[Free re-innervated Latissimus Dorsi musculocutaneous flap for treat congenital Volkmann ischemic Contracture: a case report]. / À propos d'un cas exceptionnel de syndrome de Volkmann néonatal traité par transfert libre de grand dorsal ré-innervé

OBJECTIVES: Congenital Volkmann ischemic contracture is a rare entity. The neonate presents nerve palsy, cutaneous and muscular necrosis of the forearm. METHODS: We report a case of a newborn who presented with necrotic subcutaneous tissue of the right forearm and absence of active flexion and extension of the wrist and fingers. She was initially treated with debridement of necrotic tissues and orthosis of the wrist. Latissimus dorsi free flap was used for forearm reconstruction at age of 7months. The thoracodorsal nerve was anastomosed with a motor branch of the median nerve. The proximal part of the muscle was fixated to the lateral epicondyle of humerus, and the distal part of muscle was sutured with a flexor digitorum tendons and radial extensor carpi. The cutaneous component of the flap was used to cover a defect of soft tissue of the forearm. RESULTS: At age of 12 months, the patient has a good two-hand function with a pollici digital clamp of the right hand. She also has a recovery of active wrist extension and fingers flexion. DISCUSSION: Free re-innervated latissimus dorsi muscle transfer is an alternative to restore a useful hand function in case of congenital Volkmann ischemic contracture.

[Kirner's deformity. 4 case reports and review of the literature]. / La déformation de Kirner. A propos de 4 cas et revue de la littérature.

Kirner's disease is a rare deformity of the distal phalanx of the little finger, with a combination of camptodactyly and clinodactyly and clinodactyly. A review of the literature and analysis of our cases show that this anomaly appears to result from a unusual insertion of the deep flexor over the growth cartilage. No treatment is required in view of the absence of any clinical and functional symptoms.

[Anorectal traumas by impalement in children. Apropos of 3 cases]. / Les traumatismes ano-rectaux par empalement chez l'enfant. A propos de trois observations.

Traumatic impalement is an exceptional cause of anorectal lesions in the child. The clinical diagnosis is sometimes difficult and associated lesions raise the problem of the most appropriate exploratory examination. Based on our experience with three cases, we would emphasize the usefulness of hydrosoluble enema study prudently performed by the surgeon during the preoperative work-up. The precise localization of the lesions must be obtained with careful emergency exploration before repair. Treatment of the trauma includes lavage, drainage and sometimes colostomy. Antibiotics must always be prescribed. Early complications are dominated by infection and long-term sequellae, requiring a long follow-up.

[Flaps for covering extensive losses of cutaneous substance on the upper limb. Apropos of 15 cases]. / La couverture par lambeaux des grandes pertes de substance cutanée du membre supérieur. A propos de 15 cas.

The authors report on their recent experience concerning flap treatment of upper limb complex trauma, based on 15 cases. Proper wound care, and the use of healthy, well vascularised tissues for coverage is of paramount importance for good results, whose quality mostly depends on the severity of initial lesions. The results of this series are encouraging and appear to be a consequence of the great possibilities offered by the cutaneous or muscular flaps used.

[Traumatic atlanto-axial dislocation in children: 7 cases]. / Luxation traumatique atloïdo-axoïdienne chez l'enfant: à propos de 7 cas.

Seven cases of atlantoaxial rotatory dislocation in children are reported. The CT scan permitted differentiation of the lesions in all the cases. Analysis of the results has led us to introduce two modifications for Fielding's classification: a distance between the atlas and odontoid of less than 5 mm is normal. sagittal dislocation must be included in the same classification. We propose the following therapeutic protocol: rotatory luxation without tears of the transverse ligament should receive orthopedic treatment, rotatory luxation with tears of the transverse ligament should have surgical treatment if orthopaedic treatment fails. sagittal luxation with or without rotatory fixation needs surgical treatment.

[Characteristics of fractures of the distal part of the clavicle in children]. / Particularités des fractures des extrémités de la clavicule chez l'enfant.

