[Trigger digits]. / Les doigts à ressort.

Trigger finger is an entity seen commonly by hand surgeons. It is produced by a size mismatch between the flexor tendon and the A1 pulley, which causes pain, clicking, catching, and loss of motion of the affected finger. The diagnosis is usually easy but other pathological processes (extensor apparatus instability, locked metacarpo-phalangeal joint) must be excluded. Treatment modalities in trigger finger include splinting, corticosteroid injection and/or surgery. Indication depends on the clinical form of trigger finger.

[Value of somatosensory evoked potentials in spinal surgery monitoring in children and adolescents: 110 cases]. / Intérêt des potentiels évoqués somesthésiques dans la surveillance de la chirurgie du rachis chez l'enfant et l'adolescent: à propos de 110 cas.

This study shows the results obtained in 110 patients, children and adolescents by monitoring somatosensory evoked potentials during spinal surgery: Cotrel-Dubousset instrumention, surgical anterior correction by plating, spondylolisthesis and hemivertebra surgery. The recordings were made in preoperative, peroperative and postoperative period; the anaesthetic and electrophysiological conditions allowed us to obtain reliable recordings. In the peroperative period, the recordings were made: after induction of anesthesia and exposure of the spine, after instrumentation, after maximum traction and at the end of the operation. Analysis of the peroperative somatosensory evoked potentials (PESEP) showed significant differences in latencies, but also in amplitudes and morphology during distraction in scoliosis or spondylolisthesis. These impairments gradually improved and recovered their normal values at the end of the operation. The impairments were, with equal correction, 4 times more important in Cotrel-Dubousset instrumentation than in surgical anterior correction by plating. During instrumentation and in two cases, the impairments observed led the surgeon to change his operative behavior, certainly avoiding a postoperative neurological disorder, the "wake-up test" was made in one case. The correlation between the neurological problems, and the impairments of the potentials allowed us to define alarm criteria, and if they persist the "wake-up test" becomes necessary.

[Supracondylar fractures of the humerus associated with ipsilateral fractures of the forearm]. / Fracture supra-condylienne de l'humérus associée à une fracture homolatérale de l'avant-bras chez l'enfant.

We report 20 cases of ipsilateral supracondylar elbow fracture and forearm fracture in childhood. The mean follow-up was 20 months. For an analysis of the results, we used a global rotation of the upper limb. We appreciated the motion and the carrying angle of the elbow and the wrist. 15 cases were very good or good; there were 4 cubitus varus without functional impairment and 1 failure after one open Monteggia fracture. The therapeutic strategy is discussed. If one does not want to increase the damage to periosteum in the elbow during the forearm reduction, one must first reduce the supracondylar fracture and fix it by 2 pins like in Judet procedure. Then, the forearm fracture should be treated conservatively.

[Total paralysis of the brachial plexus caused by supra-clavicular lesions]. / Les paralysies totales du plexus brachial par lésions supra-claviculaires.

From 1983 to 1987, 50 adult patients who suffered total palsy of brachial plexus were operated on. The average follow up was 39 months. They suffered severe supra-clavicular lesions of all the roots. All the roots damaged in the scalenic area were grafted, the avulsed ones were not. One root was grafted in 23 patients, two roots in 9 patients, three roots in 5 patients, four roots in 1 patient. No root was grafted in 12 patients. An active flexion of the elbow (over M3+, M4) was recovered in 39 patients (76 per cent). An active adduction of the shoulder (m. pectoralis major) was recovered in 24 patients (48 per cent), and an active abduction (supraspinatus or deltoid) in 13 patients (26 per cent). Twenty seven patients had severe pain before surgery. After grafting, pain decreased in 17 (62 per cent. At follow-up, 31 of the 50 patients had no pain or mild pain. These results justify for the authors nerve repair in total palsy of brachial plexus by supra-clavicular lesions.

[Improvement of muscular re-innervation by using an enriched biological glue in the rat]. / Amélioration de la réinnervation musculaire par utilisation de colle biologique enrichie chez le rat.

The use of biological glue for the repair of nerve lesions offers the possibility of acting on axonal regeneration by means of trophic substances included in the glue. A comparative study conducted in the sciatic nerve of the rat shows that incorporation of the liquid exuded by sectioned nerve extremities into the glue to repair a section of the sciatic nerve trunk of other animals significantly increases the muscular tension of the force jerk and the of tetanic contraction of the reinnervated extensor digitorum longus 21 and 28 days after repair. It therefore appears possible to influence the regeneration or the maturation of the regenerating axons by local application of exogenous substances.

[Osteoid osteoma of the lunate. Apropos of a case. Value of x-ray computed tomography]. / L'ostéome ostéoïde du semi-lunaire. A propos d'un cas. Intérêt de la tomodensitométrie.

The authors report a new case of osteoid osteoma of the lunate. The absence of any specific clinical or radiographic features emphasises the importance of computed tomography, which not only confirms the diagnosis, but, more importantly, defines the topography and also guides the surgical approach and even the surgical technique.

[Osteoid osteoma of the semilunar bone. Apropos of a case. The value of x-ray computed tomography]. / L'ostéome ostéoïde du semi-lunaire. A propos d'un cas. Intérêt de la tomodensitométrie.

The authors report a new case of osteoid osteoma of the lunate. The absence of any specific clinical or radiographic features emphasises the importance of computed tomography, which not only confirms the diagnosis, but, more importantly, defines the topography and also guides the surgical approach and even the surgical technique.

[Mixed fractures of the posterior wall of the acetabulum. Value of x-ray computed tomography]. / Fractures mixtes de la paroi postérieure du cotyle. Intérêt de la tomodensitométrie.

The authors have studied three cases of fracture of the posterior wall of the acetabulum in which one fragment was separated and another was impacted. The nature of the lesions were not able to be appreciated on standard radiographs but was visualised by means of tomodensitometric studies. The patients were treated surgically to obtain an accurate reconstruction of the articular surface. The importance of tomodensitometry in the diagnosis of such lesions is stressed.