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Biomedical subjects

D Goutallier

Publications and source records attributed to D Goutallier.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Plexus nerve blocks for postoperative analgesia after orthopedic surgery of the lower limbs].

In our institution, plexus nerves blocks have been performed in seventy patients after lower limb surgery. The technique is considered as simple and reliable. The administration of a 0.375 per cent bupivacaine epinephrine containing solution allows to obtain analgesia longer than 15 hours in 45 p. 100 of the patients, devoided of side effects. Lower limb plexus nerves blocks appear as an efficient technique for postoperative analgesia following orthopaedic surgery.

Adult↗
PubMed1992

[Mathematical modelling of open-wedge tibial osteotomy and correction tables].

This study analyzes mathematically the orientation of the superior tibial epiphysis in frontal and sagittal planes for knees with genu varum arthrosis. The assessment of the opening is determined mathematically for the osteotomies; this leads to the establishment of tables which can be used in practise during upper tibial osteotomies.

Humans↗
PubMed1992

[Vertebral hydatidosis. Complications, contribution of modern imaging].

Vertebral hydatidosis is the commonest skeletal manifestation of echinococcosis. It is also the most serious: among 6 patients followed-up for a mean period of 10 years, all had neurological complications and only one is free of neurological sequelae at the present time (at the price of multiple spinal operations). While current medical treatment remains essential, it does not always control this skeletal parasite infestation which requires careful monitoring (CT scan, NMR) in order to detect and treat all possible recurrences.

Adult↗
PubMed1992

[Value of false profile of the pelvis in the monitoring of total hip prosthesis].

The authors used a retrospective series of cases of total hip replacement with a follow-up of between 6 and 12 years, including 10 undergoing reoperation for slipping of the prosthesis, to define the value of the false lateral view of the pelvis in the monitoring of such patients. This view provides earlier detection than AP views of wearing of polyethylene which manifests itself by penetration of the femoral head into the acetabular implant. This penetration, which can be measured radiologically, is better visualised in the false lateral view of the pelvis for simple reasons of radiological incidences. The false lateral view of the pelvis has another use in the monitoring of total hip replacements. It enables visualisation of the posterior part of the acetabulum which is generally the site of first appearance of the earliest signs of slipping in the form of a thin line.

Acetabulum↗
PubMed1991

[Indications of prosthesis in the treatment of knee diseases].

Hinge prostheses of the knee expose to so many local or even systemic complications that they should be used only for reconstruction of the knee after tumoral excision. In all other indications, prosthesis of the knee must be semi-constrained or non-constrained. Moreover, it seems that it would be useful to choose the prosthesis that preserves the ligaments to the best, in order to reduce as much as possible the stress imposed on bone/prosthesis interfaces and to limit the size of the prosthesis that preserves the ligaments to the best, in order to reduce as much as possible the stress imposed on bone/prosthesis interfaces and to limit the size of the prosthesis on which depends the amount of bone removed and the risk of septic complications. In rheumatic diseases prosthesis of the knee is the only sensible surgical treatment. Since the inflammatory process involves all three compartments of the knee, the prosthesis must be of the three-compartment type. In degenerative (gonarthrosis) and post-traumatic diseases of the knee, prosthesis is needed only when conservative surgery (osteotomy for realignment or malunion) is inadequate, with global femorotibial or femoropatellar involvement and major laxity of the ligaments. In global femorotibial diseases the prosthesis utilized can only be three-compartmental; in one-compartment femorotibial diseases, one-compartment prosthesis is rational if there is no lesion of the capsule and ligaments. When anatomical conditions are still compatible with conservative surgery, prosthetic surgery will be preferred only when the patient's general condition requires prompt resumption of walking.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Rheumatoid↗
PubMed1991

[Examination of the non-injured shoulder].

Modern imaging methods are undeniably very attractive. They should make possible an easy study of the musculotendinous rotator cuff of the shoulder joint, lesions of which are the cause of most painful or stiff shoulder syndromes. However, not all shoulder symptoms are due to rotator cuff lesions. Also, not all methods of imaging are equally suited to showing the different cuff lesions. Further, one cannot consider the treatment of a symptomatic shoulder without having an assessment of the present condition upon which to gauge the functional improvement due to the treatment. Hence clinical examination of the painful shoulder remains essential. This makes it possible (1) to exclude an extra-articular pathology, (2) to choose the method of imaging most suited to showing the suspected lesion, and finally (3) to quantify the functional state of the shoulder.

Arthrography↗
PubMed1991

[Infections after massive bone allografts in surgery of bone tumors of the limbs. Incidence, contributing factors, therapeutic problems].

