Incidence of osteosynthesis of members in France.

PURPOSE: Little data is available on the number of osteosynthesis of limbs in a country. Incidence of osteosynthesis is an essential element for the formation and organization of care. Based on the data from the work of the Hospital Information Technology Agency ( http://www.atih.sante.fr/ ) and available in open access, we wanted to know the incidence of the number of osteosynthesis performed in France and their evolution over ten years between 2006 and 2015. METHODS: The data analyzed are derived from the website of the technical agency of information on the hospitalization (ATIH). RESULTS AND CONCLUSIONS: In France, in 2015, 267,999 limb osteosyntheses were performed. Between 2006 and 2015, the number of osteosynthesis increased by 9.1%. The incidence of limb osteosynthesis is 403.7 per 100,000 people, rising 3.9% between 2006 and 2015. In comparison, the incidence of hip prostheses increased by 12.6%, knee prosthesis by 57.4%. The main bias of the study is of course the quality of the coding of the surgeons and the establishments, a type of fracture that can enter into one or several categories of acts. In ten years, the incidence of osteosynthesis has increased little in France. The evolution is more pronounced on fractures affecting mainly the elderly, fracture of the upper end of the femur, fracture of the distal end of the radius and fracture of the ankle. The incidence of many acts of osteosynthesis is very low and therefore responsible for a weak experience for most surgeons.

The use of a photogrammetric method for the three-dimensional evaluation of spinal correction in scoliosis.

PURPOSE: Clinical parameters, characterizing the spinal deformations due to scoliosis, are still directly measured on the spinal curve plane projections. METHODS: A 3D spinal curve has been reconstructed from its two projections, using photogrammetric techniques. Each spinal curve is a compound of several plane regions, where it is purely flexed, and short zones of connection, where abduction and axial rotation components are concentrated. All spinal curves are represented as linear chains of regional planes articulated together. The regional plane is represented by a triangle, where one summit corresponds to the point of maximum offset. The set of weight forces, representing pelvis and spine, forms a bundle of vertical forces. The dispersion of the bundle illustrates the postural stability of patients. RESULTS AND CONCLUSIONS: The first objective was to numerically describe the changes of the 3D spinal feature, due to the correcting treatment. Changes are calculated from the comparison between 3D radiologic situations, between before and after treatment. The second objective was to determine the direction of the external force, which would be the most efficient for correcting the patient set spine/rib cage. A mild mechanical analysis is proposed, for representing the transit of the external force, from rib cage to thoracic regional plane.