[Anterior recurrent luxation of the shoulder. Postoperative recurrences]. / La luxation récidivante antérieure de l'épaule. Les récidives post-opératoires.

Seventy-nine recurrences have been seen after surgical procedures for recurrent dislocation of the shoulder. There were 58 "true" recurrences, 17 shoulders with anterior instability and 4 with instability in all directions. The "true" recurrences were more frequent in young people with a mean age of 20 years at the time of the first surgical procedure. Two-thirds of them occurred on the dominant side. Most of the cases had been treated by distal displacement or lengthening of the coracoid process (38 Trillat procedures, 8 Latarjet procedures and 8 Oudart procedures). Only two had been treated by a Bankart procedure. The main cause of recurrence was a failure of repair of the antero-inferior part of the joint. Twenty three cases were operated on again, the most usual procedures being the Trillat procedure and rarely the Latarjet or Eden Hybinette procedures. Six cases recurred once again. Cases with anterior instability were observed after the Trillat procedure. They were due to capsular laxity and did not have to be operated on again. Instability in multiple directions was observed in young women who continued to dislocate their shoulder inferiorly or posteriorly, despite two or three surgical procedures.

[Present role of Hartmann's operation. Apropos of 50 cases]. / La place actuelle de l'opération de Hartmann. A propos de 50 cas.

Of 50 Hartmann's operation conducted, 22 (including 19 for sigmoid diverticulitis) were for non-neoplastic lesions. Emergency surgery was necessary for lesions complicated by perforation, abscess, or occlusion in 34 cases, the indications for operation being local and general conditions, where immediate re-establishment of colorectal continuity was not possible, in the other 16 patients. Overall mortality was 22 p. cent, being much higher in cancer cases (32 p. cent) than in those with sigmoiditis (52 p. cent). Postoperative morbidity was marked, and was dominated by parietal complications and those due to the colostomy, and by thromboembolic complications particularly in the sigmoiditis cases. Secondary re-establishment of intestinal continuity was possible in 19 patients (6 cancers and 13 benign lesions) with a single postoperative death. Whereas the employ of Hartmann's operation in cancer would appear to be justified only in urgent complicated cases it is certainly a valid procedure in the acute phase of sigmoid diverticulitis, where its mortality is relatively low. Current mechanical suturing techniques, by facilitating secondary re-establishment of continuity, reduce the classical inconveniences of Hartmann's operation, suggesting its wider use for the emergency treatment of complicated lesions of the colon.

[Radio-anatomic and microangiographic study of pulmonary systemic vascularization]. / Etude radio-anatomique et micro-angiographique de la vascularisation systémique pulmonaire.

The systemic pulmonary vascularization of 26 subjects was studied by a microangiographic technique after total body injection by micropaque. By our microangiographic technique was observed an average of 2 bronchial arteries per subject whereas by dissection we found an average of 2,5. We also noticed in 80% of our subjects a right intercosto-bronchial trunk, in 15% a right bronchial artery, in 30% a common trunk for both left and right bronchial arteries, and an average of 1.2 left bronchial arteries per subject. Besides microangiography revealed: 1) Numerous and variable aspects of systemic intra-pulmonary vascularisation except for the trifurcation of the right bronchial artery. 2) The importance of the arterial network in the submucosa of segmental and subsegmental bronchi. 3) The vascular supply of the visceral pleura by bronchial vessels.