Biomedical subjects

C Chantelot

Publications and source records attributed to C Chantelot.

At least 19 recordsLinked to original sources

PubMed2001

Variations of pelvic anteversion in the lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup.

The position of the acetabular implant plays a dominant role in the displacement of a total hip prosthesis. CT allows precise measurement of the position of the cup, but the influence of pelvic rotation on this measurement is unknown. The aim of this study was to determine, in a group of healthy subjects, whether a pelvic equilibrium exists specific to each individual, and whether this is constant over time on the one hand and between the standing and lying positions on the other. The study concerned 15 men and 9 women with a mean age of 31 years. Each subject had strictly lateral radiographs of the pelvis, lying and standing, repeated at two different times. Pelvic version was measured in these radiographs. Each individual had a pelvic position constant over time, both in the lying and standing positions. However, there were important variations of the position of the pelvis during passage from the lying to the standing position: 22 patients had retroversion of the pelvis by a mean of 7 degrees (2-18 degrees) and 2 others had an anteversion of 3 degrees. These major variations of the pelvic position between the standing and lying positions explain why CT studies made in the lying position do not allow for the anteversion of the cup in the standing position, which is close to the dynamic situation during which displacement may occur. Thus, an excessive anteversion of the cup may be masked when the scan is made in the lying position, since in this position the anteversion of the pelvis leads to retroversion of the cup. The error may reach 20 degrees, so that we recommend that CT measurements made without allowing for the position of the pelvis should be interpreted with caution.

Adult↗

PubMed2000

Effect of the Steindler procedure on the median nerve branches to the medial epicondylar muscles.

Usually the median nerve gives off six branches to the muscles arising from the medial epicondyle, which could be tightened during Steindler's procedure. We studied these branches before and after Steindler's procedure in 20 fresh cadavers and observed a considerable variation in the origin of the branches. The muscular branches arising from the median nerve did not seem to limit the mobilization of the medial epicondyle when performing Steindler's transfer. The limitation of the flexion observed after Steindler's procedure was mainly related to the tension of the transferred forearm flexor muscles. The variability of the origin of the branch to the flexor digitorum superficialis muscle could explain a lesion of this branch when Steindler's procedure is carried out with Brunelli's modification. The lateral transfer and the anterior transfer on to the humeral shaft did not influence the limitation of elbow flexion or result in tightness in any nerve branch to the transferred muscles.

Humans↗

PubMed2000

[Primary carpal bone defect].

We present a review of management options in case of carpal bone defect, a relatively frequent discovery. In the literature, diagnosis is usually a fortuitous radiographic finding showing one or several images of carpal defect. Pain is observed in some cases, more exceptionally pathological fracture. The scaphoid, lunatum and hamatum are most frequently involved. Bilateral defects may be observed. Different mechanisms have been put forward to explain the development of intraosseous defects in the carpal bones including intraosseous penetration of synovial tissue, or in situ metaplasia of bone tissue. The main differential diagnoses are osteonecrosis sequellae (for the lunatum and the scaphoid), subchondral defects due to hyperpression and arthropathies in dialysis patients. All authors propose simple surveillance for asymptomatic images. In case of pain, with soft tissue swelling or pathological fractures, filling-excision is warranted depending on the severity of the clinical signs. Prognosis is generally good and recurrence exceptional.

Bone Diseases↗

PubMed2000

[Bankart procedure: clinical and radiological long-term outcome].

