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J P Cahuzac

Publications and source records attributed to J P Cahuzac.

At least 19 recordsLinked to original sources
PubMed2003

Long-term effects on tibial growth after intraosseous infusion: a prospective, radiographic analysis.

BACKGROUND: Evaluate, by radiographic analysis, tibial growth after an intraosseous infusion (IOI) in a pediatric population. METHODS: We performed a prospective simple blind study, between January 1, 1994, and July 1, 2001, which included pediatric patients who needed an intraosseous trocar in emergency situations. During the follow-up, roentgenographs were performed. On each radiologic view, different measurements were carried out: anterior and lateral tibial length, anterior and lateral width at 2 diaphyseal levels. We compared the anterior length values to those published in the Anderson et al tables. When only one tibia was punctured, the mean measurements were compared with the control leg measurements using a paired t test. RESULTS: The initial population included 78 patients. Of these 78 subjects, 42 died, 10 families could not be contacted, and one refused to participate. Two children were excluded because they had other conditions that could influence tibial growth. The study included 23 children. The puncture site was the proximal tibia. The mean age was 18.6 months at the time of IOI, the mean time of infusion was 5 hours, and the mean perfused volume was 225 mL. The mean radiologic follow-up time was 29.2 months. When compared with the Anderson et al tables, all the anterior length values were within the 95% confidence interval. For the other measurements, the statistical analysis showed no significant difference between punctured and control legs. CONCLUSION: There is no long-term effect on tibial growth after an IOI when the IO trocar is properly placed.

Age Determination by Skeleton↗
PubMed2002

Obstetrical brachial plexus palsy. Prediction of outcome in upper root injuries.

Thirty obstetrical brachial plexus palsies involving the upper roots were retrospectively reviewed. There were 20 C5-C6 palsies and ten C5-C6-C7 palsies in which recovery of C7 occurred by the end of the first month. Recovery of elbow flexion at 3 months, C7 involvement and high birthweight were the best early predictors of outcome, but all were unreliable when used separately. In combination, recovery of elbow flexion and birthweight predicted the final outcome reasonably satisfactorily, particularly when elbow flexion at 9 months, and not 3 months was considered (risk of error = 13%). Brachial plexus reconstruction may therefore be justified when there was initial C7 involvement associated with increased birthweight and poor elbow flexion at 6-9 months.

Adolescent↗
PubMed2001

[Scarf osteotomy of hallux valgus in children and adolescents].

PURPOSE OF THE STUDY: The aim of this study was to analyze the results of surgical treatment of hallux valgus using scarf osteotomy in children and adolescents. MATERIAL AND METHOD: Twelve children and adolescents (19 feet) operated on with scarf osteotomy were reviewed retrospectively with a mean follow-up of 15 months. Clinical and radiographic results were assessed. RESULTS: We obtained 10 good results (asymptomatic cases), 9 poor with residual symptoms such as pain or cosmetic problems. Two populations could be identified considering the metatarsus varus and distal metatarsal angle. Those with metatarsus varus >/= 10 degrees or normal distal metatarsal angle had good results. Those without metatarsus varus had poor results. There was no disturbance of growth. DISCUSSION: Scarf osteotomy can be used in children without risk of hindering growth. Nevertheless, good results can be achieved only in cases of true metatarsus varus and normal distal metatarsal angle. In other cases, a different osteotomy of the first metatarsal would be preferable.

Adolescent↗
PubMed2001

[Recurrent aggressive chondroblastoma: two cases and a review of the literature].

Chondroblastoma is a rare benign bone tumor. Treatment currently consists of curettage and bone graft. Prognosis depends basically on a relatively high rate of recurrence, between 5 and 38%, sometimes with local seeding of soft tissues and joint space. Such recurrences require wide resection with arthrodesis or even amputation. A 13-year-old girl with a humeral head chondroblastoma as treated by curettage and iliac bone graft. Six months later, a recurrence occurred with extension into the rotator cuff and the metaphysis. Remission was achieved by extensive surgical resection and hemiarthroplasty. The second case was a 14-year-old boy with a chondroblastoma of the right talus. He was treated by curettage and packing with bone substitute. After 2 recurrences with soft tissue and intra-articular extension, we performed a wide resection with reconstruction using a vascularized fibular graft. Many other cases in the literature illustrate such complications. We tried to find factors predictive of recurrence. Recurrence is observed when curettage was incomplete or when tumor cells were disseminated during surgery. Chondroblastoma is a benign bone tumor, but prognosis depends on the rapidity and severity of recurrence. Curettage should be as complete as possible and care should be taken to avoid contaminating the operative field.

