Les pseudoarthroses post osteomyelitiques: a propos de 25 cas operes

The autors report a study of 25 pseudarthrosis and bone defect following osteomyelitis in children and adolescents between 8 month and 17 years. The sites affected were the tibia in 17 cases, femur in 8 cases, forearm in 4 cases and 1 metatarsus. The treatment varied depending to the localizations. In the lesions of tibia our preferential treatment were Hahn and Huntington procedures. The results were satisfactory in 24 cases and the problem of consolidation were resolved

Le decollement epiphysaire de l'extremite inferieure du femur: a props de 18 cas

The authors report a Study of 18 cases of traumatic separation of epiphysis of the lower end of the femur. The patients ranged in age from 1 to 16 years. The lesions were classified according to the scheme of Salter and Harris, there were 4 type I fractures, 11 type II and 3 type IV. 5 fractures without deplacement have had a cast, 10 have been treated by closed reduction, 3 of them had percutaneous pins. 4 patients have been treated with open reduction. 14 patients have been seen after follow up average of 3 years the results were satisfying in 7 cases and bad in 7 other cases with 6 premature epiphyseal closure

Syndrome de Larsen: a propos de 2 cas

The authors report the cases of two children affected by LARSEN'S syndrome. The children present multiple joint dislocation, and the priority was given to treatment of the knee dislocation In second part, the authors review the clinical and radiological caracteristics of this rare affection whose actiopathogeny and the hereditary problem remain unknown

Traumatisme du coude de l'enfant

After an anatomical and a perfectly detailed original work on the elbow biokinetics, different authors relate their experience on various traumatic lesions of the elbow. The fractures of the humeral shaft: a series of 121 cases is reported among which we have 72 complete fractures and 49 parceled fractures. An anatomical study as well as analysis of the results allow us to get to the conclusion that surgical treatment with stable osteosynthesis [screwed plate] is superior while pining the pining should be reserved only to comminutive fracture. Orthopaedyc treatment should be used in exceptional fractures which have been a little displaced or not at all. OLECRANON fractures are studied in terms of 109 fractures. Surgical treatment is used in 72% of the cases, with tension band wiring as the principal method. The authors believe that surgical treatment is advantageous even in the cases of non displaced fractures, and consider the tension band wiring as the most reliable method, [whatever type of the fracture] and especially comminuted fractures. In terms of the fracture of the upper end of the radius involving 72 cases, the authors insist on the radiographic incidences which permit the analysis of the fractures and their classification in 4 types. The treatment using either the plastered immobilisation or the surgical resection of the radial head has given acceptable results. [68% good results]. The fractures of monteggia, studied through 26 cases, have been treated by osteosynthesis of the cubitus and orthopaedic reduction of the radial head except for 3 irreducibilities because of late treatment. The authors have come to the conclusion that the prognosis depends first of all of the treatment urgency as well as of the quality of the fracture reduction, both guarantees of a spontaneous and stable reduction of the luxation. The centre of the cubitus fracture and the degree of luxation of the radial head have also an influence on the results. Luxations and luxations-fractures are exposed through 48 cases, reduced and immobilized for an average of 16 days and reeducated, 3 resections of the radial head and 10 osteosynthesis for associated fractures. The authors have analysed the results which are encouraging [75% good results]. Then, the complex traumatisms of the elbow are exposed through 33 cases. The complexity notion is defined according to the evidence of the traumatism, to the anatomopathological lesions and finally to the treatment. The treatment has practically always been surgical. A comparative study with war fractures has been done through all the work. We have learnt from the latter that the painful stiff ness is a frequent after-effect. [30 to 40% good results]. Elbow traumatism and nervous-vascular lesion have not been studied. One case of contusion, of the humeral artery by luxation of the elbow with vascular re-establishment is exposed with a review of the literature. The authors consider that the vascular reconstitution has to keep place with the luxation reduction. In terms of stiffness and ankylosis of the elbow, dangerous complication of elbow traumatisms, the authors have analysed 87 documents representing 63 cases of stiffness and 24 cases of ankylosis, and the centre of the obstacle to the elbow mobilization. The enlarged arthrolysis is recommended with satisfactory results [87% of the operated patients have recuperated a sector of 50° to 70° of mobility]. Later, children elbow traumatisms have been studied. As these traumatisms are various, the authors have limited themselves to the most frequent ones namely [supra - condylar fractures], the fractures of the external condyl, the fractures of the upper end of the radius