[Adventitial mucoid cyst of the radial artery associated with volar wrist ganglion. A case report]. / Kyste mucoïde adventitiel de l'artère radiale associé à un kyste arthrosynovial radiocarpien de la gouttière du pouls. A propos d'un cas.

The authors report a rare case of a 51-years old woman presenting with cystic mucoid adventitial disease of the radial artery associated with a volar wrist ganglion. Imaging namely doppler sonography, magnetic resonance scanning and angio-MR was performed preoperatively because of a history of radial artery aneurysm in the opposite wrist. The radial artery was resected and the defect bridged by a venous autograft; the volar wrist ganglia was removed. Postoperative histological analysis confirmed mucoid adventitial cyst without communication with the volar wrist ganglion. Surgeons ought to be aware of this rare differential diagnosis (less than ten cases in the literature) in cases of preoperative or peroperative diagnostic doubt.

[Percutaneous compression plate for pertrochanteric fixation of hip fractures: surgical technique and first results]. / Ostéosynthèse des fractures du massif trochantérien par plaque de compression percutanée: Technique chirurgicale et premiers résultats.

We have used a minimally invasive technique for fixation of trochanteric fractures since 2003. We use the percuntaneous compression plate described by Gotfried. We describe here the osteosynthsis technique and our special approach which limits operative time. This technique avoids wide opening of the aponeurosis of the tensor fascia lata, major detachment, and section of the vastus lateralis. The plate is inserted via a 2-cm incision over the greater trochanter. Head and shaft screws are inserted via a second incision measuring 3 to 4 cm. Perfect reduction before plate insertion is the key to success. The results of our first twenty cases have demonstrated an uneventful postoperative period and a short operative time of 25 minutes on average. Peri-operative bleeding has been very limited. Radiographic healing was obtained in three months. Weight bearing was possible immediately after fixation in five cases and was delayed in fifteen. There were two early displacements which were analyzed.

[Extensor tendon rupture after dorsal surgery of the rheumatoid wrist: analysis of nine reviewed cases]. / Les ruptures des tendons extenseurs aprés chirurgie dorsale du poignet rhumatoïde: analyse de 9 cas revus.

We led a retrospective study to determine the causes of the tendon ruptures post-operating in the surgery of the wrist rheumatoid dorsal and to estimate the clinical result. At follow-up, we measured the extension lag and the rolling-up of fingers by the distance palm-pulps. Nine patients were so revised in the average of 40 months, average age was of 50.7 years. The tendon ruptures arose in 3 months in 67% of the cases. Seven times, a procedure on the distal radio-ulnar joint had been necessary (5 Sauvé-Kapandji and 2 Darrach). Thirty tendons had been concerned in this study, that is 3.3 tendons on average (1-5). Two main causes were found: attrition on the stub ulnaire and great intra-tendinous synovitis (per operating observation). At the revision, the lag extension means was 23 degrees (0-40). Rolling-up of the long fingers was complete 4 times on 7. The best results were observed after tendinous grafting or index proprius transfer with a lateral suture. Tendinous adhesions had arisen 6 times and persisted still at 3 patients. Our study underlines the interest to stabilize the stub ulnaire to prevent the post-operating ruptures and proposes a transfer or a graft in front of tendons very weakened by the synovitis.

[Fracture-dislocation of the second carpometacarpal joint. Case report and review of the literature]. / Fracture-luxation carpométacarpienne du deuxième rayon à propos d'un cas et revue de la littérature.

A 26-year-old man was involved in a car crash then he presented an isolated trauma of the hand. We found out a dorsal dislocation of the second carpometacarpal joint with trapezoid fracture and a Rolando fracture. In emergency, closed reduction with percutaneous wires to stabilize, was performed. In the same time, the Rolando fracture was treated by internal fixation (plate). In a second time, after computerized tomography of the carpus, the trapezoid was reduced through a dorsal incision and held with two Kirschner-wires. At last follow-up one year after injury, the result was good. All movements of the wrist and fingers were full and pain free. Thumb index pinch and grasp were approximately 80% those of the uninjured hand. The mechanisms of injury, anatomic factors and management of seventy-one cases of similar trauma (included at least a dislocation of the second carpometacarpal joint) were reviewed in the literature.

[An original procedure for cement diaphyseal extraction. The segmental cement extraction system or SEG-CES]. / Un procédé original d'extraction des gaines cimentées diaphysaires. Le segmental ciment extraction system ou SEG-CES.

