[Pronator quadratus preservation for distal radius fractures with locking palmar plate osteosynthesis. Surgical technique]. / Préservation du muscle carré pronateur dans les ostéosynthèses des fractures de l'extrémité distale du radius par plaque palmaire verrouillée. Technique chirurgicale.

INTRODUCTION: A surgical technique is described to preserve the pronator quadratus muscle when fixing distal radius fractures with volar locking palmar plates. TECHNIQUE: Using a classic volar Henry approach to the wrist, the fibrous distal attachments of the pronator quadratus muscle are released. The locking palmar plate is passed under the pronator quadratus muscle and its correct placement is checked by fluoroscopy. Locking screws are inserted through mini-incisions in pronator quadratus. DISCUSSION: The pronator quadratus muscle plays an important role in wrist function, both in forearm pronation and as a stabilizer of the distal radioulnar joint. Mechanical impingement between the volar plate and the flexor tendons can cause adherences, ruptures and tenosynovitis. These should be reduced if pronator quadratus were intact. CONCLUSION: Preservation of the pronator quadratus muscle is possible for the majority of the fractures of the distal radius treated with locking volar plate osteosynthesis.

[Thoracolumbar fractures]. / Fractures du rachis thoracolombaire.

Thoracolumbar fractures are frequent and the functional outcomes are sometimes severe. This multicentric study, including five medical centers, was performed to evaluate the long-term outcomes of the patients. One hundred and thirty six patients with thoracolumbar fracture (T11 to L2) was evaluated with a minimal follow-up of two years. Every one had a clinical exam with a score of Oswestry and an X-Ray study (before and after treatment and at revision). Most of them presented compression fractures, the most often at L1 level. On X-rays, a gain was noted on the vertebral kyphosis immediately after surgery, but there is a loss of correction over time whatever the treatment. The clinical outcomes for the patients were great, with an Oswestry average score of 6,4. A correlation was noted between this functional score and vertebral kyphosis. So, an anterior column strengthening (isolated or performed during the surgery) could improve these functional outcomes. Moreover, the Thoraco Lumbar Injury Severity Score (TLISS) seems to be a simple organigram to determine the most appropriate treatment of these fractures, with particular attention to the distraction mechanism or posterior ligamentous complex lesions. However, RMI before surgery is necessary to evaluate these lesions.

[Scarf osteotomy for the treatment of hallux valgus: a review of 123 cases with 4.8 years follow-up]. / Ostéotomie Scarf dans le traitement de l'hallux valgus: à propos de 123 cas avec un recul moyen de 4,8 ans.

PURPOSE OF THE STUDY: Many different osteotomies can be used for the treatment of hallux valgus. The purpose of this study was to evaluate the Scarf osteotomy associated or not with phalangeal osteotomy and to search for deformation cutoff points beyond which corrections appear to be difficult to achieve. MATERIAL AND METHODS: This retrospective analysis included 87 patients (123 feet) among 130 who underwent hallux valgus surgery between October 1993 and November 2000. Mean follow-up was four years eight months. The serie included 83 women and 4 men. Mean age at surgery was 53.5 years. A Scarf diaphyseal osteotomy was performed in all patients associated or not with phalangeal osteotomy. Each patient was reviewed clinically and radiographically with anteroposterior and lateral views of the foot in the standing position. RESULTS: 84.6% of the patients were satisfied or very satisfied. There was a correlation between the index of satisfaction and clinical symptoms (metatarsalgia, stiff hallux, pain over exostosis). There was a statistically significant decrease in hallux valgus (31.2 degrees to 17.5 degrees ), of metatarsus varus (12.1 degrees to 7.5 degrees ), and articular angle of the distal metatarsus (13.3 degrees to 11.1 degrees ). Patients who had phalangeal osteotomy achieved the best hallux valgus correction (15 degrees versus 21.4 degrees ). Mean shortening of the first metatarsus was 2.2 mm with a decrease in the metatarsus-ground angle (19 degrees versus 20.1 degrees ). Cutoff limits for deformations which are difficult to correct satisfactorily were M1M2 angle > or = 15 degrees and distal metatarsal articular angle > or = 13 degrees . The overall Groulier score showed 70.7% very good and good results, 27.6% fair results and 1.7% poor results. DISCUSSION: The Scarf technique is a reliable method to achieve significant correction of hallux valgus deformation. It requires a rigorous technique with specific attention to the elevation of the first metatarsus and excessive shortening, two factors favoring metatarsalgia. Adding a phalangeal osteotomy can improve the radiological result, but it is very difficult to obtain satisfactory correction if the initial deformations are severe and associated. Rotation of the plantar fragment helps for better orientation of the articular surface of the first metatarsus but limits the correction of the metatarsus varus. Function is the basic objective of hallux valgus surgery and patient satisfaction is related solely to clinical symptoms.

