[Tarsal tunnel syndrome and local post-traumatic disease. 1 case].
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Biomedical subjects
Publications and source records attributed to C Ficat.
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Thirty-eight patients with the diagnosis of postoperative epiduro-arachnoiditis are reported upon. All had had previous surgery for disc herniation, and the diagnosis of epiduro-arachnoiditis was confirmed at repeat surgery. Massive epidural scarring with no coexistent pathologic condition was found in every patient, and adhesive arachnoiditis was noted in three. The common clinical presentation consisted of low-back pain and sciatica, and radicular pain was usually a continuation or a recurrence of the preoperative sciatic pain. Neurologic deficits were mild, and no patients with the classic picture of adhesive arachnoiditis were found. Myelographic patterns did not disclose any correlation with the clinical symptoms. Five myelograms were normal, while six others simulated a recurrent disc herniation. The results of scar excision were good in 13 patients, fair in eight, and a failure in 17.
Some chondromalacia are caused by an hyperpressure on the lateral articular facet of the patella. The authors describe the clinical signs and the radiological findings in this condition. It is due to a retraction of the lateral patellar ligament. They have operated on 133 cases and reviewed 115 knees. After a simple section of the lateral patellar ligament, results were satisfactory in 80 percent of the cases. Biopsies of the malacic cartilage were performed and pathological changes were described.
Experiments were conducted in 20 rabbits to study the effects of a single measured trauma applied to the femoral articular cartilage. The author found that, at the fifteenth day, there was fibrillation localised to the area of the trauma associated with necrosis of superficial chondrocytes and clusters of young chondrocytes. Fissures in the cartilage can be seen to be lined by chondrocytes in clusters. These findings are similar to those described by other authors after different types of injury (contusion, defect, instability, repeated trauma).
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