Biomedical subjects
Publications and source records attributed to C Lefevre.
The authors report 2 cases of infantile digital fibromatosis. These benign tumours occur in newborns and infants, involving mainly the extremities (fingers, toes). Its prevalence is probably higher than the reported cases. The pathogenesis and treatment are discussed. The diagnosis of such fibrous tumours is useful since surgical treatment can be avoided in a majority of cases.
A literature review allowed classification of seven cases of Sprengel's deformity based on that described by Rigault et al. This classification into three types as a function of degree of elevation defines each case within the context of associated malformations, and appropriate therapy. Surgery is indicated, employing Woodward's type of operation, for patients with functional and esthetic deficits, particularly in Rigault's type II deformity.
Since May 1982, when the pediatric surgery group of Rouen has published their study in the 39th congress of "Societe Française de Chirurgie Infantile", regular surgical attitude in treatment of intussusception was abandoned by our team. Seventy cases were admitted in our section in the period (06-82/06-86), age ranged from one month to nine years. All except one were subjected to radio-opaque enema as a method of treatment with success rate of 89% reduction. Optimum conditions, failures (7 case), perforation (one case) and recurrence are presented. We conclude the efficacy of this treatment in condition of a rigorous technic.
The initial contact between blood and vascular grafts may be a determinant of the fate of the implants. They behave in different ways depending upon their nature: the processed human umbilical vein and the bovine heterograft just lead to minimal thrombotic retention; the expanded PTFE is even more antithrombogenic; the porous polyesters which are porous textiles, should be totally impregnated with a thrombotic matrix to make the wall impervious. These observations were clearly determined by exposing the grafts to blood, incorporating either labeled platelets or labeled fibrinogen, and they were correlated by SEM examination.
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Lumbar surgery is currently benefiting from the development of anterior approach to the spine and the possibilities of body reconstruction by plate and bony graft. The anterior extraperitoneal approach enables access to the spine. The Fraser approach expose the lumbar and the lumbo sacral spine.
Anatomopathologic study of fractures of lower end of femur in 87 patients demonstrated the frequency of compound lesions in adults, epiphyseal detachment being the most common finding in children. Therapy used resulted in consolidation within a mean period of 4 months. Anatomic results were satisfactory in 87% of cases, 2 of 3 patients recuperating a knee compatible with a normal active life. Complications were rare. The current therapeutic attitude in adults is resolutely surgical, particularly in case of an intra-articular fracture line. In children, treatment remains orthopedic, except for epiphyseal detachments when minimal fixation allows perfect anatomic reduction and avoids secondary growth disorders.
After a brief description of the classification of fractures of lower and of humerus in children, methods are described for the application of different orthopedic and surgical procedures developed over the years. Treatment of supracondylar fractures remains very conventional (Judet's method), experience lacking in the use of contention in strong flexion for these fractures. Emphasis is placed on two points: the need for perfect reduction under all circumstances, since growth will have little impact on correction of residual faults, and the quality and reading of review radiographic images to avoid major mistakes in reduction.
In this report concerned with luxation of the elbow and fractures of the upper end of two forearm bones in children emphasis is placed on the importance of the initial treatment, since sequelae are not corrected during growth. Correct therapy requires firstly a precise diagnosis, this depending on the obtaining of images of very good quality, if necessary taken during sleep if the child has to be anesthetized. Therapy should be as atraumatic as possible, particularly in the region of the head of radius, to avoid its subsequent necrosis.
The radiographic results of treatment of unstable thoracolumbar spinal injuries by Harrington rods are reviewed. The loss of initial correction of kyphosis is 8 degrees on average. Correlation between good anatomical reduction and lapse of time before operation, level of instrumentation and solid spinal fusion exists. But, in burst fracture with deficient anterior pilar, the incidence of loss of reduction is important. The influence of Harrington rods on the spine is significant.
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In order to illustrate the phenomena which occur at the first contact between arterial prostheses and blood, an in vitro test is suggested which may be used to quantify the retention of the cruoric matrix using labelled compounds and confirming the nature by scan electron microscopy. Reorganisation of the cruoric matrix is dependent upon the scarring of polyesters which retain considerably more blood substances than microporous polytetrafluoroethylenes or the biological models dealt with, the course of which after implantation is closer to passivation.
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