This study was carried out on a sample of 115 patients receiving massive allografts that were sterilized by irradiation and implanted after tumor resection, and having a remission period of 2-5 years. Among the 11 post-operative infections that occurred, 9 arose early and 2 arose late. The risk of infection was augmented when reconstruction by allograft followed tumor surgery requiring adjuvant chemotherapy and/or radiation treatments. Treatment of these allograft infections was difficult due to the presence of multiple bacteria as well as the general circumstances surrounding the infection (immunosuppressed patients under chemotherapy): 5 of the 11 patients required amputation secondary to infection.

Bone Neoplasms↗
PubMed1991

[Anterior approach to the high thoracic spine by the subscapular route].

The authors report their experience of the approach of the high thoracic spine (from T1 to T3), with the help of a thoracic flap resected under the location of the scapula. This approach has only given few functional disorders after the operation: besides, it offers the possibility to widen towards the low thoracic spine or the cervical spine.

Aged↗
PubMed1991

[Anatomy of the trochleo-condylar junction and its consequences on the femoro-patellar joint in single-compartment prostheses].

A search was made for impingement of the femoral part upon the patella on femoropatellar axial views made at a 90 degree angle of flexion in 81 cases of unicondylar arthroplasty (46 medial and 35 lateral). The patients were followed up during a period ranging from 5 to 10 years. 16 cases of impingement between the condyle part and the patella were found. Radiologically, this resulted in a notch on the patella. Clinical symptoms were usually moderate. The anomaly most often found at the onset of this complication was faulty positioning of the condyle part. The complication was more frequently observed in lateral femorotibial arthroplasty (10 cases out of 35) than in medial one-compartment arthroplasty (6 cases out of 46). This variation can be explained on the basis of morphological differences between the medial and lateral sides of the trochleocondylar junction. A study carried out using anatomical specimens, X-rays and scanner sections was used to define the differences.

Arthroplasty↗
PubMed1991

[The risk of transmission of HIV virus during orthopedic surgery and its prevention].

The risk of transmission of HIV virus by blood transfusion or by bone transplant during cold orthopedic surgery has been studied on the basis of known French epidemiological data concerning the problem. The authors take the opportunity to discuss appropriate methods for limiting these risks (programmed and delayed self-transfusion, sterilisation of grafts) and their own experience in this area.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Deformities of the hip in adults who have sickle-cell disease and had avascular necrosis in childhood. A natural history of fifty-two patients.

We report the natural course of the hip in fifty-two patients (ninety-five hips) who had sickle-cell disease and had had avascular necrosis in childhood. There were twenty-one African, twenty-one West Indian, and ten Mediterranean patients. At the most recent follow-up examination (at an average duration of nineteen years after the onset of the disease), 80 per cent of the hips that had been affected by avascular necrosis during childhood were painful and had permanent damage with regard to decreased mobility, limb-length discrepancy, and an abnormal gait. When the patients were evaluated, at an average age of thirty-one years, fifteen hips (16 per cent) had had an operation for progressive disability and sixty (63 per cent) had major problems because of pain. Of the twenty hips (21 per cent) that were not painful, five were in patients who had an abnormal gait, with decreased agility. The mean Iowa hip-rating score at the most recent follow-up examination was 73 points (range, 30 to 100 points). Correlations were found between the hip score and the patient's age at the onset of the disease and at the latest follow-up, between the hip score and degenerative changes in the hip, and between degenerative changes and radiographic evidence of deformity of the hip.

Adult↗
PubMed1991

Absence of the medial malleolus. A case report with a 20-year follow-up study.

This may be the second case report of the absence of the medial malleolus in the orthopedic literature. A six-year-old girl had an open fracture with a loss of the medial malleolus. During the 20-year follow-up study, she had no instability of the ankle, as in the first report, but after time she developed degenerative arthritis in the tibiotalar articulation.

Amputation, Surgical↗
PubMed1990

[Results of intersomatic arthrodeses in essential lumbalgia].

The results of 50 intersomatic arthrodeses, performed via an anterior approach, because of chronic, disabling low back pain with degenerative disc disease, was evaluated with a mean follow-up of 7 years (revision rate = 74.5 p. cent). Preoperative exploratory discography of the overlying and underlying vertebrae was systematic. The overall functional results evaluated according to an original quotation scale, show that only less than half of the patients who were operated upon are markedly improved at maximum follow-up. The clinical course of pain radiating to the lower extremities and associated with disabling lumbalgias, seems to be on a par with the course of lumbalgias and does not require a posterior surgical approach. Factors improving the success rates are an effective fusion (in first intention in 80 p. cent of the cases) and a healthy neo-joint from a discographic standpoint; factors that deteriorate the long-term success rate (and not short-term), essentially socio-professional ones (work related accidents). The contribution of the discographic data is emphasized: they anticipate the deterioration of the neo-joint discs, which, when present, causes most of the functional failures. Although these results are imperfect, arthrodesis (the authors remain faithful to the intersomatic arthrodesis), may not be completely excluded as treatment of essential disabling lumbalgias, resisting to medical and physiotherapeutic treatments.

Adult↗