PURPOSE OF THE STUDY: We report our first eleven uses of a new cement mantle extraction system. The basis of this technique relies on a cement bone interface with a lower strength compared to the old cement-new cement interface. MATERIAL AND METHODS: The first stage of the procedure consists in a specific preparation of the inner surface of the old cement, mantle. It should be clean and dry after being abraded with a stainless steel wire brush. Then a thin cement syringe filled with low Viscosity PMMA cement, is injected in the old mantle in a retrograde fashion. A threaded rod with nuts is centered within the cement sheath to the bottom and held until the injected cement has fully polymerised. Then the threaded rod is unscrewed from the femur; nuts are established along the entire length of the cement column. To prevent trochanteric fracture occurring upon cement extraction, its is important to clear away sufficient bone from the lateral aspect of the canal. A series of extraction rods are then used to sequentially remove the cement mantle. The removal rod is screwed back into the threaded channel at a distance of every one to three nuts, and then attached to the slap hammer via a quick release connection. Cement extraction is performed using deliberate slaps of the slap hammer. The last segment is drilled with the use of a distal plug drill centering sleeve. After having inserted the plug removal rod, the last segment is extracted. We used this technique eleven times in 8 hips for 5 loosening of femoral component and 3 revisions hip arthroplasties without loosening and 2 revisions knee arthroplasties without loosening (an extraction system for the femur and the tibia). RESULTS: For the 5 loosening cases extraction was easy. In 2 cases, cement mantle was removed as a single "en bloc" piece. In the 3 other cases, the extraction was segmental only in the distal third of the cement mantle. Without loosening, the extraction was completely segmental. In all cases, cement mantles were successfully removed. There was no fracture and no loss of bone stock. There was only one "fissuration" alpha the great trochanter and we only made one distal window. All hip arthroplasties were replaced and arthrodesis were performed after removal of the knee arthroplasties. DISCUSSION: The cement-assisted mantle removal technique appears to be a simple, quick and effective methods for cement mantle removal. Perforation and diaphyseal window can be avoided by the technique even when loosening does not exist. However, it is necessary to establish a thorough preoperating plan in order to eliminate contraindications such as too narrow or too curved sheath. CONCLUSION: It appears that this new procedure will facilitate future reoperations which are reputed to be difficult and dangerous.

[An unusual variation of luxation of the wrist: external vertical luxation. Apropos of a case. Review of the literature]. / Une variété rare de luxation du carpe: la luxation verticale externe. A propos d'un cas. Revue de la littérature.

A case of lateral dislocation of the carpal scaphoid associated with a fracture of the triquetral and carpo-metacarpal dislocation of the ring and little finger is described. A thorough search of the literature failed to reveal any previous report of this combination of injuries. The dislocation was reduced by manipulation, but the scapholunate ligament required surgical repair. The results after two year was good.

[Ilizarov method used for the sequela of growth cartilage lesions]. / La méthode d'Ilizarov dans les séquelles de lésions du cartilage de croissance.

Ilizarov distraction osteogenesis is a good way to correct sequelae of growth plate injury after completion of the growth. There is often both limb length discrepancy and angular deformation in varus, valgus, flexum, and recurvatum after surgery or trauma in childhood. Such deformations of the distal femoral growth plate, both proximal and distal tibial and distal radial will be presented, treated by a one-step Ilizarov method.

[Tenosynovial osteochondromatosis of the hand. A case report]. / Ostéochondromatose téno-synoviale à la main. A propos d'une observation.

A 14 year old boy presented with swelling of the middle finger. X-rays showed calcifications of the palmar surface of the head of the third metacarpal and over the first and second phalanges. The natural course was followed over a period of two years with a diagnosis of calcifying peritendonitis. Due to the increased volume of the calcification deforming the proximal phalanx, the masses were resected revealing a diagnosis of chondroma. The discovery of free foreign bodies in the synovial sheath of the flexors and histological examination established the diagnosis of tenosynovial osteochondromatosis, which is rarely located in the hand. No recurrence has been observed after 8 years of follow-up.

[Thalamic fractures of the calcaneus. Value of computed x-ray tomography in therapeutic decisions]. / Les fractures thalamiques du calcanéum. Intérêt de la tomodensitométrie dans la décision thérapeutique.

The authors have studied 35 fractures of the calcaneal thalamus and compared the information provided by plain radiology and CT scans of the calcaneal tuberosity, especially those connected with the condition of the posterior subtalar joint. In 8 cases out of 35, the study of the CT sections yielded information that allowed changing the indications for treatment. The authors emphasize the quality of the data obtained, which makes it possible to justify a functional treatment or to establish a preoperative schedule.

[Extra-abdominal desmoid tumors. Apropos of a case in the calf]. / Les tumeurs desmoïdes extra-abdominales. A propos d'une observation sur le mollet.

A young 15 year old girl presented with a voluminous desmoid tumor of the calf. Three attempts to excise the tumor were only partially successful because of the risk of vascular and nerve damage, and excision was incomplete on each occasion. These tactics appeared to be justified, however, since the tumor had little functional effects and appeared to become stable at the last examination. The tactical surgical problems are discussed, the benign nature of the tumor imposing conservative surgery which is often incomplete, although in certain cases the operation can be combined with a recovery arterial shunt. The various etiopathogenic elements of these tumors are described.