[Shoulder fusion for sequelae secondary to brachial plexus palsy]. / Arthrodèse d'épaule pour séquelles de paralysies du plexus brachial.

PURPOSE OF THE STUDY: We examined clinical and radiological outcome in fifteen patients who underwent shoulder fusion after brachial plexus palsy. MATERIAL AND METHODS: This retrospective analysis included 15 patients who underwent shoulder fusion between 1981 and 1997 for the treatment of sequelae secondary to brachial plexus palsy. There were 13 men and two women, mean age 24.6 years (range 18-33 years). The right shoulder was fused in nine cases and the dominant shoulder in ten. There was one obstetric paralysis and one paralysis secondary to a cervical neurinoma. Eleven patients were motorcycle accident victims and two were automobile accident victims. The patients were installed in the lateral supine position with 30 degrees antepulsion and 60 degrees abduction, measured from the axillary axis of the scapula, and internal rotation. All patients had internal fixation by plate through a posterior approach. The same observer examined all the patients at last follow-up. Clinical and radiological findings were recorded and the position of the arthodesis was analyzed. RESULTS: There was one case of delaved fusion and one case of late humeral fracture. The arthrodesis position was abduction 52 degrees, internal rotation 20 degrees, flexion 20 degrees (means). Hand-mouth and hand-pocket movements were possible for all patients. Seven had no pain. Active motion was: 48 degrees abduction, 46 degrees antepulsion, 40 degrees internal rotation, 4.6 degrees external rotation, 23 degrees retropulsion. For 13 patients, mean lifting force was 5.2 kg.

[Anuerysm of the ulnar artery in a mountain biker. A case report and review of the literature]. / Anévrisme de l'artère ulnaire chez le cycliste tout terrain. A propos d'un cas clinique et revue de la littérature.

A case of ulnar artery aneurysm following repeated hand injury in a mountain biker, is reported. The patient underwent surgical aneurysm resection with venous graft end-to-end anastomosis. Complete relief of symptoms is observed at 3 years follow-up. A literature review is presented.

[Reconstruction of the distal radius for primary bone tumors using a non-vascularized fibular graft (report of 4 cases)]. / Reconstruction du radius par greffon fibulaire non vascularisé pour tumeur osseuse primitive (à propos de quatre cas).

We report four cases of primary bone tumour of the distal radius. Follow-up averaged ten years with a range of four to 13. Each case underwent excision of the tumour followed by reconstruction with a non-vascularised fibular graft. The aim of our study was to investigate the carcinologic, functional and radiological results at an average of ten years after the initial surgery. There were three high grade osteosarcomas and one giant cell tumour of bone. The mean postoperative wrist flexion was 45 degrees, extension was 20 degrees, pronation 30 degrees and supination 50 degrees. Radial tilt was a mean 10 degrees and ulnar tilt 15 degrees. All the patients had satisfactory function so as to be able to perform activities of daily living and to work. Grip strength was normal in three cases and reduced in one. Bone graft healing occurred at a mean of six months with a range of from four to nine months. Resection followed by a non-vascularised fibular graft is an effective way to managing these patients.

[Atypical Fenton syndrome]. / Syndrome de Fenton atypique.

The case of a patient 41 years old is reported. He sustained a posterior open carpal fracture dislocation transcapho-trans-capitate with radius styloid process fracture. The original aspect of this observation is that the lunatum was enucleated. The treatment was not usual. Capitatum bone was first fixed and associated with an external fixation. Proximal row carpectomy was performed in a second procedure when removing internal and external fixation, capitatum being healed. Follow up is now at four years with a very good radiological and clinical result. The patient is working with an intermittent mild pain. Radiographic examination demonstrated a very good vascularisation of the capitate head.

[Surgical treatment of carpometacarpal joint osteoarthritis of the thumb by trapeziectomy-interposition-ligamentoplasty]. / Traitement chirurgical de la rhizarthrose par trapézectomie-interposition-ligamentoplastie.

INTRODUCTION: Osteoarthritis of the carpometacarpal joint of the thumb is a common pathology. Several surgical methods exist, including trapeziectomy, arthrodesis, cemented or cementless prosthesis. Therefore, one must question the legitimacy of non prosthetic surgery. The authors have tried to answer this question. METHOD: Surgery consisted in trapeziectomy and ligament reconstruction with tendon interposition arthroplasty (LRTI). Authors reviewed 47 cases with five years follow-up. Patients were evaluated using a functional score, including pain, professional and domestic activities, and leisure involving the hand. Objective data were also assessed: thumb opposition, radiographic scaphometacarpal mobility, key and tip pinch, grasp strength. RESULTS: Functional results ranged from good to excellent in 42 cases. Opposition was satisfactory in 46 cases. Scapho-metacarpal range of motion was 16 degrees. Pinch strength was 4.2 kg and grasp strength was 23 kg. There were no complications. Loss of pinch strength was 1 to 2 kg as compared to our reference group. Such a loss does not impair patients' daily life. Age and operated side do not influence results. Scores do not decrease with time. Radiographic staging seems to be linked with scoring. Reducing the trapezial space does not influence results. We had none of the complications described in other techniques: synovitis, ossifications, loosening and reflex sympathetic dystrophy. DISCUSSION: This study, as well as literature, confirms that trapeziectomy and ligament reconstruction with tendon interposition arthroplasty gives satisfactory functional results which are stable with time and without complication. For all these reasons, the authors prefer this technique in degenerative osteoarthritis.

[Rhabdomyosarcoma of the hand. Apropos of a case confined to the thenar eminence]. / Rhabdomyosarcome de la main. A propos d'un cas localisé à l'éminence thénar.

A case of alveolar rhabdomyosarcoma of the hand in a 21-year-old patient is reported. In the light of this case, the authors review the literature and analyse the therapeutic implications.

Effect of phosphate on antibiotic and extracellular protein production by Myxococcus coralloides D.

The effect of inorganic phosphate concentrations on antibiotic and extracellular protein production by Myxococcus coralloides D have been examined. Antibiotic production by growing cells of this myxobacterium was maximal at phosphate concentrations of 10-20 mM, but was inhibited by concentrations higher than 20 mM. The total extracellular protein and the extracellular protein per cell ratio were independent of phosphate levels in the culture broth.