所有这些因素都可能对预后具有重要意义。
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引用次数: 70
Prothèse totale de hanche chez des patients de moins de 30 ans : problématique 30岁以下患者全髋关节假体:有问题
Pub Date : 2008-10-01 DOI: 10.1016/j.rco.2008.07.258
F. Bonnomet , C. Glorion
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引用次数: 1
Prothèse totale de hanche chez des patients de moins de 30 ans : présentation de la série et méthode d’analyse 30岁以下患者全髋关节假体:系列介绍及分析方法
Pub Date : 2008-10-01 DOI: 10.1016/j.rco.2008.07.259
D. Pourreyron , H. Ayadi , F. Bonnomet
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引用次数: 1
Mélorhéostose et entorse du ligament croisé antérieur chez une jeune fille de 15 ans 一名15岁女孩的前交叉韧带糜烂和扭伤
Pub Date : 2008-10-01 DOI: 10.1016/j.rco.2007.12.018
Y. Glard, F. Launay, G. Edgard-Rosa, E. Viehweger, J.-L. Jouve, G. Bollini

Nous rapportons le cas d’une jeune fille de 15 ans victime d’un traumatisme indirect du genou ayant occasionné la réalisation de clichés radiographiques du genou. Ces clichés ont mis en évidence des images de coulée osseuse en cire de bougie obstruant partiellement le canal médullaire du fémur et du tibia. À l’IRM, ces lésions étaient en hyposignal en T1 et en T2. Le diagnostic retenu devant l’aspect radiologique est celui de mélorhéostose. Une biopsie a été réalisée afin d’écarter les autres diagnostics possibles. L’IRM a en outre mis en évidence une rupture du ligament croisé antérieur (LCA). Un traitement conservateur a été proposé pour cette rupture du LCA et une surveillance clinique et radiologique a été proposée pour la mélorhéostose.

We report the case of a 15-year-old girl who suffered an indirect knee trauma. The standard X-rays revealed a tract of ivory-like bone partially obstructing the medullary canal of the femur and the tibia. Magnetic resonance imaging produced a hypointense signal on the T1 and T2 sequences. The radiographic diagnosis was melorheostosis which was confirmed on the biopsy specimen which ruled out other diagnoses. The MRI also revealed a tear of the anterior cruciate ligament, treated conservatively. Clinical and radiological surveillance were proposed for the melorheostosis.

我们报道了一个15岁女孩的案例,她的膝盖受到了间接创伤,导致了膝盖的x光照片。这些照片显示了蜡烛蜡骨流的图像,部分阻塞了股骨和胫骨的髓管。mri显示这些病变在T1和T2均为阴性。放射学方面的诊断是牙髓下垂。为了排除其他可能的诊断,进行了活检。mri也显示前交叉韧带(acl)断裂。对acl破裂提出了保守治疗,并对牙髓下垂进行了临床和放射监测。我们报告了一名15岁女孩遭受间接膝关节创伤的病例。. The standard X-rays钦传单of ivory-like bone报告部分obstructing运河(The medullary of The大举逮捕and The胫骨。= =地理= =根据美国人口普查,这个县的面积为。melorheostosis which was The 16261用电fut文字标本biopsy which新来out confirmed on The other diagnoses。The MRI also钦,都曾向圣母anterior cruciate韧带,看到两个conservatively。对黑口病进行临床和放射监测。
{"title":"Mélorhéostose et entorse du ligament croisé antérieur chez une jeune fille de 15 ans","authors":"Y. Glard,&nbsp;F. Launay,&nbsp;G. Edgard-Rosa,&nbsp;E. Viehweger,&nbsp;J.-L. Jouve,&nbsp;G. Bollini","doi":"10.1016/j.rco.2007.12.018","DOIUrl":"https://doi.org/10.1016/j.rco.2007.12.018","url":null,"abstract":"<div><p>Nous rapportons le cas d’une jeune fille de 15 ans victime d’un traumatisme indirect du genou ayant occasionné la réalisation de clichés radiographiques du genou. Ces clichés ont mis en évidence des images de coulée osseuse en cire de bougie obstruant partiellement le canal médullaire du fémur et du tibia. À l’IRM, ces lésions étaient en hyposignal en T1 et en T2. Le diagnostic retenu devant l’aspect radiologique est celui de mélorhéostose. Une biopsie a été réalisée afin d’écarter les autres diagnostics possibles. L’IRM a en outre mis en évidence une rupture du ligament croisé antérieur (LCA). Un traitement conservateur a été proposé pour cette rupture du LCA et une surveillance clinique et radiologique a été proposée pour la mélorhéostose.</p></div><div><p>We report the case of a 15-year-old girl who suffered an indirect knee trauma. The standard X-rays revealed a tract of ivory-like bone partially obstructing the medullary canal of the femur and the tibia. Magnetic resonance imaging produced a hypointense signal on the T1 and T2 sequences. The radiographic diagnosis was melorheostosis which was confirmed on the biopsy specimen which ruled out other diagnoses. The MRI also revealed a tear of the anterior cruciate ligament, treated conservatively. Clinical and radiological surveillance were proposed for the melorheostosis.</p></div>","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 6","pages":"Pages 596-598"},"PeriodicalIF":0.0,"publicationDate":"2008-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2007.12.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92061241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Revue de chirurgie orthopedique et reparatrice de l'appareil moteur
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