Fractures of the clavicle are frequent in children and mostly affect the middle third. On the other hand, traumatic fractures of both medial and lateral thirds of the clavicle are rare. The lesions have special characteristics: difficulty in diagnosis for the medial third; risk of callus formation in the absence of surgical reduction of the lateral third. The authors report two observations of fractures of the medial and lateral thirds of the clavicle; they insist on the value of investigation by CT scan.

[Giant cell tumor of the tendon sheath of the long extensor muscle of the thumb in a 7-year-old child]. / Tumeur à cellules géantes de la gaine du tendon du long fléchisseur du pouce chez une enfant de 7 ans.

The authors report the case of a giant cell tumour of the flexor pollicis longus tendon sheath in a child. This benign tumour, usually observed in women between the ages of 30 to 50 years, has a highly controversial aetiopathogenesis; the existence of initial trauma is found in 50% of cases. The present case concerns a 7-year-old girl with swelling of the right thumb for two years. Surgical resection established the definitive diagnosis by histological examination of the specimen. The follow-up is currently two years, with no local recurrence.

[Preservation of a foot by shortening tibial osteotomy after a circumferential electric burn to the leg]. / Sauvetage d'un pied après brulure électrique circonférentielle de la jambe par ostéotomie tibiale de raccourcissement.

A patient presented with circumferential loss of skin substance of lower quarter of leg. The patient's advanced age and the poor local conditions could have produced an aleatory result for a flap graft. It was therefore decided to perform a shortening tibial osteotomy as a conservative surgical procedure.

[Epiphyseal fracture-avulsion of the distal extremity of the clavicle. Apropos of a case]. / La fracture-décollement épiphysaire de l'extrémité distale de la clavicule. A propos d'une observation.

Fracture of the clavicle is the commonest fracture in children. It is generally due to direct trauma to the shoulder. Orthopaedic usually ensures consolidation within three weeks. Fractures of the lateral third is uncommon and unusual. It corresponds to an epiphyseal avulsion of the distal extremity of the clavicle, equivalent to an acromioclavicular "pseudodislocation". The coracoclavicular ligaments remain intact. Surgical reduction of the clavicle into its periosteal sheath is necessary. The authors report a case of fracture of the lateral third of the clavicle in a 5 and a half year old child with spontaneous formation of a "neoclavicle".

[Osteoid osteoma of the femoral neck in children: diagnostic problems]. / Ostéome ostéoïde du col fémoral chez l'enfant: problèmes diagnostiques.

The authors report a case of an osteoid osteoma of the femoral neck in a child, aged 3 1/2. This is a benign bone tumor, frequently painful with variable relief obtained with salicylates. Clinical latency is not exceptional in children, owing to the delayed diagnosis. When located in the femoral neck it is usually discovered after a delay, owing to the misleading clinical signs and the frequently normal standard x rays. The only treatment for cure is the excision of the nidus, which is usually difficult because of the anatomical location and the perioperative adjustment.

[Primary colonic intussusception protruding from the anus in adults. Two cases]. / Invagination colique primitive de l'adulte, procidente à l'anus. Deux observations.

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colo-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

[Primary colonic intussusception protruding from the anus in adults. Two cases]. / Invagination colique primitive de l'adulte, procidente à l'anus. Deux observations.

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

[Ledderhose's disease. Report of 7 cases]. / Maladie de Ledderhose. A propos de 7 cas.

Ledderhose's syndrome, or plantar fibromatosis, is a rare fibrous dystrophy and the plantar equivalent of Dupuytren's disease. It occurs mainly in adult subjects, as a plantar fibrous nodule. The authors report 7 operated cases of Ledderhose's syndrome, including one in a 14-year-old adolescent. When the plantar nodule becomes symptomatic, surgery is the only means of treatment. Plantar aponeurotomy must then be as extensive as possible to prevent recurrent.

[Osteopoikilosis: apropos of a familial case]. / Ostéopoecilie: à propos d'un cas familial.

The authors have studied a case of familial osteopoikilosis. This rare radiological finding was observed in four of eight studied cases. The progressive character of the disease during the puberty was noticed.