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Biomedical subjects

B Longis

Publications and source records attributed to B Longis.

At least 19 recordsLinked to original sources
PubMed1997

[Value of orthopedic treatment of distal fractures of the forearm in children. Apropos of 152 cases].

PURPOSE OF THE STUDY: Distal forearm fractures in children are frequent. Management is conservative except in rare cases which will be discussed. MATERIAL AND METHODS: Retrospective analysis of 152 distal forearm fractures after 10 and a half months (6 to 48 months) of follow-up was carried-out. Age ranged from 2 to 16 years (mean 10 years). Orthopaedic treatment was proposed in each case, but in 5, surgical treatment was required at onset. Clinical and radiological fracture reduction analysis was conducted immediately post op and during follow-up. 92 per cent of these fractures had a posterior or posterolateral angulation (with a mean angulation of 28 degrees 5). Among these cases, 64 per cent had instability criteria. Degree of translation when present (79 cases) was at 100 per cent in 55 cases (70 per cent); greater than 50 per cent in 11 cases (14 per cent) and less than 50 per cent in 13 cases (16 per cent). In 12 cases (8 per cent), the displacement was anterior with a degree of translation greater than 50 per cent in 6 cases and an angulation always greater than 30 degrees in the 6 remaining cases. RESULTS: In 5 cases, surgical treatment was necessary due to initial instability and/or irreducibility. In 147 cases, analysis of instability criteria, reduction and cast quality, and of fracture location showed displacements in cases of non-adapted and incorrect X-ray work up (6 cases of 6); in 18 cases of 24 when the cast was adapted but with incorrect X-ray work-up; in 5 cases of 10 when the cast was non-adapted with correct X-ray work-up, in 3 cases of 7 when the fracture was superiorly located; and in 6 cases of 6 when cast was prematurely opened. DISCUSSION: Close reduction is possible for fractures with large displacement but must be done perfectly and the cast must be adapted. If instability, irreducibility and/or incorrect reduction exist, management must include posterolateral and intrafocal percutaneous pinning, especially in older children. While rare, this indication must be known.

Adolescent↗
PubMed1996

Extramucosal pyloromyotomy by laparoscopy.

Since 1990, we have performed extramucosal pyloromyotomies by laparoscopy in 70 infants presenting with congenital hypertrophic pyloric stenosis. Ever since the first cases, the technique and the instruments have been adapted. The surgical technique and the precautionary measures are here explained again. This technique is beneficial for infants with a better postoperative course and avoidance of any skin scar.

Anesthesia↗
PubMed1996

Laparoscopic fundoplication in children: our first 30 cases.

We report our experience performing 30 laparoscopic fundoplications in children (24 using the Nissen Rossetti technique and 6 using the Toupet fundoplication). Special instruments adapted to the young children are used: first, a miniature parietal suspender to decrease the intra-abdominal pressure and to provide more space; second, a retractable losenge-shaped liver retractor; and third, a Babcock forceps articulated at 60 degrees. In the Nissen Rossetti procedure, the wrap is fixed to the anterior face of the esophagus, the anterior wall of the fundus, and the upper right crus. In the Toupet procedure, the wrap is a retroesophageal partial fundoplication: the first suture attaches the wrap to the right crus, the second attaches the wrap to the esophagus, and the third recreates the oesogastric angle. We do not use gastrostomy. Patients have no gastric tube after the intervention. Thirty children from 2 to 15 years have undergone laparoscopic fundoplications. One conversion to open procedure was necessary. An average follow-up of 12 months was observed for 18 children with 3 complications: dysphagia for a psychotic girl, intrathoracic valve without any trouble, and recurrent episodes of digestive bleedings during 6 months. Laparoscopic fundoplication is a feasible extension of minimally invasive surgery in the hands of experienced surgeons; however limitations must be recognized to do a safe operation.

Adolescent↗
PubMed1995

[Priapism. Apropos of a case in a 10-year old child].

We report a case of post-trauma priapism observed in a 10-year old boy. Arterial blood flow was high with normal venous backflow, an exceptional situation in the child. Locoregional caudal anaesthesia was successful.

Accidents, Traffic↗
PubMed1993

Monitoring of the motor pathway during spinal surgery.

Paraplegia caused by irreversible lesions of the spinal cord is one of the major possible complications after scoliosis surgery. Several monitoring methods have been proposed but none are completely satisfactory. Since 1986 the authors assessed motor pathways during scoliosis surgery, using electrical stimulation of the motor cortex and lower limb muscle recordings (tibialis anterior muscle). Twenty-seven patients were included in this study: 25 with idiopathic scoliosis and 2 with dorsal kyphosis. Recordings in anesthetized patients with hypothermia were performed before and after spinal derotation during the surgical procedure. Magnetic cortical stimulation was carried out in ten awake patients before and after surgery. Reproducible responses were obtained in 22 patients under anesthesia. In eight patients no difference of the latency of the muscle response was detected before and after the correction of the spinal angulation. In 14 patients the increase of latency ranged from 0.4 ms to 5.2 ms. No correlation was found between the slowing of motor conduction and the magnitude of spine correction. No central neurologic complications were seen after surgery. The authors concluded that their study demonstrated that motor pathway assessment in anesthetized patients can be performed at different times during the surgical procedure. This technique should help in the future monitoring spinal function during scoliosis surgery.

