[Stress fractures of the tibia and gonarthrosis. apropos of 2 cases of pseudoarthroses and literature review]. / Fractures de contrainte du tibia et gonarthrose: à propos de deux pseudarthroses et revue de la littérature.

Stress fracture of the tibia is a rare complication of osteoarthritis of the knee joint. It rarely results in pseudarthrosis. Two cases with such an evolution are reported, together with a survey of the literature.

[Musculocutaneoplasty by combined flap with tensor of the fascia lata- gluteus medius in trochanteric pressure sores. Apropos of a clinical case]. / Myocutanéoplastie par lambeau combiné tenseur du fascia lata-moyen fessier dans les escarres du grand trochanter. A propos d'un cas clinique.

The authors describe a musculocutaneous flap which can be used in trochanteric pressure sores in paraplegics. Described by Little and Lyons (1983), this reconstructive unit combines the proximal muscular segment of the tensor fasciae latae (TFL) and gluteus medius muscles in a round shaped flap pedicled on the lateral circumflex femoral artery. The anatomical basis of this muscle combination is found in the anastomotic network between the superior gluteal artery which supplies gluteus medius muscle and lateral circumflex femoral artery, the principal vascular pedicle of the TFL muscle. Cutaneous defects of the trochanter and associated osteitis are frequent complications in paraplegic patients which often require ostectomy and coverage of the bony prominence by well vascularised, padded skin. Musculocutaneous flaps are well suited for this purpose and we review various reconstructive units that may be brought into trochanteric defects. Among these, the gluteus medius-TFL flap appears to be an interesting option for, in case of recurrent ulcers, other donor areas are left intact, and the flap itself could give rise to a subsequent "traditional" TFL flap.

Bone regenerate formation in cortical bone during distraction lengthening. An experimental study.

The aim of this study was to delineate the pattern of bone regeneration from cortical bone segments during distraction lengthening. The lengthening procedure was applied for various periods through the Ilizarov system on the forearms of mature dogs. Bone was sectioned either by corticotomy, preserving the nutrient artery integrity, or by osteotomy. When an osteotomy was performed, the marrow cavity was in some cases plugged with either resorbable bone wax or nonresorbable material. Under distraction, both periosteal and medullary callus on either side of the gap gave rise to new bone trabeculae. The trabeculae on either side were oriented along the direction of distraction and progressively approached one another. This striated callus emerging from both sides was the most characteristic pattern of bone regeneration subsequent to distraction lengthening. Fusion was achieved approximately four weeks after the end of the lengthening period. Most of the new bone was formed by membranous ossification; some cartilaginous nodules developed. Corticalization of the bone trabeculae that had begun at three months was not fully achieved at five months after the lengthening period. There were no differences found in the pattern of bone healing and the amount of newly formed bone after corticotomy or osteotomy with or without resorbable bone wax plugging.

[Subacute osteomyelitis in young children. Study of 17 cases]. / L'ostéomyélite subaiguë chez le jeune enfant. Etude de 17 cas.

Subacute osteomyelitis is characterised by absence of symptoms of generalised infection and a favourable prognosis. In the last 15 years, the authors have observed 17 such cases in children, aged between 3 months and 4 years. Three were situated in the epiphysis and 14 in the metaphyseal region. On three occasions, a tarsal bone was involved and in five cases the lesion was in the spine. The radiological signs were very characteristic and biological changes were minimal. Exploration of the site of the infection was done on ten occasions, but only on two were organisms found. Treatment was based on antibiotics active against staphylococci and drugs inhibiting prostaglandins. Only one case was treated surgically. Healing occurred eventually in all cases.