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P Rigault

Publications and source records attributed to P Rigault.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Fractures of the talus in children. Apropos of 23 cases].

The authors have reviewed 23 fractures of the talus in children. They propose a classification based on the radiological maturity of the bone and the specific type of fracture. Group I: Children younger than 6 years (6 cases). The fracture line separates the bone into two parts. The diagnosis was difficult, with displacement being underestimated in some cases. Associated lesions in the same limb were present in 5 cases. Five fractures of the neck of the talus were treated conservatively with excellent or fair results. One comminuted fracture was treated surgically with a poor result. In all cases treatment should aim to maintain a good tibio-tarsal joint. Group II: Children older than 6 years (17 cases). Eight cases were osteochondral fractures, two were partial fractures and seven were complete fractures. Two of these developed subsequent avascular necrosis. The relationship between osteochondral fractures and osteochondritis is discussed.

Adolescent↗
PubMed1986

[Results of the orthopedic treatment of scoliosis in children under 7 years of age. Apropos of 75 cases].

Seventy five children suffering from scoliosis under the age of 7 years have been treated by the authors. The treatment was commenced before the age of 4 in infantile scoliosis and before the age of 6 in juvenile scoliosis. It was based on the use of the Milwaukee brace used directly in cases of angulation less than 50 degrees and preceded by a plaster cast in other cases. The treatment was continuous with sometimes a few hours of freedom from bracing. Occasionally the treatment had to be stopped. The development of the curve was very variable. The authors have distinguished seven different types of development. The prognosis was therefore difficult to establish and was mainly based on the specific features of the progress of the curve. At puberty, deterioration was often seen despite bracing and there were many indications for spine fusion.

Braces↗
PubMed1985

The variable manifestations of dysplasia epiphysealis hemimelica.

Dysplasia epiphysealis hemimelica (DEH) is an osteocartilaginous overgrowth involving one or multiple epiphyses or ossification centers, usually in a lower extremity on one side of the body. Characteristically the involvement is hemimelic i.e. either the medial or lateral part of the ossification center is involved. We have studied 24 patients with DEH and are adding 15 new cases to the literature. Because of the variable manifestations of the dysplasia and its different degrees of involvement in the affected children, we have subdivided it into localized, classical and generalized forms. In the generalized form, there is involvement of a whole lower extremity from the pelvis to the foot, and some of these patients show megaepiphyses with enlargement of a whole epiphyseal center, not only its medial or lateral part. We have also described and illustrated other special features of the dysplasia especially the advanced bone age and the metaphyseal and growth plate involvement.

Child↗
PubMed1985

[Surgical treatment of scoliosis of 100 degrees and greater in children and adolescents (neurological and myopathic scoliosis excluded). Apropos of a series of 66 cases].

In a retrospective study the authors had compared the results obtained in two series of identical scoliosis. All were examined after a two year minimal follow-up. Group A. There were 31 children operated on between 1966 and 1972. The average initial curve measured 111 degrees, and the average follow-up was eight years. In this group there was no preoperative preparation, and a Harrington rod was accompanied by cancellous grafting. The average correction was 34 degrees. Four paraplegias were seen, three of which recovered. Group B. There were 45 children operated on between 1973 and 1980. The average initial curve was 170 degrees and the average follow-up was 4.5 years. In this group, there was pre-operative use of a Halo cast routinely. In 14 children, Harrington rodding was supplemented by anterior fusion to correct associated kyphosis. The posterior Harrington rodding was completed by tibial grafting. The average correction was 47 degrees, without any neurological complications. It was noted that after one year, pulmonary function was not impaired to a greater extent after an anterior fusion than after a purely posterior fusion. Two-thirds of the cases gained considerable cosmetic benefit.

Adolescent↗
PubMed1985

[Traumatic hip dislocations and acetabular fractures in children].

This paper concerns 39 children, 15 with dislocation of the hip, 8 with acetabular fracture and 16 in which both lesions occurred together. The three types of lesion each had a different outcome. The results were good in 86 p. 100 of the isolated dislocations treated conservatively. They were good in 75 p. 100 of acetabular fractures, only one of which was operated on. The results were good in 50 p. 100 of cases with both lesions. Five cases were operated on to restore a congruent and adequate acetabulum. The overall rate of complications was 20 p. 100 and were mainly post-traumatic degenerative arthritis (2 cases), destruction of the triradiate cartilage (1 case), necrosis of the femoral head (2 cases due to separation of the femoral epiphysis). Seventy per cent of the patients finally had a satisfactory result. However, the risks of development of a late degenerative arthritis are high. These children should be followed up for a long period of time.

Acetabulum↗
PubMed1985

[Association of Ewing's sarcoma with fibrous dysplasia of the tibia. Apropos of a case report].

