[Trans-scapho-perilunar dislocations with internal instability of the carpal bones]. / Les luxations trans-scapho-péri-lunaires avec instabilité interne du carpe.

The authors have shown both in patients and in cadavers that the posterior triquetro-lunate ligament plays a major role in the stability of the carpus. They suggest a new concept associating pronation and dorsal flexion of the wrist, the hand being immobilised, to explain instability following perilunate dislocations with fractures of the scaphoid. They recommend both the fixation of the scaphoid fracture by a screw and primary repair of the triquetro-lunate ligament.

[Long-term results of the forage-biopsy in grade I and II osteonecrosis of the femoral head. Apropos of 133 cases re-examined after an average time of 9 years 6 months]. / Résultats à long terme du forage-biopsie pour les ostéonécroses de la tête fémorale aux stades I et II. A propos de 133 cas revus après un délai moyen de 9 ans 6 mois.

The results of 133 operations of cervical forage are reported with an average follow-up of 9 years. There were 94 p. 100 of good results in grade I cases and 82 p. 100 in grade II cases. The basis of the procedure is to produce a decrease of pressure in the venous circulation of the bone. The importance of early operation is stressed.

[Histopathology of bone and cartilage lesions in reflex sympathetic dystrophy of the knee. Apropos of 16 cases]. / Histopathologie des lésions osseuses et cartilagineuses dans l'algodystrophie sympathique réflexe du genou. A propos de 16 observations.

In 16 cases of reflex sympathetic dystrophy of the knee, the authors obtained by drill biopsy 29 bone samples from the epiphyseal and metaphyseal regions of the femur and tibia and 8 cartilagenous samples (including 6 by arthrotomy and 2 after patellectomy). They noted thinning of the cortical bone, lacunae of cortical reabsorption, rarefaction of the trabeculae, of which some were dead, stasis and fibrosis of the bone marrow. The 8 cartilage samples were pathological, with, in particular, fibrosis of the surface cartilage (vascular pannus formation). The association of chondromalacia of the patella with an S.R.D. syndrome of the knee is frequent.

[Chondromalacia of the hip]. / La chondromalacie de la hanche.

The authors have shown that the initial phase of coxarthrosis consists purely of cartilaginous lesions, not visible in radiographs. They have studied 200 arthrograms of the hip using a precise technique which is described. They have found cartilaginous lesions both in cases of insufficiency of the lateral wall of the acetabulum, and in cases of insufficiency of the medial wall of the acetabulum. Cartilaginous lesions may range between a simple decrease of articular cartilage height and complete ulceration either on the cephalic or acetabular sides. These lesions may be present at a time when the radiograph is still normal, especially in cases of hip dysplasia. It is concluded that the articular cartilage of the hip may chondromalacic in the same way as in the patello-femoral joint, and that arthrosis may be secondary to this chondromalacia. Arthrography makes early diagnosis possible.

[Histopathology of bone lesions in 9 cases of algodystrophy of the hip]. / Histopathologie des lésions osseuses dans 9 cas d'algodystrophie de la hanche.

The authors present the results of histo-pathological observations made in 9 cases of sympatic algodystrophy reflex of the hip, subjected to a punch biopsy of the head and neck of the femur. The punch biopsy was decided upon, either because of difficult diagnosis, or because of the abnormally long duration of the pain syndrome. In all cases, there were bone lesions. The most common were in the marrow tissue, with stasis (9 cases), fibrosis (7 cases) and necrosis at small, isolated points (5 cases). There was osteoclastic resorption in the bones in 3 cases, and rapid osteogenesis in 6 cases. The latter anomaly revealed the rapid reconstruction characterizing the syndrome. Finally, the authors comment on the relationship between algodystrophy and necrosis of the hip, and the advantages of punch biopsy.

[Coxarthroses due to ischemia. Ischemic coxarthropathy]. / Les coxarthroses d'origine ischémique. Coxopathies ischémiques.

In the first part of their work, the authors present radiological, histopathological and experimental results showing that cartilage of the joint can be originally damaged by articular ischemia. In the second part, they analyze the clinical and radiological features of 40 cases of ischemic coxarthrosis, substantiated by histological examination: these are chronic coxarthropathies with changes in the cartilage without rupture of the femoral head but with medullary necrosis and often trabecular necrosis involving the head and the neck of the femur. These ischemic coxarthroses are most often well centered with a superior or supero-internal pinching and show few osteophytes. They constitute a group of coxarthrosis called "primitive", involving the structure because of a previous weakening of the cartilage.

[A new model of experimental arthrosis: contusion of the cartilage. Experimental and clinical study]. / Un nouveau modèle d'arthrose expérimentale: la contusion du cartilage. Etude expérimentale et clinique.

The effects of a single contusion without surface disruption and without fracture of the patella were studied in 40 rabbits. Macroscopic observation as well as light and electromicroscopy revealed lesions comparable to those observed in patients with chondromalacia of the patella and arthrosis. Three successive stages can be distinguished: a degeneration of the chondrocytes, a temporary proliferative reaction and an extension of the degenerative lesions resulting in an arthrosis. This is therefore a new model of chondromalacia and experimental arthrosis which is comparable in every respect to what is observed in human traumatology.