Adolescent↗
PubMed2001

[Imaging of the hip in healthy children in MRI: evaluation of the acetabular coverage].

PURPOSE: To define with MR imaging a reference value for acetabular coverage on coronal and sagittal images for a population of healthy children. MATERIALS AND METHODS: 36 children (72 hips) where prospectively studied over 1 year. T1-weighted spin-echo images in both coronal and sagittal planes were obtained. Slice thickness was 4 mm. Measurement of acetabular coverage (AHI: Acetabular-Head Index) was made in both planes with two different landmarks: bone and cartilage. Study of the evolution with age was made. RESULTS: The acetabular coverage is symmetrical and decreases with age. Its measurement is reproducible. CONCLUSION: This study shows that measurement of acetabular coverage (AHI) is easily obtained at MR imaging and is reproducible. We suggest 83 (mean 1SD) as the inferior limit for AHI based on cartilage measurements. We introduce sagittal values, never published. We believe that MR, by its ability to demonstrate the cartilaginous surfaces, will play a major role in the true understanding of the anatomical relationship between the femoral head and the acetabulum.

Acetabulum↗
PubMed2000

Accuracy and precision of in vivo bone mineral measurements in sheep using dual-energy X-ray absorptiometry.

We evaluated the precision and accuracy of in vivo measurements of spine bone mineral density (BMD) and bone mineral content (BMC) in five ewes using dual-energy X-ray absorptiometry (DXA, Lunar DPX-L). The short-term in vivo reproducibility expressed as the coefficient of variation (CV) varied from 0.9 to 1.6% for spine BMD and from 1 to 3.1% for spine BMC. The ex vivo measurements, performed in 20 cm of water to simulate soft tissue thickness, correlated closely with the in vivo measurements, yielding an r value of 0.98 and 0.97 for spine BMD and BMC, respectively. The accuracy was determined by comparing the total BMC of each vertebra measured in vivo with the corresponding ash weight. The correlation coefficient between the two measurements was r = 0.98, with an accuracy error of 5.6%. We concluded that the DXA allows a precise and accurate measurement of spine bone mineral in live ewes using the methodology designed for humans.

Absorptiometry, Photon↗
PubMed2000

Repair of lumbar spondylolysis using Morscher material: 14 children followed for 1-5 years.

We evaluated the results of spondylolysis repair in children and adolescents with the Morscher system. 14 patients (8 girls) with symptomatic spondylolysis unresponsive to closed treatment were operated on. Mean age at operation was 12 (7-15) years. The average follow-up was 33 (16-66) months. Results were assessed clinically according to the Henderson classification and radiographically. Clinical results were excellent in 9 patients, good in 4 and poor in 1. Radiographs showed that fusion was obtained in 12 patients, it was doubtful in 1 and 1 patient had non-union. Loosening of the screw on one or both sides was noted in 8 patients and necessitated removal of the osteosynthesis material which, however, did not alter the final outcome. The satisfactory results obtained in our series are similar to those reported in the literature.

Adolescent↗
PubMed1999

Kienböck's disease and multiple hereditary osteochondromata: a case report.

A case of bilateral forearm localization of multiple hereditary osteochondromata and unilateral Kienböck's disease is reported. Ulnar minus variance is frequent in both diseases. Carpal slip is often found in multiple hereditary osteochondromata. In this case, the extremity having both multiple hereditary osteochondromata and Kienböck's disease had no carpal slip. This might have produced an excess load on the lunate, which might have provoked Kienböck's disease.

Adult↗
PubMed1999

Assessment of hindfoot deformity by three-dimensional MRI in infant club foot.

In 12 infants aged under 16 months with unilateral club foot we used MRI in association with multiplanar reconstruction to calculate the volume and principal axes of inertia of the bone and cartilaginous structures of the hindfoot. The volume of these structures in the club foot is about 20% smaller than that in the normal foot. The reduction in volume of the ossification centre of the talus (40%) is greater than that of the calcaneus (20%). The long axes of both the ossification centre and the cartilaginous anlage of the calcaneus are identical in normal and club feet. The long axis of the osseous nucleus of the talus of normal and club feet is medially rotated relative to the cartilaginous anlage, but the angle is greater in club feet (10 degrees v 14 degrees). The cartilaginous structure of the calcaneus is significantly medially rotated in club feet (15 degrees) relative to the bimalleolar axis. The cartilaginous anlage of the talus is medially rotated in both normal and club feet, but with a smaller angle for club feet (28 degrees v 38 degrees). This objective technique of measurement of the deformity may be of value preoperatively.

Calcaneus↗
PubMed1999

[Somatosensory evoked potentials during surgery of scoliosis: significance of epidural recording].

