Biomedical subjects
Publications and source records attributed to M Jacquemier.
Three cases of sleeve fractures of the patella are reported. These lesions are epiphyseal fractures. Attention is drawn to the fact that the diagnosis may be missed. Surgical treatment is necessary to attaining and maintaining reduction. The authors focus on that avascular necrosis is important in sleeve fractures and the open reduction increases this risk.
One hundred hips in children were examined by computer assisted tomography. They were either dysplastic, subluxated or dislocated. The study resulted in more precision as to the degree of femoral anteversion and acetabular anteversion. The indications for femoral or pelvic osteotomy can thus be more accurate. Mechanical effects of some pelvic osteotomies have been analysed.
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The authors study 14 femoral neck fractures in children after a four and half years follow up. They point out the scarcity of these fractures in children. They describe their therapeutic methods and results. They corroborate the bad prognosis of this injury (femoral neck necrosis or further growth trouble) and emphasise the importance of a long term follow up to appreciate precisely the sequellar growth trouble. They discuss the responsibility of the femoral neck's vascularisation pattern in the origin of the sequella. They ask two questions : -- Is it useful to treat these fractures in emergency? -- Is the surgical dogma still valid?
On the basis of 12 cases, the authors suggest use of the axillary approach in everyday surgery on the shoulder and the upper end of the humerus, because of the quality of healing it offers. They describe its safety and limitations. Problems are restricted to slight transverse adhesions across the axilla which are easily cured and even more easily avoidable.
A centrally located bone bar of the lower tibia was removed after epiphyseolysis with an Ilizarov device. The bone bridge attached to the metaphysis was easy to remove, and methylmethacrylate was used as an interpositional material. Varus deformity was corrected at the level of the epiphyseolysis. At the 2-year follow-up, there was evidence of further growth and correction of the varus was maintained.
Sixty-two patients with histiocytosis X were followed for an average of 5 years. The patients were classified into three groups: general visceral types (14 cases), multiple eosinophilic granulomas (nine cases), and solitary eosinophilic granulomas (39 cases). One hundred bony lesions were noted in 60 of the 62 patients. The bone lesions showed progressive improvement in single and multiple eosinophilic granulomas independent of treatment type. After biopsy, patients received no treatment unless there was a dangerous extension into the soft tissues because of its site, i.e., in the skull. In the general visceral types, chemotherapy was effective in visceral sites and in extensions of the tumor outside the bone but did not alter the natural history of the bony lesion.
Acetabular anteversion analysis was performed in 143 normal children, who ranged in age from 1 to 15 years. The mean anteversion value, which remained constant during growth, was 13 degrees.
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