[Proximal median nerve compression. A series of 35 consecutive cases]. / Compressions du nerf médian dans la région du coude et de la partie proximale de l'avant-bras. À propos d'une série de 35 cas consécutifs.

Median nerve entrapment at the elbow and the proximal forearm represents 7 to 10 % of median nerve mononeuropathies. Literature distinguishes two distinct syndromes: the pronator syndrome and the anterior interosseous nerve syndrome. We report a retrospective series of 35 cases of proximal compression of the median nerve, including a previous study of 13 cases assessed in 2001. Thirty-four patients were operated on between 1994 and 2011. The series included 15 men and 19 women with a mean age of 57 years. Subjective complaints were the main reason of consulting with or without a deficit. All but one benefited from a preoperative electrical study. Neurography showed abnormalities in 18 cases and myography in 30 cases. At least one site of compression was found at surgery. Thirty-one cases, including nine of the 13 cases previously evaluated in 2001, were assessed with a mean follow-up of 69 months. Twenty-height considered them improved and all but one were objectively improved by surgery. The nine cases evaluated in 2001 had better results in 2011. Through this series and an exhaustive literature review, we concluded that there are no preoperative criteria that can differentiate a pronator teres syndrome from an anterior interosseous nerve syndrome. If no improvement occurs, surgical treatment should be proposed, one must then assess all potential sites of nerve entrapment. Patients must be informed that improvement can take several years.

[Isolated trapezoid fracture: a case report]. / Fracture isolée de l'os trapézoïde : à propos d'un cas.

The authors present a case of isolated fracture of the trapezoid bone. The diagnosis was made late and needed modern diagnostic tools such as CT scanning. Diagnostic and treatment strategies for isolated fractures of the trapezoid bone are reviewed according to the literature.

[Epidemiological survey of wrist fractures in children]. / Les fractures du poignet de l'enfant: étude épidémiologique.

PURPOSE OF THE STUDY: The incidence of wrist fractures is increasing in children. We undertook an epidemiological survey in western France to determine characteristic features. MATERIAL AND METHODS: A prospective multicentric study was conducted over one year in five university hospital centers in western France. The survey included 839 wrist fractures in children aged 6 to 16 years. The following criteria were recorded: age and gender, date and energy of the trauma, side and description of the fracture. Displacement was measured on the AP and lateral radiographs. RESULTS: The boys were older than the girls at the time of the wrist fractures, generally during the summer season (May to October). The left wrist was involved in 55% of the fractures; 83% were metaphyseal fractures. Fractures with epiphyseal detachment were more frequent in adolescents and occurred after high-energy trauma. Metaphyseal fractures were more common in girls than in boys. Displacement was greater in older children, particularly in case of epiphyseal detachment. DISCUSSION: We did not observe the male predominance often reported in our country. The girls probably practice sports as much as boys.

Lateral femoral sliding osteotomy lateral release in total knee arthroplasty for a fixed valgus deformity.

We treated 13 patients who had a fixed valgus deformity of the knee with a semiconstrained total knee arthroplasty combined with advancement of the lateral collateral ligament by means of a lateral femoral condylar sliding osteotomy. At follow-up of between one and 6.5 years all patients were assessed using the Knee Society score. The mean knee score improved from 32 to 88 and the functional score from 45 to 73. The mean tibiofemoral angle was corrected from 191 degrees to 180 degrees. There was no postoperative tibiofemoral or patellar instability and, in most knees, distal transposition of the lateral femoral condyle achieved satisfactory stable alignment.