Biomedical subjects
Publications and source records attributed to H Bracq.
The authors report Larsen Syndrome in a male newborn with severe cervical spine malformations: segmentation abnormalities of the cervical spine and atlanto-axial dislocation. The severity of the cervical malformations occurring more often in the autosomal recessive form is emphasized.
The authors report a case of a 7-years-old boy who sustained a complete rupture of the cervical trachea during a blunt cervico-thoracic trauma. The clinical presentation, pathophysiology, diagnosis and treatment are discussed.
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TAR syndrome is usually an autosomal recessive disease; we report a family where the father of the propositus presented malformations of the feet, and review the known cases involving several generations. The authors of these cases concluded that the TAR syndrome is probably genetically heterogeneous.
The authors report their experience about the surgical treatment of drooling in handicapped children. They operated on twelve patients suffering from cerebral palsy, ranging from eleven to nineteen years of age. The procedure included the posterior rerouting of parotid ducts to the anterior pillars as in the Wilkie's operation but with tubularization of the mucosal flaps. The excision of the distal part of the submandibular duct on both sides was performed in a second operation, one to five years later in four patients, but in the initial operation for the last six cases. A successful control of drooling was reached in ten patients. But the two parts of the procedure are necessary to get a good result. The only first part is always insufficient as in the other two cases. There were few complications: one salivary cyst after rerouting of a parotid duct which required marsupialization, another one with spontaneous regression. Only one patient is complaining of feeling an excessive dryness of his mouth and lips. Other methods of treatment: physiotherapy and different kinds of surgical procedures are recalled. However, this series is too short to permit a valid conclusion and to define the place of the procedure in the treatment of drooling.
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The authors have investigated the process of degeneration of articular cartilage in its early stages using an experimental model which has made it possible to show, for the first time, the effects of a mechanical parameter other than excessive pressure--that is excessive friction. The two healthy hips in twenty anaesthetised young rats were used for the study. One hip was kept immobile and served as a control. The other was subjected to physiological movements of flexion and extension continuously and without rest for periods varying from twelve hours to seven days. The articular cartilage of the two femoral heads was examined by light microscopy, transmission electron microscopy and scanning electron microscopy. A new fact was demonstrated. Cartilage wear is also associated with the simple movement of two joint surfaces over one another without any muscle contraction being involved. In the genesis of cartilage wear, excessive friction alone seems to be as important as excessive pressure.
The authors report a case of an exostosis of the base of the acetabulum seen at the age of four months in a routine radiograph of the pelvis in a child suffering from osteochondromatosis. The growth in size of this exostosis led to subluxation of the hip at the age of three years. Surgical removal resulted in reduction of the subluxation and restoration of joint stability three years after operation. An intra-acetabular site for an exostosis has rarely been described.
The authors report two cases of Reflex Sympathetic Dystrophy (RSD) significant by their releasing factor: initial trauma followed by surgical act. They describe the particularities of RSD in children compared with RSD in adult: differents localizations, X Ray films often normals or showing a local homogeneous osteoporosis, bone scintigraphy with variable result (increased or normal or less uptake of isotope), more rapidly favorable evolution.
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After a severe polytraumatism, a 14 year-old boy presents paraplegia without vertebral lesion. Angiocardiography showed rupture of aortic isthmus. Surgical treatment resulted in successful outcome. The authors insist on the rarity of traumatic rupture of aorta in children and or the particularity of the diagnosis revealed by paraplegia.
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Fractures and Epiphyseal separations of the proximal humerus are usually non-operatively treated with a generally good result. However, sometimes, a surgical treatment may be required. Twenty fractures of the proximal humerus occurring in children were treated operatively. From these 20 cases, the authors precise the indications and the ways of surgical treatment in this type of lesion. They insist upon the value of the angulation on the lateral radiograph of the shoulder which, if important, may often signify an interposition of the tendon of the long head of the biceps between the fracture fragments causing irreductibility; they propose a classification of the fractures referring to this angle. Considering surgical procedure, delto-pectoral approach is the most commonly used, although axillary way is more esthaetic. Kirschner wires and screws are the best means of synthesis. Anyway, this surgical treatment has to remain exceptional.
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The authors propose an original classification of the polydactyly. They opposed: polydactyly "symptom" and polydactyly "disease". Discussion about five personal pedigrees.
The authors have operated on 2 children aged 7 and 8 years who had developed a large unicameral bone cyst in the trochanteric and upper femoral diaphysial region. Ender's nails were inserted into the bone above the lower femoral epiphysial plate. Healing occurred rapidly.