Adolescent↗
PubMed1992

[Pyloric stenosis in infants. Contribution of ultrasonography and video-surgery].

Hypertrophic pyloric stenosis is the commonest condition requiring abdominal surgery in infancy. The Fredet-Ramstedt pyloromyotomy gives a very rare morbidity rate as shown by a review of 300 personal cases. The diagnostic value of sonography is gaining significance over contrast roentgenography, a pyloric diameter of more than 14 mm and a muscular thickness of more than 4 mm being required for the diagnosis. Over the last 18 months, we performed extramucosal pyloromyotomies using laparoscopy in 19 infants. This new surgical technique using laparoscopy with precautionary measures for the pneumoperitoneum appears to be very promising and should become a widespread technique in the future.

Gastroesophageal Reflux↗
PubMed1991

[Pyloric stenosis in infants. New surgical approaches].

Pyloromyotomy as described by Fredet and Ramstedt is still widely used for the treatment of infantile hypertrophic pyloric stenosis, with a very low mortality rate. Three hundred case-records of patients treated using this technique were reviewed. Pyloromyotomy can benefit from the use of videosurgical methods. The creation of a pneumoperitoneum requires special precautions in infants. Nineteen infants were treated using laparoscopic Fredet-Ramstedt pyloromyotomy, a technique which can be expected to gain widespread acceptance during the next few years.

Female↗
PubMed1990

[Contribution of continuous peridural analgesia to neo-natal surgery].

UNLABELLED: Continuous epidural analgesia is an common technique in neo-natal surgery. It will be possible with a fitting material. Principal indications are: omphalocele, gastroschisis, oesophagol atresia an diagphragmatic hernia. TECHNIQUE: our protocol has been approved by the Regional Ethical Committee and informed written consent has been obtained from parents. General anaesthesia was induced and children were placed in lateral position. After skin preparation, the interspace L 3-L 4 has been punctured to identify the epidural space by loss of resistance. An epidural catheter (19 to 27 G) has been placed. 0.5 ml.kg-1 of 0.25% bupivacaine have been immediately injected, followed by a continuous injection of 0.3 ml.kg-1h-1 of the same bupivacaine. Epidural has been kept for four to five days. ADVANTAGES: very good analgesia; abdominal and vascular pressures decreased; to wean from respirator very quickly. No accident was founded.

Analgesia, Epidural↗
PubMed1990

[Single preoperative intravenous dose of metronidazole for appendectomy in children].

One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis.

Appendectomy↗
PubMed1989

[Antibiotic prevention with a single dose of metronidazole in appendectomy in children].

One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis.

Appendectomy↗
PubMed1988

[Traumatic epiphyseal separation of the lower end of the femur].

Forty-one children suffering from displacement of the distal femoral epiphysis were reviewed with a five year follow-up. This is a rare lesion, caused by severe trauma. It is seen at all ages, four of the cases being neonatal, but principally in adolescence, in 22 cases. The Ogden classification is preferable to the Salter-Harris classification for these fractures, which are usually in type II (39 cases). The prognosis is related to the severity of the initial displacement and to the quality of the reduction and its maintenance. Epiphysoidesis developed frequently and early, in 15 cases. It seemed to be due to an initial vascular injury rather than to mechanical compression. The results were not very satisfactory with 23 good, 11 fair and 7 bad results. It is recommended that an anatomical reduction should be maintained by percutaneous crossed pins. In adolescents aged 15 years or over, primary surgical epiphysiodesis of the whole growth cartilage seems to be a reasonable possibility.

Adolescent↗
PubMed1988

[Osteoid osteoma of the femur neck in children and adolescents. Apropos of 12 cases].

Specific characters of the osteoma osteoid as a beniGN tumor are well known. We report twelve cases of femoral neck localisation. Delays in diagnosis of six months to one year after the onset of symptoms are quite common. Chronic or recurrent pain is localised in the inguinal area with a projection to the leg and to the knee. The pain was relieved by Aspirin in six cases only. X ray of the pelvis antero-posterior showed the tumor, but did not always show the lucent image with the surrounding sclerotic area that is well observed with tomography. The scintigraphy with technetium 99 is perhaps more sensitive as a way of diagnosis. The lesion is the place of intensive uptake. Although the surgical excision "in block" and the replacing of bone graft and material of osteosynthesis gave positive results, many technical problems are present during the intervention because of the important cortical reaction and bone densification. In six cases, peroperative X Ray and histology did not give diagnosis.

Adolescent↗
PubMed1986

[Fractures of the upper part of the radius in children].

The authors analyse the results of forty five cases of fractures of proximal radius in children with average follow up 7 years. The average age of the children was 9 years. Detailed radiological examination warrants classification under four degrees of displacement (four cases displaced, 17 cases lower 30 degrees, 15 cases between 30 degrees and 60 degrees, 9 cases upper 60 degrees). Associated lesions was present in 15 cases. For treatment, 21 immobilisations, 10 closes reductions, 6 percutaneous reduction by means of a kirshner nail, 8 open reduction were done. Pronostic is good for degrees I and II (20 excellent, 1 good result), pronostic is incertain for degrees III and IV (13 excellent, 2 good, 3 fair and poor results). Correlation is straight between procedure of management and result. The authors suggest their indications, who are depending from age and displacement.

Adolescent↗