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PubMedDate not supplied

[The first total hip prostheses in man (1890 - 1960)].

We owe the first total prosthesis to Th. Gluck from Berlin (1880-1890), (they were in ivory), and to Jules Pean from Paris (1890-1894) (they were in platinum and cemented with plaster and pumice). Hardly successful though they were, the idea of replacing an articulation by foreign material was born. It would take sixty years to come to a successful hip total prosthesis. In the 1930 ies, Smith-Petersen, from Boston, designed moulds to be set between the femoral head and a cotyle in glass, pyrex, Bakelite and eventually a metal cupule (vitallium) either set on to the cotyle or the femoral head. After 1940 Bohlmann and Moore were the first to replace the upper part of a femur bearing a tumour and a metal prosthesis. In 1947, Jean and Robert Judet proposed a femoral head in acrylic. The first successful femoral prosthesis (more than 50 % good results) was Moore's new metal prosthesis in 1950. In the 50ies, some surgeons had the idea of connecting the two prosthetic pieces (cupule and femoral prosthesis) to get a total prosthesis, mainly in metal (Mc Kee from Norwich in 1951 and Herbert from Aix les Bains around 1955). In 1960, Charnley used dentist's methalcrylate cement for a Moore femoral prosthesis. In 1962, Charnley used this cement for a total prosthesis, with the low-friction concept and a 22 millimeter femoral head, which could move in a polyethylene cupule. This prosthesis is still in use today, in 1999.

Hip Prosthesis↗
PubMedDate not supplied

[Compression method throughout the ages].

The compressive method was practiced instinctively in farthest antiquity. Its development in Western Europe over the past two centuries may be artificially divided into 3 phases. The first phase, which belongs to the prehistory of Phlebology, includes two notable facts: the start of ambulatory compression in London around 1800, and the interest that the French school immediately showed in this discovery. However, this measure was soon abandoned, since around 1880, in the Paris hospitals, ulcers of the leg were being treated by mercury plasters and rest in bed. The second phase--1900 to about 1950--is marked by the empirical development of the compressive method, mainly in chronic phlebopathies. The synergic effect of walking is definitively established; the treatment of deep-set phlebites by ambulatory compression is discovered by H. Fischer in Germany and then in France by L. Nard. Beginning in 1950, this empirical data is both spread by the new Phleboloby Societies, and submitted to rigorous scientific study. Clinicians (especially H. R. Van der Mollen), assisted by physicists, physiologists and biologists, establish the laws of "therapeutic counter-pressure" and transpose them in the textile industry. New materials facilitate the use of elastic pressure. Underestimated or little known by most physicians, ambulatory elastocompression remains for Phlobologists a fundamental therapy. At a time when sedentary living and excess use of drugs are being widely denounced, it still has a promising future.

Bandages↗
PubMed1996

[Fractures of the anterior rim of the distal part of the tibia. Apropos of a series of 38 cases].

PURPOSE OF THE STUDY: Fracture of the anterior rim of the distal tibia is a rare injury. This fracture seems less serious than other pilon fractures but its treatment is often difficult and didn't give better results. The aim of this study was to describe problem we dealed with and to suggest solutions in order to improve long term results. MATERIAL: The study included 38 cases, treated in 5 Paris district trauma centers, with a minimal follow-up of 6 months. All patients were asked for clinical and radiological review between september 92 and march 93 ; otherwise, latest review datas were used. METHODS: Authors suggest a radiological classification based upon type, width and talus anterior displacement. Different surgical procedures were performed for 33 cases (screw, plate, external fixation) ; conservative treatment was used 5 times (non weight bearing plaster cast). Anatomical reconstruction was analysed. Functional results scoring system included pain, global abilities and ankle range of motion. Ankle arthritis was rated according to 1992 SOFCOT scoring system at 1 and 3 year follow-up. RESULTS: Follow-up ranges from 6 months to 11 years (average 28 months). 55 per cent of cases were lost for review with 1 year mean follow-up. 45 per cent of patients were recently tested with 4 year mean follow-up. Three ankles had joint fusion 6 to 18 months after trauma. Functional result was poor. For 35 ankles analysed 1 out of 4 remained totally painless (9 cases), 1 out of 2 had a good function (20 cases) and 1 out of 3 normal X-rays (12 cases). Arthritis was found for 2 ankles out of 3 after one year follow-up (16 cases out of 23). Loss of reduction or incomplete reconstruction seemed the most important point (13 cases out 38, 13 cases after 35 surgical procedures). DISCUSSION: Many patients didn't get a long term evaluation, and this study has no statistical value. Anyway, function loss was always early on a weight bearing joint. A perfect and stable reconstruction gives a higher rate of good result (11 out of 14). Analysis of cases with anatomic imperfection leads to recommendations: fixation of separation fracture, even undisplaced, bone grafting to correct impaction, appropriate use of external fixation for neutralization. CONCLUSION: Better results should come from a better analysis of the bone lesions : separation, impaction or mix fracture. This analysis leads to appropriate surgical procedure which give back a stable and anatomic distal tibia. External fixation can be usefull for immobilization ; this can't avoid open reduction and internal fixation of the fracture. Bone grafting can be useful for impaction fracture.

