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Biomedical subjects

P Rigault

Publications and source records attributed to P Rigault.

At least 109 records · Page 6Linked to original sources
PubMed1980

[Humerus varus (author's transl)].

Humerus varus is a rare disease and has led to many controversies concerning its classification, its physiopathology, its treatment and even the measurement of the varus angle of the huméral head. This study is based on four personal cases and a review of the literature since 1900 about fifty cases. The relation between humerus varus, congenital aplasia of the glenoïdal articular surface of the scapula, and congenital dislocation of the shoulder, sometimes referred as shoulder dysplasia, is discussed. Two entities must be distinguished: The "true" humerus varus where the epiphyseal plate is in a varus position with a shortened arm. The deformities of the humeral head in varus without main alteration of the epiphyseal plate orientation. When there is a restricted function, especially in abduction, a valgization osteotomy of the proximal part of the humerus can be proposed (one case). The authors have no experience in lengthening of the humerus.

Child↗
PubMed1980

[Pre-operative correction of severe scoliosis by halo and walking-frame system (author's transl)].

Ten cases of very severe scoliotic curves have been corrected pre-operatively by permanent traction with a halo suspended at a walking-frame device. The mean initial angulation was 110 degrees and the mean pre-operative correction was 48% for a mean use of two months. This procedure permits the patients a sub-normal activity, gives a good correction as "halo-cast" or "halo-pelvic" and avoids all cutaneous, neurological or psychological complications.

Adolescent↗
PubMed1980

[Non-ossifying fibroma in children: a surgical condition?].

From 21 non osteogenic fibromas submited to surgery, authors bring their surgical experience of that tumor. This frequent benign tumor of the bone in childwood has generally a good pronostic; it evolves to spontaneous recovery in most of the cases. It is often latent, asymptomatic, and of an accidental diagnosis. The roentgenographic exam allows most often an accurate diagnosis. Sometimes it remains doubtful, and a biopsy is then necessary. The histologic exam will easily confirm the nature of the lesion. In half of the cases, non ossifying fibroma is revealed by a spontaneous fracture. It seems illusive to hope a complete filling of the tumor cavity with an orthopaedic treatment alone; it must be done a resection of the tumor together with a bone graft and an osteosynthesis. In the end, in some cases of a fortuitous diagnosis, the bone is made so weak that a resection with bone graft is necessary. And so, during the evolution of non osteogenic fibroma, there is a certain place for surgical treatment.

Adolescent↗
PubMed1980

[Osteoarticular deformities in pseudo-achondroplastic dysplasia].

Mistaken in the past for classical achondroplasia, pseudoachondroplasic dysplasia is indeed a clinical and roentgenologic entity. Moreover under electronic microscope and using microchemical technics, specific pathological patterns may be observed in the growth cartilage cells. Aside from severe micromelic dwarfism, osteoarticular deformitites must be considered as an evolutive complication of P.A.D. The osteoarticular complications are well defined and confirme the specifity of the disease. Clinical and roentgenological evaluation are highly desireable and, if necessary, elective surgical orthopedic management should be performed, with prevention being it's principal goal. The authors give the details of the osteoarticular abnormalities observed in 15 cases of P.A.D. and relate their therapeutic experience herein. The atlanto-axial deformity, which is life threatening, must be looked for with special attention, and treated before neurological complications arise. In the lower limbs, deformities are constant and severe. Epiphyso-metaphyseal growth disorders result in axial deviations and aggravate the above-mentioned pre-existing articular-deformitites. Classical surgical orthopedic management is applicable to these types of malformations and should contribute to a better functional prognosis in this constitutional disease.

Achondroplasia↗
PubMed1980

[Spinal cord complications in the surgery of spinal deviations. Apropos of 24 cases].

The authors review 24 medullary complications which they encountered while treating scoliosis and kyphosis over a period of 8 years. They studied separatly the complications encountered in the pure kyphosis and those encountered in the scoliosis. 7 medullary complications occured while treating pure kyphosis, 5 Potts disease, 1 achondroplasia and 1 Morquio disease. All the kyphosis were of importance with a mean curve over 100 degrees. In 6 cases the medullary symptoms occurred during elongation prior any surgery. The authors distinguished between Pott disease where the symptoms occurred after minimal reductions and the chondrodysplasia where the symptoms occurred after important reductions. Thus the stiff Pott kyphosis where elongation results in medullary symptoms because of medullar compression before any correction, appears to be different from reductible kyphosis where the strong medullary tension is responsible for the symptoms. Two complications occurred after a vertebral osteotomy one immediatly and one after an elongation of a pelvic halo.

