[Modified Dyplay technique in the treatment of anterior hypospadias. Immediate and long term results in 321 cases and review of the literature]. / Technique de Duplay modifiée dans le traitement de l'hypospadias antérieur. Résultats immédiats et à long terme à propos de 321 cas et revue de la littérature.

OBJECTIVES: Description of a surgical technique in the treatment of anterior hypospadias, a frequent malformation for which the treatment is not devoid of complications. Evaluation of the short-term as well as the long-term results. MATERIAL AND METHODS: Retrospective study of 321 patients treated according to this method. 58 patients were reviewed with a mean follow-up of 71 months. RESULTS: The immediate results were marked by the development of 16 fistulas (5%), 4 of which closed spontaneously. Five cases (1.6%) of meatal retraction and 6 meatal stenoses (1.9%) were observed. The overall complication rate requiring specific treatment was 5.6%. The long-term results showed meatal retraction in 20.7% of cases, meatal stenosis in 1.7% of cases and fistula in 3.5% of cases. This is the series with the longest mean follow-up. Comparison with the currently proposed technique suggests that this technique is indicated in the treatment of anterior hypospadias. Long-term analysis of the results strongly encourages regular and prolonged follow-up of children treated for hypospadias in the first 2 years. CONCLUSION: The modified Duplay technique is reliable, can be easily performed, and gives perfectly satisfactory results, even in the long-term, for the treatment of anterior hypospadias.

[Fibrous frame of the rotator cuff. The concept of fibrous lock]. / Le squelette fibreux de la coiffe des rotateurs. La notion de verrou fibreux.

MRI assessment of shoulder suggests the presence of a strong fibrous structure in the depth of the supra spinatus muscle. An anatomical study has been performed in 20 fresh human shoulders. There was a very strong fibrous frame within the anterior part of the supra spinatus m. and within the upper part of the sub scapularis. The upper part of the infra spinatus m. contained a significant fibrous reinforcement too so as in the teres minor m. The authors describe fibrous structures around the rotator interval, which constitute an antero-superior Fibrous Lock of the scapulo humeral joint and may help the repair of the full thickness tears of the rotator cuff.