[Epicondylalgia, diagnosis and treatment A review of a series of 31 surgically treated cases]. / Les épicondylalgies, diagnostic et traitement. Revue d'une série de trente et un cas opérés.

Thirty-one of lateral elbow pain have been reviewed, with an average follow-up of 32.4 months after surgery. The necessity of an adequate surgical procedure for each cause is confirmed. The etiology are: epicondylitis, posterior interosseous nerve entrapment and humero-radial articular pathology. We tried to define a correspondence between etiology and clinical examination. For type I (pain by palpation on lateral epicondyle = tendinitis) and for type II (isolated pain on the head of the radius = nerve entrapment) the correlation is good with operative findings. In contrary there is a correspondence in type III (regional pain with irradiation) only for 50% of the cases. Specific surgical technique is employed for each supposed cause. The results at follow-up are good for 87% of the patients (27 cases) and failed in two. These two cases can be explained: by multiple surgery, psychologic context and inadaptation of the work for full activity. The value electrophysiological examination before operation is examined.

[Massive osteolysis of the metacarpal bones. Apropos of a case of an osteolytic form of psoriatic rheumatism]. / Ostéolyse massive des métacarpiens. A propos d'une observation de rhumatisme psoriasique à forme ostéolytique.

The authors report a case of massive osteolysis of all of the metacarpal bones of the right hand in a 26 year old man. The disease commenced 9 years previously with painful symptoms associated with inflammation and the initial X-rays showed periosteal reaction of the 2nd and 3rd metacarpals. Massive osteolysis of all of the metacarpal bones, including the 1st metacarpal, developed progressively over a period of one year, although no signs of osteolysis were observed in the carpal bones or phalanges. A surgical operation, performed to realign the ring and little fingers, revealed a 4 mm thick periosteal sheath explaining the maintenance of a certain degree of stability of the metacarpals despite the massive osteolysis. Histological examination eliminated any neoplastic or infectious aetiology and confirmed the inflammatory origin with vascular and lymphocytic proliferation. The development of palmo-plantar psoriasis several months after the onset of the painful symptoms suggested the diagnosis of psoriatic rheumatism. This is a rare site with an unusual clinical course with massive osteolysis of all of the metacarpal bones, but it appears to be the most likely hypothesis. The clinical course was stabilised by non-steroidal anti-inflammatory agents but there was no bony reconstruction.

[Revascularization of the 2 lower limbs from the descending thoracic aorta without laparotomy]. / Revascularisation des deux membres inférieurs à partir de l'aorte thoracique descendante sans laparotomie.

Arterial bypass of the lower limbs from the thoracic aorta approached through a thoracic or abdominal route has already been described. The technique reported here is original in that the descending thoracic aorta is exposed through thoracotomy, and the prosthesis is passed behind the left kidney, then, for the right leg bifurcation, through Retzius' space without laparotomy. Two patients were operated upon with this technique which is described in detail, together with its potential indications, advantages and disadvantages.