PURPOSE OF THE STUDY: There are few reports onlong-term outcome after Bankart procedure. The purpose of this study was to determine the rate of recurrent dislocation, the clinical results and the incidence of glenohumeral osteoarthritis after a minimum 10-year follow-up. MATERIAL AND METHODS: Ninety-seven Bankart procedures were performed in 97 patients between 1972 and 1986 for treatment of anterior shoulder instability with recurrent dislocations. We retrospectively reviewed 74 patients and obtained 64 complete radioclinical evaluations for an average follow-up of 16 years. Clinical evaluation was based on the G. Walch and the Duplay group score but for easier comparisons, we also calculated the Rowe et al. score. Radiographical evaluation was established on the Samilson and Prieto classification but real glenohumeral osteoarthritis with joint narrowing was noted independently as grade four. We also studied the contralateral shoulder. RESULTS: At last follow-up, 7 shoulders (9.5%) had recurrent dislocation, but two of them occurred subsequent to severe trauma over 18 months. Most patients (95 %) were satisfied or very satisfied. Six patients (8.1%) had persistent apprehension but in some it was not due to anterior apprehension. According to the Duplay score (or the Rowe score), 25 shoulders (44.6%) had an excellent result (35/61.4 %) 16 (28.6%) a good result (7/12.3%), 11 (19.7%) a fair result (11.19.3) and 4 (5.4 %) a poor result (4/7%). Operated shoulders were pain free for 75% and painful for forced movements only for 25%. External rotation at 90 degrees of abduction was reduced by 8.7 +/- 15.7 degrees. There was no limitation of internal rotation. Patients returned to preoperative sports activities at the same level for 70.9 % and at a lower level for 12.7%. According to the Samilson classification, 7 (13%) of the shoulders had grade 2 and 2 (3.7%) had grade 3 glenohumeral osteoarthritis. We found 4 cases (7.4%) of real glenohumeral osteoarthritis (grade four) and 2 of these patients had contralateral osteoarthritis of a non unstable shoulder. There was no perioperative complication. DISCUSSION: In our hands the Bankart procedure is appeared as a safe procedure with a low rate of glenohumeral osteoarthritis and a high rate of patient satisfaction.

Adolescent↗

PubMed1999

Innervation of the medial epicondylar muscles: an anatomic study in 50 cases.

The median nerve is classically distributed to the medial epicondylar muscles by two branches (superior and inferior) for the pronator teres muscle, a common trunk for the flexor carpi radialis and palmaris longus muscles, and a branch for the flexor digitorum superficialis muscle. The 50 dissections were made by two workers on 30 upper limbs of formalized cadavers and 20 limbs from fresh-frozen cadavers. The innervation of the pronator teres m. was classical in only 26% of cases, and the "normal" pattern for the flexor carpi radialis and palmaris longus mm. was found in only 40% of cases. The innervation of the flexor digitorum superficialis m. was the least subject to variations, a single branch being observed in 68% of cases. We found a solitary medio-ulnar anastomosis of Martin-Gruber to the flexor carpi ulnaris muscle. This study confirmed the great variability of the branches of the median nerve at the elbow, and the importance of identifying them in surgical procedures for transposition of the medial epicondyle.

Cadaver↗

PubMed1999

Martin-Gruber communicating branch: anatomical and histological study.

We dissected 72 upper limbs of fresh cadavers and found 17 cases with a Martin-Gruber communicating branch (23.6%). These were classified into 4 types: type I (n = 5, 29.4%): communicating branch between the anterior interosseous and ulnar nn, type II (n = 3, 17.6%): Communicating branch between the median and ulnar nn., type III (n = 3, 17.6%): Communicating branch between the muscular branches to the flexor digitorum profundus m., type IV (n = 6, 35.3%): combination of type I or II and type III. At histologic examination the number and size of the nerve bundles each communicating branch contained proved to be very different. In one case of type II only a single nerve bundle was found. We suggest that the different numbers of nerve bundles innervate different amounts of the intrinsic hand musculature. The communicating branch with a single nerve bundle probably innervated only the first dorsal interosseous muscle.

Aged↗

PubMed1999

A trans STT, trans capitate perilunate dislocation of the carpus. A case report.

We report a case of carpal injury not previously described, associating three lesions of the carpus secondary to a hyperextension mechanism: fracture of the capitate, scapho-trapezio-trapezoid sprain and lunotriquetral ligament rupture. The patient was operated by percutaneous pinning after closed reduction. The capitate fracture was not fixed. At follow-up, the patient had no restriction of his everyday activities and was very satisfied.

Carpal Bones↗

PubMed1999

Synovectomy combined with the Sauvé-Kapandji procedure for the rheumatoid wrist.

The aim of synovectomy-stabilization (synovectomy combined with the Sauvé-Kapandji procedure) of the rheumatoid wrist is to obtain a stable painless wrist, retaining enough mobility for function. Thirty-nine wrists were retrospectively examined, at a mean follow up of 64.8 months. The improvement in pain was very significant. We noticed a decrease in wrist motion affecting both flexion and radial deviation. The arthritic change in the wrist continued to increase. We noticed a mean ulnar shift of 2.2 mm and a mean increase in the radial deviation of the wrist of 7 degrees. Only transfer of the extensor carpi radialis longus tendon to the extensor carpi radialis brevis tendon was effective in correcting radial deviation of the carpus. Ninety-seven per cent of patients were very satisfied or satisfied. These encouraging results, even at advanced stages of wrist arthritis, have prompted us to lessen the indications for wrist arthrodesis.

