[Spondylodiscitis due to Fusobacterium nucleatum: new diagnostic method]. / Espondilodiscitis por Fusobacterium nucleatum: nueva forma de diagnóstico.

Fusobacterium spp. are Gram negative anaerobe bacteria. Vertebral osteomyelitis caused by these bacteria is very unusual; in fact, we could only find 11 cases in the literature. We report the case of a male, 46 year-old patient who had had lumbar pain for several weeks that irradiated to the right leg, and did not respond to NSAID treatment. The work-up included MRI, biopsy with draining of the collection and a universal PCR followed by 16S rDNA sequencing. The latter was used to make the microbiologic diagnosis, which identified Fusobacterium nucleatum as the causative agent. Final treatment consisted of clindamycin. In conclusion, spondylodiscitis due to Fusobacterium spp. is a rare and difficult to diagnose entity, due both to its clinical characteristics and to the difficulty in making the right microbiologic diagnosis. Vertebral biopsy and molecular microbiologic techniques such as Universal PCR rDNa, are essential to identifying the organism, making the diagnosis and prescribing appropriate antibiotic therapy.

[Treatment of sections of the long flexor tendon of the thumb using the Rouhier technic. Apropos of 25 cases]. / Traitement des sections du tendon long fléchisseur du pouce par la technique de Rouhier. A propos de 25 cas.

We treated 28 cases of Flexor Pollicis Longus tendon injury by Rouhier's technique between 1989 and 1996 and reviewed 25 cases, with a minimum follow-up of 6 months and maximum of 8 years. Nine patients presented an associated collateral nerve section. We used the International Federation of Hand Surgery Societies (IFSSH) topographic classification. The surgical technique consisted of Flexor Pollicis Longus lengthening and transosseous pull-out in 16 cases and distal suture in 9. The immobilization time ranged from 4 to 7 weeks. The results were evaluated according to Tubiana's classification, with 2 very good, 14 good, 9 fair and no poor results. Flexor Pollicis Longus simple suture in T2 zone may produce suture blockade, tendon shortening and adherences. Suture through the digital canal must be avoided to decrease these complications. In the absence of bone injuries, better functional results can be obtained with Rouhier's technique than with simple suture.

Paravertebral muscles in experimental scoliosis: a light and electron microscopic study.

Experimental structural dextroconvex scoliosis was produced in rabbits by costotransversolisis with transversectomy and releasing of paravertebral muscles between TVII and TX on the right side. Two compensatory curves developed on the upper dorsal and lumbar levels. Biopsies of paravertebral muscles in experimental animals included, besides areas of normal tissue, a considerable derangement of the cell contractile apparatus with sarcoplasmic dilation and eventual cell disintegration and necrosis. Histological changes varied along levels, the convexity being more affected. The severity of changes and reduction in body weight and length were correlated with the degree of scoliosis. A selective atrophy of slow-twitch fibers was observed in experimental animals, especially at the level of the main curve, whereas fast-twitch fiber atrophy was more important caudally. Control animal biopsies always appeared normal. Our experimental model shows an overt participation of paravertebral muscles in the establishment of compensatory processes following scoliosis, although the role that paravertebral muscles play in the etiopathogenesis of human idiopathic scoliosis requires further investigation.

Peri-pyramidal semilunar dislocation of the carpus.

Peri-pyramidal semilunar dislocation of the carpus is a very rare variety of perilunar dislocation. For this reason, the authors present a case of open peri-pyramidal semilunar dislocation, discuss the aetiopathogenetic mechanism involved, and report the excellent result obtained with reduction and immobilisation in plaster for six weeks.