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Biomedical subjects

L Favard

Publications and source records attributed to L Favard.

17 recordsLinked to original sources
PubMed1999

[Shoulder instability].

Shoulder instability is a sign described by the patient. The etiology of this instability is varied: sometimes it is the result of a traumatic luxation with tear of the gleno-humeral inferior ligament, sometimes it is the result of an abnormal hyperlaxity. The examiner must be able to do a difference between these two causes because treatment and consequence are very different. Nevertheless, these two factors can be associated at variable degrees. A careful history and examination, a precise x-rays and scanning can help the examiner to solve this difficult problem.

Diagnosis, Differential↗
PubMed1999

[Long-term evolution following shelf procedure for hip dysplasia in adults. Shelf survival analysis in 68 cases and retrospective review of 44 with at least 26 years follow-up].

Using Kaplan-Meier's method, the authors found a survival probability of 50% after 25 years in a group of 68 shelf arthroplasties in adult hips. Forty-four shelf procedures, performed at a mean age of 33 years, had sufficient clinical and radiological data to perform a retrospective study with at least 26 years of follow-up. There were 16 dysplastic non-dislocated hips, 19 subluxated hips and 9 dislocated hips. Fifteen shelves (34%) were still in place in 1996 with a mean follow-up of 31.6 years and 29 (66%) underwent reintervention after a mean interval of 20.4 years. The functional result at the latest follow-up, or just prior to reintervention for the reoperated shelves, was good in 13 cases (30%), fair in 28 and poor in 3. Progressive deterioration following shelf procedures was mainly associated with two factors: preoperative congruency (ratio of the largest to smallest joint line thickness), especially if below 0.7, and preoperative osteoarthritis. Reoperation rate climbed from 30% for grade 1 or 2 osteoarthritis, to 73% for grade 3 and to 88% for grade 4. The mean age at the time of reintervention was 54.5 years. Shelf arthroplasties performed for secondary hip osteoarthritis with joint space narrowing (77% in this series) had a mean survival of 20.5 years. The authors believe that a shelf procedure has its place in the conservative surgical management of painful acetabular dysplasia in the adult, even in the presence of osteoarthritis.

Acetabulum↗
PubMed1996

[Long-term review of homogeneous and consecutive series of 100 "Charnley"-type total hip prostheses].

PURPOSE OF THE STUDY: Long-term studies of total hip replacements often give diverse results because the series studied are not homogeneous. We report the long-term result in a homogeneous, consecutive series of 100 Charnley total hip replacements for idiopathic hip osteoarthritis in patient without previous surgery, by the same operator. MATERIALS: Of 200 patients with 223 Charnley or Charnley-Kerboull total hip prostheses, implanted more than 13 years earlier, 94 patients with 104 implants were alive at the time of the study. Ninety of them (95.7 per cent) with 100 implants were clinically and radiographically examined. Mean follow-up was 14 yr 8 mo and minimum follow-up was over 13 yr 6 mo. METHODS: Hip function was clinically assessed according to Merle d'Aubigné's criteria. Immediate postoperative x-rays and x-rays at 1, 5 and 10 years and at maximum follow-up were examined. For the acetabulum, alignment, radiolucent line, loosening and wear of the socket were analysed. For the femur, the position of the implant, radiolucent line and loosening, changes in the calcar and cortical bone were analysed. RESULTS: Two femoral implants had to be replaced because of implant fracture. The acetabulum became loose in 3 cases and the femur in 2, but did not require revision at the time of examination. Mean acetabular wear was 0.93 mm (0-5 mm). Wear was greater if the subjects were active (p < 0.05) overweight (p < 0.05) and if the acetabulum was vertical (p < 0.05). Changes in calcar, generally lysis, were more frequent when wear was marked (p < 0.001). Thinning of cortical bone was more frequent in women (p < 0.05), sedentary subjects (p < 0.001) and those in poor general condition (p < 0.05) and was less frequently associated with acetabular wear (p < 0.01). DISCUSSION: This study is characterised by its homogeneity: same etiology, same operator, same implants. Functional outcome at a mean of 14 yr 8 mo after surgery was good, as in most series of Charnley's total hip prostheses. Acetabular wear gave most cause for concern. It was linked with the weight and activity of the patients and with socket alignment. This wear led to deterioration of the calcar, due to granulomas and not to stress shielding. In spite of the homogeneity of the series, no factor was found to account for cortical thickening, whereas cortical thinning occurred in light-weight, osteoporotic patients whose prosthesis did not entirely fill the medullary canal. CONCLUSION: Charnley's total hip prostheses are a good method for treatment of idiopathic hip osteoarthritis. Cement does not appear to be a major deterioration factor over time, unlike polyethylene sockets in which wear and its consequences are a matter for concern.

