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P Groulier

Publications and source records attributed to P Groulier.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Tuberculosis of the greater trochanter. Apropos of 2 cases].

INTRODUCTION: The authors report two cases of tuberculosis of the greater trochanter as an uncommon localization in osseous tuberculosis. MATERIAL AND METHODS: 1st case: A 77 year old male presented with hip pain and swelling. Laboratory studies revealed an increased erythrocyte sedimentation rate. The patient had a positive skin test reaction for tuberculosis. Radiographs showed greater trochanter remodeling. M.R.I. demonstrated a bilobed abscess. There were enough arguments to initiate medical treatment, before surgery: excision of the abscess and partial trochanteric resection. 2nd case: In a 51 year old male, a large lytic lesion of the whole greater trochanter suggesting benign bone tumors was found an radiographs after a traumatism. Curettage and grafting were undertaken. The final diagnosis was made with the results of the intra-operative samples culture of and led to appropriate medical treatment. RESULTS: The outcome was good in both cases with four years follow-up for the first case, and two years for the second one. DISCUSSION: Trochanteritis Tuberculosis occurs in 1.8 per cent of bony tuberculosis cases. Local symptoms are discrete and the diagnosis is belatedly made when the tuberculous abscess appears. Radiographs and CT scan show the bony lesions: unevenness of the contours of the trochanter and several gaps in it. MRI shows the abscess and its spread. The microbiological test (when antibiotic therapy has not been initiated) and anatomo-pathological tests confirm the diagnosis. General treatment is based on a six month long specific antibiotic therapy. Local treatment concerns the abscess and the bony lesions. As the case may be; careful curettage is undertaken, or wide excision is performed.

Aged↗
PubMed1994

[Arthrodesis of the first metatarsophalangeal joint].

INTRODUCTION: The goal of this study was to evaluate the place of arthrodesis of the first metatarso-phalangeal joint in surgery of the fore foot. MATERIAL AND METHOD: The authors studied 225 arthrodesis of the first metatarso-phalangeal joint. 195 had a follow up of from two to fifteen years. The indications were: hallux valgus 52.5 per cent, hallux rigidus 20 p. 100, rheumatoid arthritis 12.5 per cent. The procedure used a stable axial fixation with an antero-posterior screw. The preparation of the joint surfaces allowed equalization of the length of the first two toes. RESULTS: The study found a patient subjective satisfaction rate of 89.6 per cent. There was no pain for 90 per cent of them. Activities returned to normal 80 per cent of patients. There was radiographic evidence of lack of fusion in 25 cases (13 per cent). Only two cases were painful and justified a revision. In 15 per cent of the cases slight pain at the inter phalangeal joint was noted due to excessive joint function. DISCUSSION: The best results were obtained with a dorsal flexion angle between twenty and thirty degrees. Restricted dorsal flexion concerning ankle or inter phalangeal joint is a contra-indication of the procedure. Stable fixation is essential but weight bearing on the fore-foot is not allowed for six weeks. CONCLUSION: Arthrodesis of the first metatarso-phalangeal joint restores painless satisfying function and normal use of shoes.

Arthritis, Rheumatoid↗
PubMed1992

[Surgical treatment of ruptures of the achilles tendon in athletes. 31 cases operated on with an average follow up of 4 years].

The authors analyze a series of 31 tendo achillis ruptures occurring after sport accident. All were treated surgically. The actual follow up being of 4 years (1 to 12 years). In nearly one third of the cases, either a change in the training methods or intensive activity was noted. 80% of cases showed an causal violent trauma. Tendinopathy preceded the rupture in 20% of the cases, without being an important prognosis factor. In 70% of cases, diagnosis was made within the 24 following hours, and later (more than 8 days after) in one patient out of ten. Type of the surgical procedure does not seem to make any change in the long term prognosis. Each time a severe post op. complication occurred, the final result was bad. In one third of cases pre op. and post op. tendon lengths were not identical, this detail not seeming to bother the patients. In 60% of cases, same sport level was reached. In 80% of cases the final results were good or excellent.

Achilles Tendon↗
PubMed1992

[Post-operative iatrogenic hallux varus. Surgical treatment. Apropos of 19 cases].

The post operative iatrogenic hallux varus associates varus, big toe's dorsal flexion and supination. The pathogeny is dominated by musculo-tendinous lack of balance created by the initial operation and excessive exostosectomy. The authors have nineteen times surgically corrected this deformation. The procedure included in all cases, a medial arthrolysis; five times associated with a screwed capito-metatarsal osseous shelf (or graft) (when there was a metatarsal's head maiming); thirteen times associated with a metatarso-phalangeal arthrodesis (in cases of impaired joint surfaces). The authors analyse, besides, without excluding them the other surgical procedures for hallux varus, and particularly tendinous transfers. The results show the necessity of a perfect etiopathogenic analysis of the deformation.

Adult↗
PubMed1991

[The rafter osteotomy of the first metatarsal with immediate weight bearing in the treatment of anterior and medial pes cavus in adults].

The difficulty of the exact adjustment of the first metatarsal's raising by dorsal cuneiform cutting and osteosynthesis, brought the authors to prefer proximal rafter osteotomy of the first metatarsal in the treatment of adult's anterior and medial pes cavus. Early weight bearing with a plaster cast or a wooden-shoe allowed the spontaneous raising of the metatarsal and an equal distribution of load between all the metatarsals. The excellent results reached by that single procedure in nine cases during ten years justify to suggest it for treatment of adult's anterior and medial pes cavus.

