[Traumatic epiphyseal separation of the lower end of the femur]. / Décollements épiphysaires traumatiques de l'extrémité inférieure du fémur.

Forty-one children suffering from displacement of the distal femoral epiphysis were reviewed with a five year follow-up. This is a rare lesion, caused by severe trauma. It is seen at all ages, four of the cases being neonatal, but principally in adolescence, in 22 cases. The Ogden classification is preferable to the Salter-Harris classification for these fractures, which are usually in type II (39 cases). The prognosis is related to the severity of the initial displacement and to the quality of the reduction and its maintenance. Epiphysoidesis developed frequently and early, in 15 cases. It seemed to be due to an initial vascular injury rather than to mechanical compression. The results were not very satisfactory with 23 good, 11 fair and 7 bad results. It is recommended that an anatomical reduction should be maintained by percutaneous crossed pins. In adolescents aged 15 years or over, primary surgical epiphysiodesis of the whole growth cartilage seems to be a reasonable possibility.

[X-ray computed tomographic aspects of gelatinous disease of the peritoneum. Apropos of 5 cases]. / Aspects tomodensitométriques de la maladie gélatineuse du péritoine. A propos de 5 cas.

Gelatinous disease of the peritoneum, designated by Anglo-Saxon authors as peritoneal pseudomyxoma is a rare affection characterized by the presence in the peritoneal cavity of a mucoid substance corresponding to an acid mucopolysaccharide. It develops secondary to an acid mucopolysaccharide. It develops secondary to mucosecreting malignant tumors, particularly of ovarian or appendicular origin, and its capacity to provoke multiple recurrences makes it of fairly poor prognosis. Diagnosis has been improved by the availability of non-aggressive investigations such as ultrasound and particularly computed tomography imaging. Suggestive CT scan signs are hepatic scalloping and a partitioned intraperitoneal effusion. Follow up scans can give data on the course of the disease and detect any complications (renal and digestive lesions, intraperitoneal abscess).

[Pulmonary hypertension and fetal circulation after severe congenital diaphragmatic hernia (author's transl)]. / Hypoxémie réfractaire par hypertension artérielle pulmonaire et circulation de type foetal dans les hernies congénitales de la coupole gauche à révélation néonatale. Physiopathologie et traitement à propos de quatre observations.

The authors present four new born with severe anoxemia after congenital diaphragmatic hernia repair. In three babies' hypoxemia was present from birth. Cardiac catheterization revealed pulmonary hypertension, resulting in a state of fetal circulation. Tolazoline produced an improvement in oxygenation, but became secondary ineffective. In one case ductus arteriosus was occluded during cardiac catheterization, after which immediate improvement in peripheral oxygenation was seen. Ligation of the patient ductus arteriosus was proposed in that case. In the fourth infant, hypoxemia developed secondary and was successfully treated with tolazoline. It is suggested that ligation of the patient ductus arteriosus and administration of pulmonary vasodilatators are both effective in improving oxygenation, in patients who may die an anoxic death after repair of a severe congenital diaphragmatic hernia.