Adolescent↗
PubMed2004

[Posterior spinal fusion for kypho-scoliosis associated with osteogenesis imperfecta: long-term results].

PURPOSE OF THE STUDY: A survey was conducted at the Necker-Enfants-Malades Hospital in Paris and the Roscoff Helio-Marin Center in Roscoff, France to document results of posterior spinal fusion for scoliosis associated with osteogenesis imperfecta. MATERIAL AND METHODS: The cases of 27 patients who underwent posterior spinal fusion and Harrington (n = 2) or CD (n = 23) instrumentation performed by one senior orthopedic surgeon were reviewed. Two patients had posterior arthrodesis without instrumentation and were left in halo-traction together with a plaster cast until bone healing was achieved. RESULTS: The series included eleven males and sixteen females. Mean age at fusion was 13 y 4 m. The average curvature before surgery was 77 degrees and the average correction was 37 degrees. Mean follow-up was six years. Minor complications due to halo pin infection or migration were observed in two patients and loss of correction with rod fracture in four. DISCUSSION: Because of the risk of physical and respiratory incapacity, we believe that spinal surgery and arthrodesis for spinal deformity should be considered after a preparation period by halo-traction with exceptional precautions to correct major curves and prevent complications that could occur in patients with osteogenesis imperfecta. Correction and stabilization of the scoliotic spine in osteogenesis imperecta has yet to be definitively described since we have noticed that the site of deformation is transferred to the sacroiliac region once spinal fusion is achieved.

Adolescent↗
PubMed1990

[Epiphyseal fractures-dislocations of the lower extremity of the tibia].

Ninety six distal tibial epiphyseal fractures were identified and treated in our institution from 1976 to 1988. The average age was twelve years and eight months (range two to seventeen years), but seventy-one were between eleven and fourteen years old. Using the Salter-Harris classification we have found twelve type 1 tibial fractures, fourty-two type 2, thirty type 3 and twelve type 4. Four were triplane fractures and seven were Tillaux fractures. Twenty-six had injuries in the medial corner of the ankle mortise (Mac-Farland). Fifty patients were treated non-operatively with closed reduction and plaster cast. Fourty-six fractures were treated surgically. Seventy patients were available for follow-up evaluation. The average follow-up was thirty-two months (range 6 months to eleven years). The tibial distal epiphyseal cartilage was closed in 48 patients. As short-term complications we have seen three post-operative displacements after closed reduction; all of them were treated surgically. Five incomplete closed reduction needed open reduction needed open reduction and bone fixation. Two infections occurred after a surgical approach. Among late complications we have seen eleven premature epiphyseal cartilage closure (rate 15%). Four were responsible of angular deformities. One child has a tibial osteotomy for varus deformity after a medial closure. Two ankle arthritis occurred: one of them was seen after a post-operative infection. In two cases of fracture of the medial mortise corner, a valgus deformity with hypertrophy of the medial malleolus occurred. Ankle arthritis is the most severe complication of the adolescent articular fractures (Tillaux and triplane fractures).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