Adult↗
PubMed1994

[The relation of the short radial extensor muscle of the wrist with the deep branch division of the radial nerve. Its significance in the physiopathology of elbow pain].

Since Roles and Maudsley's publication, in 1972, it has been admitted that the entrapment of the posterior interosseous nerve (PION) is a possible cause of lateral elbow pain. In the radial tunnel, at least 4 or 5 compressive structures have been described. The arcade of Frohse is a well known compressive cause while the medial edge of the extensor radialis brevis (ECRB) muscle is less frequently incriminated. An anatomic study of 45 supper limbs from 40 cadavers was performed to analyse the relations between the medial edge of the ECRB and the PION. The medial edge of the ECRB was a real fibrous arch in 43 cases (95%). It crossed over the PION in 42 cases, 9 mm more proximally than the arcade of Frohse. So the relationships between the ECRB and PION are very close in 93% of cases. The proximal edge of the supinator muscle was fibrous in 40% of cases but always supple. These findings suggest that the ECRB is a possible cause of PION entrapment. Its role is underestimated in pathology. The frequent association between lateral epicondylitis and PION compression can be explained by the presence of this fibrous structure. Lateral elbow pain must be considered as a regional pathology. The treatment has to deal with every pathological aspect.

Elbow↗
PubMed1993

[Intramuscular hematoma simulating a pseudomalignant tumor].

One case of a large post-traumatic cystic haematoma of the thigh presenting with a pseudotumoral aspect, and resulting in a femoral filling defect and a spontaneous fracture 7 years later, is reported by the authors. Relationships between its pathophysiology and its consequences on bone are stressed.

Adult↗
PubMed1993

Limb lengthening in children using the Ilizarov method.

By limb lengthening with the Ilizarov method on 24 children with an average age of 11 years, the average lengthening was 50 mm. The results were judged by the healing index and the corticotomy index. The average time for lengthening was 50 days. The healing index was on average 35 days per centimeter. Five complications were noticed during the first stage of the surgical procedure. During the lengthenings, eight cases of joint stiffness were observed, and in five normal biomechanical axes of the limb were modified. Only one abnormal biomechanical axis was perfectly corrected of eight present before surgery. There were three wire-tract infections. Only 13 of 26 patients were without any complications. The Ilizarov method had a lower rate of complication than the Wagner technique, however. Open corticotomy, as modified by De Bastiani, may accomplish lengthenings with somewhat fewer complications.

Biomechanical Phenomena↗
PubMed1992

[Experimental study of primary fixation of screw-ring acetabular components. Role of initial screw-cutting].

Three types of screw-ring acetabular components were implanted to determine the characteristics of their holding power and to study the influence of screw-cutting. The acetabular components were screwed into vinyl polychloride foam. Their resistance was measured. The optimal value of the locking screw couple and the value of the couple beyond the one at which the acetabular component loosened were determined. One of acetabular components was screwed in with and also without preliminary screw-cutting. Its resistance to wrenching was measured in both situations. The resistance curve at wrenching was characteristic of each screw-ring acetabular component. The resistance to wrenching was significantly higher (p < 0.01) for a given acetabular component if it was screwed into a largely open block of foam at its bottom. The screw-cutting allowed for a significantly higher resistance to wrenching (p > 0.05). It allowed for the screwing in with the least effort and for a better perception of the tightening. Knowledge of the comportment of screw-ring acetabular components once installed, usage of preliminary screw-cutting and recourse to a dynametric key are the means of improving the installation of screw-ring acetabular components.

Acetabulum↗
PubMed1991

[The combined luxation of the trapezoid and 2nd metacarpal bones. Apropos of a case].