PURPOSE OF THE STUDY: To evaluate the usefulness of the epidural recording in scoliosis surgery in children or young adults. MATERIAL AND METHOD: We used somatosensory-evoked potentials in 60 children or young adults in surgical treatment of scoliosis. Somatosensory-evoked potentials were elicited and recorded using a standard method recording of cortical P40 and subcortical P27, simultaneously with the monitoring of spinal cord function using epidural electrode to record the ascending somatosensory volley (by tibial nerve stimulation) at a high thoracic level. RESULTS: The use of subcortical and epidural recording sites for the somatosensory-evoked potentials indicated that a reliable response could be obtained in 96 p. 100 of the patients. Cortical somatosensory-evoked demonstrated a 48 p. 100 false positive rate. DISCUSSION: Epidural recording in scoliosis surgery is safe and reliable. Combined subcortical and epidural recordings are especially useful in patients with neuromuscular scoliosis or with cerebral palsy that may not have reliable cortical potentials.

Adolescent↗
PubMed1999

Natural course of osteochondritis dissecans in children.

Results are reported from an absence of physiotherapic, orthopaedic, or surgical treatment in 31 cases of osteochondritis dissecans in 24 children. The mean age at diagnosis was 11 years and 4 months, and all the children were suffering from pain for an average of 3 months. None of these children were treated, except for instructions to discontinue involvement in sports activities until their pain had disappeared. In all cases pain disappeared, and these children have all returned to their former activities. According to x-ray findings, 30 lesions disappeared totally, although there was one case of a loose body. As a result, absence of treatment is recommended for osteochondritis dissecans in children.

Adolescent↗
PubMed1997

Imaging evaluation of subluxation in Legg-Calvé-Perthes disease: magnetic resonance imaging compared with the plain radiograph.

The aim of the study was to evaluate the advantages of magnetic resonance imaging (MRI) in determining subluxation in Legg-Calvé-Perthes (LCPD) disease. Twenty-six patients with unilateral LCPD received 33 MRI and plain radiographs. For each patient, acetabulum head index (AHI) was measured on both hips (affected and unaffected) in a blinded fashion. Measurements were made from the cortical bone margin on the plain radiograph and from the cartilaginous surfaces on MRI. On the unaffected side AHI was 92.8% on the plain radiograph and 85% on MRI. On the affected side, AHI was 87% on the plain radiograph and 77% on MRI. These differences were statistically significant. With regard to the unaffected side, the femoral head should be considered subluxated if AHI is less than 86% on the plain radiograph and less than 77% on MRI. On the affected side, in 14 cases the femoral head was well-contained on both the plain radiograph and MRI. In 11 patients the femoral head was subluxated both on the plain radiograph and on MRI. In 8 patients the femoral head was well-contained on the plain radiograph but subluxated on MRI. This was due to thickening of the cartilaginous portion of the femoral head, which was clearly seen on MRI. MRI appeared to be more sensitive in determining the subluxation of the femoral head during the active phase of LCPD.

Child↗
PubMed1995

[Value of the study of somatosensory evoked potentials during surgical correction of scoliosis associated with syringomyelia. Apropos of 4 cases].

PURPOSE OF THE STUDY: The presence of a syringomyelia cavity increases the rate of neurological complications on the course of surgical treatment of scoliosis. We have evaluated the results of monitoring of somatosensory evoked potentials (SEP) in these situations. MATERIAL AND METHODS: Four patients presenting a scoliosis associated with syringomyelia have been operated through a posterior-approach with CD instrumentation. SEP monitoring was performed pre and intraoperatively. We studied the latency and the amplitude of P40. RESULTS: Preoperative SEP showed in all cases posterior spinal cord involvement (even without clinical manifestations). During monitoring, we noted in one case no variation. In one case a flattening of the response with normalisation within 5 minutes. In two cases a persistent flattening with normalisation within 10 and 15 minutes following modification of the instrumentation. In all cases, postoperative neurological status was identical to preoperative one. DISCUSSION: Preoperative SEP can make the diagnosis of posterior spinal cord involvement even when clinical status is normal. The extent of the preoperative SEP abnormalities may preclude the risk of intraoperative neurological complications. Intraoperative SEP can be performed with the same anesthetic protocol and the same technique used when operating idiopathic scoliosis. The results seem reliable. When alteration occur as for idiopathic scoliosis alteration of the amplitude appears earlier than alteration of the P40 latency. Restoration of normal responses appears later than in idiopathic scoliosis. CONCLUSION: SEP monitoring should diminish the risk for neurological complications in the course of surgical treatment of scoliosis associated with syringomyelia.

Adolescent↗