[Subcutaneous avulsion of the flexor digitorum profundus and flexor digitorum superficialis tendons of the ring and little fingers caused by blast injury]. / Avulsion sous-cutanée des tendons fléchisseurs profonds et superficiels des IVe et Ve doigts par blast.

The authors report a case of subcutaneous avulsion of flexor profundus and flexor superficialis tendons of the ring and little finger, caused by a blast injury. Treatment consisted of excision of the flexor superficialis tendon with transosseous reinsertion of the flexor profundus tendon. The functional result was good. Subcutaneous traumatic rupture of flexor tendons occurs infrequently, but simultaneous rupture of both flexor tendons is extremely rare. Knowledge of the subject is limited and treatment of this disorder is poorly defined.

[Osteosynthesis of radial head fractures in adults]. / L'ostéosynthèse des fractures de la tête radiale chez l'adulte.

The authors report their experience and the results of internal fixation of radial head fractures in adults. They studied type 2 and type 3 fractures of Mason classification. Results were appraised with criteria of Radin and Riseborough. They found a rate of 80 per cent of objectively good or fair results. Fractures with one fragment (type 2) and without associated lesions (like sprain or dislocation of elbow) had the best results which depended of the quality of internal fixation. The series reported in the literature using the same operative technique are comparable. The results are equal or better than head resection with or without arthroplasty. Internal fixation is considered as the best operative technique for displaced fractures in adults. Reduction must be perfect. Head resection must be considered per-operatively if a perfect reduction is technically impossible to achieve.

[Value of synovectomy under arthroscopy in the treatment of persistent synovitis in chronic inflammatory rheumatic diseases]. / Intérêt de la synovectomie sous arthroscopie dans le traitement des synovites persistantes des rhumatismes inflammatoires chroniques.

Twelve patients suffering from an inflammatory rheumatic disorder with chronic synovitis of the knee joint were treated by synovectomy using a pneumatic chondrotome under arthroscopic control in combination with abundant articular lavage. All patients had been treated with one or several chemical or radioisotopic synovial instillations followed by failure of treatment or a rapid recurrence of synovitis. Eight patients had a rapid and good or very good therapeutic result with regression of synovitis and of pain during the first month after the synovectomy. This result appears to be maintained more than one year later in the case of the first patients treated. Four patients had a manifest but incomplete improvement. Postoperative follow-up was unremarkable, hospitalization period was short, and no physical rehabilitation was necessary. However, one patient developed stiffness of the knee joint which required its movement under general anesthesia. Arthroscopy with synovectomy and articular lavage appear to offer an interesting therapeutic resolution in case of chronic synovitis unresponsive to medical measures, both locally and systemically administered. Short-term results appear better than those obtained with conventional surgical synovectomy and postoperative follow-up is much simpler.

[Proliferative myositis, a muscular pseudo-sarcoma. Apropos of a case with an ultrastructural study]. / La myosite proliférante, un pseudo-sarcome musculaire. A propos d'un cas avec examen ultrastructural.

A 40-year old woman with a history of rapidly growing tumor of the brachio-radialis muscle is described. By light microscopy, the tumor had typical features of proliferative myositis, with alternating areas of well preserved muscular fibres and strands of proliferating spindle shaped cells and ganglion like cells. Electron microscopic study showed non specific degenerative muscle changes, fibroblasts and giant cells. The histogenesis and the nosologic place of proliferative myositis are discussed.

[Traumatic etiology of Kienboeck's disease. (Perilunate subluxations and semilunate necrosis)]. / Etiologie traumatique de la maladie de Kienböck. (Luxations péri-lunariennes et nécrose du semi-lunaire).

The authors have studied the incidence of lunate necrosis in 110 perilunate dislocations. Twenty-one cases (19%) developed a necrosis. The classification into three types, according to the amount of damage to the perilunar ligaments, is of prognostic value. There is no risk of necrosis in type 1, 17% in type II, and 50% in type III. An associated fracture of the scaphoid does not modify the risk. In neglected lesions, reduction of the lunate dislocation should be attempted, even at a late date, the risk of necrosis then being 50%. Surgical reduction increases the risk of secondary necrosis to a greater extent than does orthopedic treatment, but it is generally use in the most complex cases too. The authors advocate a closed reduction with percutaneous pin fixation.

[Rupture of the posterior cruciate ligament. Palliative treatment by transposition of the internal gastrocnemius mucle into the intercondyloid notch (author's transl)]. / Ruptures du ligament croisé postérieur. Traitement palliatif par transposition du jumeau interne dans l'échancrure intercondylienne.

In old ruptures of the posterior cruciate ligament, dynamic knee stabilization can be obtained by transposition of the internal gastrocnemius muscle into the intercondyloid notch. The muscle contracts when the patient walks, thus preventing posterior sliding. The technique, derived from Hugston's technique, is simple, and the intial results are very encouraging, both objectively and subjectively.

[Ender's flexible nail. Theoretical and biomechanical study. Technic, indications and results in the treatment of cervico-trochanteric fractures]. / Le clou élastique de Ender. Etude théorique et biomécanique. Technique, indications, résultats dans le traitement des fractures cervico-trochantériennes

The authors describe the Ender's technique in the treatment of fractures of the trochanteric region. They realise a blind nailing, introducing "elastic" nails in the region of the medial condyle, under Xray control. The authors have conducted a biomechanical study comparing this type of nailing with nail-plating (extensometry and mathematical theory). 51 patients were operated-on. The results are analysed. The authors point out that the surgical procedure is very fast and simple, therefore they support it for aged people.