Structural characterization and magnetic properties of sandwich-type tungstoarsenate complexes. Study of a mixed-valent VIV2/VV heteropolyanion.

Complexes K11Na1[As2W18(Mn(H2O))3O66]x27H2O (1) and Na12[As2W18(Co(H2O))3O66]x34H2O (2) have been characterized. 1 crystallizes in the orthorhombic space group Pnma, with a = 30.6484(4) A, b = 14.9946(2) A, and c = 19.17080(10) A (Z = 4), while 2 crystallizes in the monoclinic space group C2/c, with a = 14.124(2) A, b = 23.294(3) A, c = 32.247(3) A, and beta = 98.935(10) degrees (Z = 4). Structures of the anions of 1 and 2 are similar, the divalent metals adopting a square pyramidal environment. K11[As2W18(VO)3O66]x23H2O (3) crystallizes in the orthorhombic space group Pnma, with a = 30.6240(5) A, b = 14.9861(2) A, and c = 19.2651(3) A (Z = 4). The structure has revealed a disorder on two of the three metals linking the [alpha-AsW9O33]9- parts. For these two vanadium atoms, the V=O bonds are directed alternatively toward the inside or the outside of the [alpha-AsW9O33]9- cavity. The remaining vanadium shows a V=O bond always directed toward the outside of the cavity. Titration of VIV by CeIV revealed that 3 is the mixed-valent VIV2VV species. Magnetic measurements are in agreement with this formulation. The high-temperature molar magnetic susceptibility of a powdered sample of 3 clearly confirms the presence of two d1 centers. The two VIV are antiferromagnetically coupled, with J = -2.9 cm-1 and g = 1.93. Crystallographic data do not permit the location of the two VIV to be distinguished from the location of the VV. As expected, the Mn(II) are very weakly antiferromagnetically coupled in compound 1. The complex Na8[Ni(H2O)6]2[As2W18(Ni(H2O))3O66]x20H2O (4) has been synthesized. The anion crystallized with two octahedral [Ni(H2O)6]2+ as counterions. Magnetic data have been fitted assuming that the only exchange-coupled centers are the nickels of the polyanion. 4 exhibits an antiferromagnetic coupling with J = -1.7 cm-1, g = 2.27, and theta = -1.5 K.

Development of the cellulolytic microflora in the rumen of lambs transferred into sterile isolators a few days after birth.

Seven lambs, separated from their dam 24 h after birth, were kept in a conventional environment until transferred to sterile isolators between 1 and 9 days of age: two on day 1 (IA and IB), two on day 4 (IVA and IVB), one on day 8 (VIIIA), and two on day 9 (IXA and IXB). The lambs were reared in these isolators until 120 days of age. Lambs IA, IB, IXA, and IXB were free of cellulolytic bacteria when they were placed in the isolators. They were then inoculated with Bacteroides succinogenes S85 which became established in the four lambs. Until the age of 2 months, the population of this strain fluctuated and then stabilized at a high level (10(8)-10(9) cells/mL). Cellulolytic bacteria were present in the rumen of lambs IVA, IVB, and VIIIA when they were transferred to the isolators. In IVA, and IVB, the cellulolytic population slowly increased with the animal age. In contrast, in VIIIA, the cellulolytic bacteria disappeared within a few days. Bacteroides succinogenes S85 inoculated thereafter became established rapidly and reached a level comparable to that observed in lambs IA and IB. The total number of viable rumen bacteria in the isolated lambs was similar to that observed in conventionally raised animals, but differences were observed in the selective enumeration of bacteria utilizing specific energy sources.