Adult↗
PubMed1979

[Expanding intramedullary rods in the treatment of osteogenesis imperfecta (author's transl)].

Eleven cases of osteogenesis imperfecta were treated by corrective osteotomies and fixation with expanding intramedullary rods. The authors have used the Bailey-Dubow nail. Despite a short follow-up (average one year) they think that the device will avoid future repeated changes of rods during the growing period. Several technical pitfalls are described. It is thought that the same technique could be applied to congenital pseudarthrosis of the tibia.

Bone Nails↗
PubMed1979

[Traumatic injuries of the epiphyseal plate in the lower extremity of the tibia].

In a series of 110 fractures of the ankle in children the authors have observed 27 cases of "at risque" lesions: Mac Farland types of fractures and crush injuries. Epiphysiodesis occurs in all cases of crush injuries and in 25% of fracture-separation of the tibial malleolus. In order to prevent this complication the only procedure is to obtain an anatomical reduction. Desepiphysiodesis is uncommunly possible (2 cases) and rarely effective. In case of varus deformity an osteotomy must be performed and repeated if the child is still young.

Adolescent↗
PubMed1979

[Growth disturbance of the forearm in multiple exostosis and dyschondroplasia (author's transl)].

Multiple exostosis and Dyschondroplasia (Ollier's disease) are two Osteochondrodysplasia with abnormal cartilagenous growth which hinder growth of the long bones especially. Among other locations, these diseases do not affect the forearms symetrically. The ulnar bone is more often and more severely affected which results in a progressive dislocation of the forearm. The radial shaft bands while the hand incurves medially. The radial head can even dislocate completely. All the deformities of the forearm create a severe handicap. The authors report their surgical experience. Preventive management is the ideal solution and should be carried out before the onset of a complete dislocation (especially before the dislocation of the radial head). Correction should also take growth into consideration. Logically, the shortest bone (the ulnar) should be lengthened and straightened. Since it is not feasible to reasonably correct all deformities entirely by the ulnar lengthening, it is necessary to not only straighten but also to shorten the radial bone. Only regular surveillance of the growth abnormalities throughout childhood can allow a precise evaluation of the required correction necessary at the time of surgery which should be a definite one stage procedure.

Bone Lengthening↗
PubMed1978

[Spine deformity in Marfan's syndrome in childhood (author's transl)].

The authors have studied twenty cases of spine deformity in children suffering from Marfan's syndrome. They describe the main features of the disease and point out the difficulty of accurate diagnosis in children with minor involvement. The deformities are those of a dysplastic scoliosis as shown by the frequency of vertebral inversion on the lateral view: dorso-lumbar kyphosis, decreased lumbar lordosis. The treatment should be surgical because of the danger of a fatal outcome without treatment. The incidence of non-union is high and the authors recommend systematic revision of the fusion double curve scolioses with a moderate kyphosis. In cases of severe kyphosis, the addition of anterior grafting is recommended.

Adolescent↗
PubMed1978

[Vascular traumatic injuries of the limbs in children (author's transl)].

The authors review 66 case reports of trauma involving major vessels of the limbs in children and confirm the seriousness of these lesions. It becomes apparent that iatrogenic lesions are quite frequent especially after arterial punctures and arteriographies in general. They stress the importance of clinical diagnosis in vascular blocks. Arteriography should be exceptionally used for infants. Management should aim at restoring vascular continuity by deobstruction, suture or vein grafting. The ideal solution is often easily obtained when repair is undertaken quickly. Normal blood flow was satisfactorily obtained in only 36 patients whereas poor results in the remaining cases was explained because of delayed action. Sequellae are severe and more frequently encountered when blood flow is not restored. On the other hand, the repercussions on growth and development of the limb after chronic ischemia is still not a proven fact. Finally, the authors underline the severe consequences of thromboses after arteriographies by femoral puncture in infants.

Adolescent↗
PubMed1978

[Orthopedic problems in fibrous dysplasia in infant's bones. A report on 23 cases (author's transl)].

The authors report on 23 cases of fibrons in infants who had been treated surgically, and review the therapeutic problem which arise from this particular type of bone fragility. When located in the diaphysis they had been treated by screw fixation, isolated grafts being constantly unsuccessful. Various procedures had been used in 9 cases with localization in the proximal end of the femur, and they are reviewed critically.

Adolescent↗