The authors report a case of posterior dislocation of the trapezoid bone together with the second metacarpal. Among the 25 cases of trapezoid dislocations reported in the literature, no similar case has been found. The patient was seen 4 months after the injury and there was also a scaphoid instability. Open reduction and a scapho-trapezio-trapezoid arthrodesis were performed. The diagnosis, the mechanism and the treatment of this very unusual injury are discussed.

Adult↗
PubMed1990

Comparative double-blind study of two dosage regimens of low-molecular weight heparin in elderly patients with a fracture of the neck of the femur.

A randomized double-blind study comparing the efficacy and safety of two different dosage regimens of a low-MW heparin, Enoxaparin (Lovenox) 20 mg twice (group A) or 40 mg once (group B), was carried out in 103 elderly patients with a fracture of the neck of the femur. Distal and proximal thrombosis occurred in 18.3% of patients in group A and in 10.4% in group B. No major hemorrhagic complication was observed, except for two hematomas in each group. This trial suggests that a total daily dose of 40 mg of Enoxaparin can be effective in the prevention of deep vein thrombosis in elderly surgically treated patients and does not involve a major risk of bleeding.

Aged↗
PubMed1990

Two cases of plant thorn synovitis. Difficulties in diagnosis and treatment.

Two patients with inflammatory monoarthritis of the knee due to joint penetration by plant thorns are reported. Histopathology demonstrated granulomatous synovitis in both and visualized fragments of black thorn. Synovectomy was partly effective. Awareness of this cause of chronic monoarthritis will avoid delay in diagnosis and treatment.

Adult↗
PubMed1989

[Osteoarthritis of the hip in children. Proposal for a classification of sequelae guiding therapeutic indications].

Twenty-six hips in 21 patients were available at mean follow up of 5 years in a retrospective functional and radiographic analysis for the purpose of examining the late effects of infantile septic arthritis. Poor results after reconstructive efforts following hips joint sepsis suggest help classification of bony deformation. Epidemiologic and clinical findings were analysed. Late diagnosis and prematurity were found as poor forecast facts.

Acute Disease↗
PubMed1988

Fracture of the anterior arch of the atlas associated with a congenital cleft of the posterior arch. Demonstration by CT.

A case of a vertical fracture of the anterior arch of the atlas associated with a congenital cleft of the posterior arch of the same vertebra is reported. Such an association has not previously been described in the literature. X-Ray computed tomography is an excellent exam for visualizing this region and for easily distinguishing between fractures and congenital clefts.

Adult↗
PubMed1988

[Chronic anterior laxity of the knee treated by extra-articular ligamentoplasty. 226 cases reviewed after more than 2 years].

Two-hundred and twenty-six patients with chronic anterior laxity of the knee treated by Lemaire extra-articular ligamentoplasty were assessed after a follow-up of 2 to 9 years, with a mean of 4.5 years. Fifty-five knees had only an anterior laxity and 166 anterior laxity combined with medial laxity, in 100 of which tensioning or reinforcement of the medial ligament was needed. Forty-two per cent of sporting patients were able to return to sport at the same level, though half of them had some discomfort. Fifty-one per cent of patients did not experience any instability in daily and working life but half of them had occasional pain. Sixty-one per cent of knees did not, at review, show a positive MacIntosh pivot shift test and the absence of pivot shift correlated statistically with the quality of the functional result. In seventy-three per cent of knees there was a positive Lachmantest indicating definite laxity at the review. Thirty per cent of knees developed a lateral laxity, which questions the innocuousness of removal of the iliotibial tract. Twenty-seven per cent showed radiological deterioration of the medial joint space. A comparison of these results with the published results of intra-articular ligamentoplasty suggests that extra-articular ligamentoplasty with fascia lata should be limited to the treatment of isolated chronic anterior ligament laxity in middle-aged patients who do not participate in strenuous sporting activities.

Adolescent↗
PubMed1987

[Comparative study of 2 dosages of low molecular weight heparin, PK 10169, in the prevention of thromboembolic incidents during treatment of 103 femur neck fractures].

Results of this study in the elderly with fractures of femoral neck, in whom their exists an enhanced thrombogenic risk, showed that the dose of 40 mg per 24 hours as one or two divided injections of enoxaparine was as effective as adapted subcutaneous doses of calcium heparinate. It was also less iatrogenic and easier to manage (biological assays were of little use apart from platelet counts). Clinical evidence of pulmonary embolism, or mortality, were not observed in this series of 103 patients.

Aged↗