The authors have observed a child of 14 presenting fibrous dysplasia localised to the right femur and right tibia and complicated by an Ewing's sarcoma of the right tibia. The complication was marked only by pain and the radiographs were not typical. It was diagnosed only by microscopic examination after biopsy. Scintigraphy did not reveal any other site of fibrous dysplasia. The tibia was treated by a reinforcing nail followed by radiotherapy and chemotherapy. After a 4 year follow-up there was neither recurrence nor metastasis. After a review of the literature it is concluded that this combination was purely accidental and that there is no known relationship between Ewing's sarcoma and Jaffe-Lichtenstein type of fibrous dysplasia. It is remarkable that the sarcoma was not typical clinically and that the satisfactory result was probably related to very early treatment.

Adolescent↗
PubMed1984

[Congenital convex clubfoot: a diagnostic and therapeutic study of 71 cases].

We have studied 71 feet with congenital vertical talus in 51 patients. The condition is characterised by two fixed deformities, equinus of the hindfoot with a vertical talus and dislocation of the mid tarsal joint due to malposition of the navicular with respect to the head of the talus. The forefoot is usually everted, but lay in inversion in 25% of our cases. The deformity must be recognised within a few weeks of birth, and the diagnosis is facilitated by radiographs taken in extreme dorsiflexion and plantarflexion. The radiographic appearances allow classification of the deformity into three groups which aid in the choice of the correct management. Treatment is by operation. We have performed 48 open reductions, followed by lengthening of the Achilles tendon six weeks later. Our results can be equally divided into good, fair and poor. We have excised the talus on three occasions only, but we feel that this operation may well be useful in the presence of marked deformity of the talus, particularly in the older child.

Child, Preschool↗
PubMed1984

[Kyphosis caused by severe spondylodiscitis in newborn infants and young children].

The authors report their experience of 12 discitis occurring in the new born and in young children. Pyogenic infections were found with general septicemia in the new born children. The onset of cases of Pott's disease occurred later. Anterior destruction of several vertebrae accounted for severe kyphosis which were found on clinical examination. Conservative immobilisation of the kyphosis during growth does not prevent any increase in deformity before puberty with the possible onset of neurological symptoms. The only possible treatment is surgical with anterior arthrodesis of the damaged region together with a corrective osteotomy followed as soon as possible by posterior arthrodesis. If, unfortunately the patient is seen later in the course of the disease, the possibility of corrective osteotomy will depend on the degree of kyphosis and the neurological symptoms.

Child↗
PubMed1984

[Benign osteoblastoma in children. Apropos of 8 cases, 4 with spinal localization].

In a 20 year period the authors have seen 8 cases of osteoblastoma in patients less than 15 years old. Four were in the spine, three in the hand and one in the tibia. Three of the four limb osteoblastomas were lost to follow up after curettage, one of them after a recurrence. The fourth one was cured after 9 years. None of the spine lesions recurred after a follow up of from two to 14 years but two of them had a rigid kyphosis. It is concluded that osteoblastoma is normally benign in children. The pathological diagnosis may be difficult. In one the initial diagnosis had been of osteosarcoma. The treatment is based on complete excision. In the spine, it should be accompanied by arthrodesis.

Adolescent↗
PubMed1984

[Correction of scoliosis using plates. Results of 99 cases seen at a later time].

The authors have reviewed 99 scolioses with an average follow up of 4.5 years which had been corrected by plating. The complications were not infrequent, but were rarely severe. The best early mechanical results were obtained in low curves when the plating was sufficiently extensive. After one year follow up some secondary displacements of the device were seen, mainly in the thoracic region. The long term results were satisfactory both in terms of the angulation and the cosmetic and functional result, except in high thoracic curves. The causes of failure were analysed. It is concluded that this type of operation is worthwhile in idiopathic reducible low curves without rigid secondary curves. It may be applied to paralytic curves provided there is not severe lordosis.

Adolescent↗
PubMed1984

[Primary synostosis of the tarsus in children. Apropos of 32 cases in 20 patients].

The authors have studied 32 tarsal coalitions in 20 children. Twenty two were between the talus and the calcaneum, 4 were medial and 6 were rare varieties. The diagnosis is often missed because 40 p. 100 of the children with tarsal coalition had no complaints. The indirect radiological signs have been analysed and precise techniques described for detecting the coalition. Only 11 feet were operated on. On 4 occasions the coalition was simply resected. This always gave a good functional result and good mobility was obtained in the subtaloid joint in 2 cases. The other cases were treated by triple arthrodesis. The authors consider that an earlier diagnosis would lead to better prevention of secondary deformities. The best indication for simple resection is in coalition between the calcaneum and the navicular.

Adolescent↗
PubMed1984

[Primary bone tumors of the spine in children. Apropos of 66 cases].

Primary tumours of the spine in children are infrequent. The authors have studied 60 benign and 6 malignant tumours in 4 orthopaedic centres. These tumours have been diagnosed in 3 different ways - in the study of cord compression, as a finding in the course of a previously known disease, or as an isolated tumour. In most cases, the diagnosis could be made even before biopsy whose technique and indications are discussed. The treatment is based on the pathology but in all cases, it must avoid any loss of stability of the spine such as may occur after extensive resection.

Adolescent↗