Adolescent↗
PubMed1991

[Fractures of the radial head. Analysis of a series of 62 surgically treated cases].

The authors present a retrospective analysis of 62 cases of radial head fracture operated between 1967 and 1989. According to the Mason classification modified by Morrey, there were 11 Type II fractures, 22 Type III fractures and 129 Type IV fractures. Surgical treatment consisted of one of the following: osteosynthesis, fracture fragment excision, or ablation of the head with or without silastic prosthesis. The results have been studied on a functional and radiological basis with follow-up from 2 to 23 years (mean: 5 years). Finally, the authors report the following indications: internal fixation for large two or three-part fractures, resection of the head in cases of comminution, and the lesions they judge to have a poor prognosis (Type IV).

Adolescent↗
PubMed1991

[Bacillary trochanteritis. Apropos of 30 cases].

Tuberculous trochanteritis is rare. The authors report 30 cases, 2/3 of which were seen in sanatoria. They occurred in four cases out of five in patients with long standing tuberculosis but were sometimes the presenting feature. Development of an abscess of the trochanteric serous bursa is a virtually constant complication. Their minimal functional consequences and slow progression endow them with an apparently benign nature which masks the risk of secondary complications (4 cases of coxalgia). Radiological appearances, minimal in early forms, are currently becoming more abundant by virtue of new medical imaging techniques. Specific antibiotic therapy is adequate in two cases out of three, completed in advanced and aggressive forms by local procedures dominated by surgical excision (13 cases).

Adult↗
PubMed1991

[Pigmented villonodular synovitis of joints. Apropos of 16 cases. Surgical aspects. Contribution of nuclear magnetic resonance imaging].

This study of 16 cases of pigmented villonodular synovitis of joints treated by the same surgical team involved 6 cases of the localized or nodular form and 10 cases of the diffuse form. The knee was the commonest joint involved (12 cases), with involvement of the hip (3 cases) and foot (1 case) being rarer. Bone invasion is usual when the joint is narrow (hip, foot) but is rarer in the knee where joint capacity is greater (5 cases out of 12). Clinical symptomatology is rarely typical. Hemarthrosis, the most suggestive sign, was found in only two cases out of twelve. While the final diagnosis must always be based upon histology, great help may be provided by modern techniques such as arthroscopy, computed tomography and above all MRI, the presence of hemosiderin being shown by a low signal in T1 which decreases even further in T2. Treatment is based upon surgical synovectomy, with advanced osteoarticular lesions requiring joint replacement.

Adult↗
PubMed1989

[Treatment of osteo-articular infections with ofloxacin. Preliminary study].

Twenty-three patients with osteoarthritis were treated by ofloxacin. Antibiotic association was used for 22 patients. Five patients have had osteomyelitis without foreign material. Four of them recovered. Seventeen patients carried foreign material. Evaluation are in progress for 5 of them. In the 12 remaining patients, 8 recovered at a mean duration follow-up of 6 months. One patient have had arthralgia that may be attributable to the treatment. The mean duration of treatment was 6 months for the foreign material group of patient, and 3 for the other.

Adolescent↗
PubMed1988

[Results of treatment of hallux valgus by the modified McBride technic with or without complementary phalangeal or metatarsal osteotomy].

This study reports an analysis of a series of 316 cases of hallux valgus treated by a method derived from McBride's operation with some modifications and combined with bony procedures designed to correct abnormalities of bony architecture, in particular osteotomy to shorten an excessively long proximal phalanx. Two hundred feet were reviewed with a follow-up between 1 and 13 years. The results, which were satisfactory in 80 per cent of cases, were analysed according to the usual parameters of pain and deformity in relation to the pre-operative findings and the surgical methods used. The failures and complications were analysed. The results of this study makes it possible to determine the indications for and to appreciate the value and advisability of technical modifications.

Adolescent↗
PubMed1987

[A case of compression of the posterior tibial nerve by a synovial cyst with impact on the superior tibiofibular joint].

The authors report a case of compression of the posterior tibial nerve by a cyst originating from the superior tibio-fibular joint. The clinical signs were dysesthesia of the sole of the foot and paresis of the toe flexors. The diagnosis was obtained by electromyographic studies. The patient recovered completely after surgical excision of the cyst, which had developed beneath the tendinous arch of origin of the soleus muscle.

Ankle Joint↗
PubMed1984

[Intertrochanteric flexion osteotomy in aseptic osteonecrosis of the femoral head in adults. Apropos of 52 cases].

Fifty-two intertrochanteric osteotomies were performed in 42 cases of idiopathic avascular necrosis of the femoral head of which 10 were bilateral. By flexion at the osteotomy site, the operation aims to place the superior pole of the femoral head during weight bearing towards the superior part of the acetabulum. The use of a specially angled nail-plate makes the procedure safe and simple. The results were analysed with an average follow-up of 46 months and a minimum follow-up for 2 years. The overall results were good in 72 p. 100 of cases, with better results for pain and mobility than for stability and gait. The results were better when the necrosis did not reach the centre of the head and when there was true relief from weight-bearing pressure. The indication were the best in grade II necrosis in patients less than 55 years old.

Adult↗