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Biomedical subjects

J Duparc

Publications and source records attributed to J Duparc.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Results of the surgical treatment of fractures of the tibial plateau (apropos of 110 cases)].

Operation was carried out on 110 fractures of the tibial plateau. Fractures of a single condyle were the most common. Associated ligamentous injury was present in 12.7% of the patients and a meniscal lesion was seen in 15.5%. The meniscus was preserved if possible. Satisfactory results were obtained in 79% of cases, with good correlation between the clinical result and the radiological appearance at review. The late complications and technical difficulties are discussed and the difference in prognosis between simple and complex fractures is emphasised.

Adolescent↗
PubMed1987

[Correction of architectural defects by femoral osteotomy and/or shelf procedure in the treatment of secondary coxarthrosis in adult].

One hundred and forty-nine cases of secondary osteoarthritis of the hip have been analysed. Twenty-eight were treated by a simple shelf operation, 60 by a varus upper femoral osteotomy with or without derotation and 61 by a combination of the two, in an attempt to re-establish the anatomy of the hip to as near normal as possible. The consequences of the operations and their morbidity were analysed for the whole series. Thirty-four patients, only five of whom were operated on both sides were reviewed after a 10 year follow-up or more with 30 good results in 39 hips. The results seem to depend above all on the quality of the articular congruence and the acetabular cover. These procedures are intended, in general, for young adults between 20 and 45 years of age. They can equally be considered up to the age of sixty as an alternative to total hip arthroplasty when the clinical and radiological condition makes it possible.

Adolescent↗
PubMed1986

[Prosthetic arthroplasty in recent and old complex injuries of the shoulder].

Thirty-four acute and 22 old injuries of the shoulder have been operated on, using either a humeral prosthesis (24 cases) or a total Neer prosthesis (32 cases). The mean age of the patients was 66 years. There were 32 acute and 13 old four-part fractures of the upper end of the humerus and 6 dislocations of the shoulder. The surgical technique and the method of rehabilitation are described. There were 17 post-operative complications, including 4 dislocations, 2 cases of secondary displacements of bone fragments and 2 loosenings of the glenoid component. In only 4 cases was a further operation needed. The results were analysed in 43 cases with a follow-up greater than one year. In 34 cases, there was no pain, but only 17 cases had more than 90 degrees of active flexion. There were no loosenings of the humeral stem. In two cases of humeral replacement, a narrowing of the joint space was noted. There was moderate peri-articular ossifications on 6 occasions. An upward displacement of the prosthesis was noted on 10 occasions, due to rupture of the rotator cuff. The results were much better in acute lesions than in chronic ones. The authors conclude that prosthetic replacement is indicated in severe fractures of the upper end of the humerus, whether acute or chronic, and if the patient is elderly.

Adult↗
PubMed1985

[An unusual case of clear-cell chondrosarcoma with intrasynovial tumoral localization].

A case of a clear-celled chondrosarcoma of the femoral condyle extending into the knee joint is reported. At operation, many nodules looking like benign osteochondromata were found. They were found to be due to dissemination of the chondrosarcoma. An electron-microscopic study showed that the matrix was different in the osseous tumour from that in the synovial nodules. The result was satisfactory five years after resection followed by arthrodesis.

Adult↗
PubMed1982

[Traumatic etiology of Kienboeck's disease. (Perilunate subluxations and semilunate necrosis)].

The authors have studied the incidence of lunate necrosis in 110 perilunate dislocations. Twenty-one cases (19%) developed a necrosis. The classification into three types, according to the amount of damage to the perilunar ligaments, is of prognostic value. There is no risk of necrosis in type 1, 17% in type II, and 50% in type III. An associated fracture of the scaphoid does not modify the risk. In neglected lesions, reduction of the lunate dislocation should be attempted, even at a late date, the risk of necrosis then being 50%. Surgical reduction increases the risk of secondary necrosis to a greater extent than does orthopedic treatment, but it is generally use in the most complex cases too. The authors advocate a closed reduction with percutaneous pin fixation.

Adolescent↗
PubMed1982

[Radiation-induced sarcoma of the hip. Apropos of a case].

The authors describe a case of post radiation sarcoma of the hip, rare complication in the post radiation lesions. This case associates a post radiation coxopathy treated by total hip arthroplasty, a socket loosening with pelvic fracture, and a post radiation sarcoma. This last complication was fatal.

Acetabulum↗
PubMed1981

[Resection-reconstruction of the knee for bone tumor (author's transl)].

The authors report 17 cases of primary tumors of the knee treated by wide resection, removing "en bloc" the entire epiphysis in 14 cases and in the remaining 3 most of the epiphysis. The series consisted of 8 giant cell tumors of which 6 were followed for between three and fifteen years, and for 9 tumors of moderate malignancy amongst which 1 fibrosarcoma, 1 parosteal osteosarcoma and 3 cartilaginous tumors which were followed between five and fourteen years. All were free of metastatic spread except 1 fibrosarcoma whose resection was debatable. Arthrodesis was carried out on all but 2 patients received prosthesis. The arthrodeses were made by autogenous grafts protected in 11 cases by intramedullary rod, in 1 case by a plate, and in 3 cases by both. The series contains one amputation and three fractures necessitated secondary grafting with replacement of rod in two cases. The results are analysed in carcinological and technical shemes. The value of resection and the importance of grafting over the arthrodesis are emphasised. In the long term, resection-arthrodesis means the conservation of a stable and functional limb, permitting an active life one year postoperatively. Massive prosthesis are only exceptionally indicated.

Adolescent↗
PubMed1980

[Post irradiation bone lesion of the pelvis (author's transl)].

Post-irradiation bone lesions of the pelvis, rare but grave functionally, may appear from few months to some years after irradiation. The most severe lesions occur in the hip, with necrosis, fracture or cartilaginous lesions. Radiological appearances may be dissociated, giving a false impression of progression. Undisplaced fractures may consolidate. In other cases an arthroplasty is indicated, often total, but the bad quality of the bone receiving the prosthesis explain certain poor results caused by loosening.

Bone Diseases↗
PubMed1979

[Preliminary results of arthroplasty of the hip, using a pair of sealed double cups].

Arthroplasty of the hip with a pair of locked cupolas uses a metal cupola and a polyethylene cotyloid cupola. Ancillary instrumentation and 3 sets of protheses allow an acrylic fixation using a thin layer of cement. The authors report their experience with 75 surface replacement arthroplasties. The initial complications seem related to errors made in at the outset in drilling the femur, thereby compromising the solidity of the neck and the vascularization of the head. These results can be transposed upon the case of total conventional prothesis. The indications, which principally incluse centered coxarthrosis, have been widened to comprise necrosis limited to the femoral head, to rheumatoid polyarthritis, to ankyloses of the hip in a bad position, and to re-setting of non cemented cupolas. These encouraging results should be tempered by their short follow-up period (less than 2 years), and the present uncertainty as to the future performance of the lock joints and the wear of the polyethylene.

Adult↗