Adult↗

PubMed1999

[Anatomic study and review of the literature on the Martin Gruber anastomosis].

We dissected 72 upper limbs of fresh cadavers and found 17 cases of the Martin-Gruber anastomosis. The incidence was 23.6%. They can be classified into 5 types. Type I (n = 5, 29.4%): Communication between the anterior interosseous and the ulnar nerves. Type II (n = 3, 17.6%): Communication between the median and the ulnar nerves. Type III (n = 3, 17.6%): Communication between the muscular branches of the flexor digitorum profundus muscle (FDP). Type IV (n = 3, 17.6%): Communication between the anterior interosseous and the ulnar nerves, the muscular branches of the flexor digitorum profundus muscle (FDP) originated from the connection. Type V (n = 3, 17.6%): The anastomotic branch originated from the median nerve and joined the ulnar at two different points as well as connecting with the ulnar branch of the FDP. Through histologic examination, we found the number and size of nerve fascicles which every connection contained to be very different. In one case of type II only one single nerve fascicle was found. We propose the hypothesis that the different amounts of nerve fascicles innervate different amounts of intrinsic hand musculature. The communication which contained one single nerve fascicle only innervate the first dorsal interosseous muscle (FDI).

Aged↗

PubMed1999

[Reliability of the KT-1000 arthrometer in measuring anterior laxity of the knee: comparative analysis with Telos of 48 reconstructions of the anterior cruciate ligament and intra- and interobserver reproducibility].

PURPOSE OF THE STUDY: The goal of this study was to compare KT-1000 and Telos measurements after anterior cruciate ligament reconstruction (ACLR). MATERIAL AND METHOD: Forty eight patients with asymptomatic ACLR (4 failures with positive pivot shift and 12 knees with positive (+) Lachman test) were assessed (mean 2.5 years after surgery) by the same examiner by means of: 1) Lachman radiographic with Telos at 150 N, 2) MEDmetric KT-1000 at 69 N, 89 N and maxi-manuel (MM). The examiner tested more than 200 patients each year. Measurements were performed for KT-1000 according to the manufacturers' recommendations and for Telos according to Staübli. Only side to side differences in millimeters are reported. Reproducibility of KT-1000 measurements were also evaluated: interobserver reproducibility was assessed by 16 examiners on a healthy patient, and the experienced examiner tested 20 times a healthy patient. RESULTS: An Interobserver error of 4 mm range (+/- 2 mm related to 0) was observed by 12 to 44 p. 100 of the examiners, respectively at 69 N to MM. An intraobserver error of 4 mm range (+/- 2 mm related to 0) was observed in 10 p. 100 at MM and in 20 p. 100 at 89 N. Mean side to side laxity with KT-1000 was 0.93 mm +/- 1.1 [-1 to 5] at 69 N, 1.3 mm +/- 1.6 [-2 to 6] at 89 N, and 1.41 +/- 1.8 [-2 to 6] at MM. With Telos the mean side to side laxity was 3.95 mm +/- 3.84 [0 to 15]. Significant differences (p = 0.0001) were found between measurements obtained by the two methods. No statistical correlation could be detected between values observed by Telos and KT-1000 (R < 0.1). If we consider a 3 mm side to side difference 23 knees (48 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 3 (6.2 p. 100) at 89 N and 6 (12.5 p. 100) at MM (1 (2 p. 100) at 69 N). With a 5 mm side to side difference, 12 knees (25 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 1 (2 p. 100) at 89 N and 1 (2 p. 100) at MM (0 at 69 N). Only Telos measurements were correlated to positive pivot shift (p = 0.007) and positive Lachman test (p = 0.01). CONCLUSION: Interobserver reproducibility of KT-1000 measurements was low, but improved for intraobserver agreement. However, even for a unique KT-1000 experienced examiner, reliability of KT-1000 was poor when comparing Telos and KT-1000 predicitive value to diagnose ACLR failure. Telos results were much more pejorative but the only ones corelated with ACLR failures. We recommand Telos instead of KT-1000 to assess laxity after ACLR.

Adolescent↗

PubMed1999

[Laxity and functional results of Miller-Galante total knee prosthesis with posterior cruciate ligament sparing after a 6-year follow-up].

PURPOSE OF THE STUDY: The preservation of the posterior cruciate ligament (PCL) was introduced in total knee arthroplasty to improve the quadriceps efficiency and the range of flexion in stairs. The purpose of this study was to determine if these goals were achieved with the Miller-Galante total knee prothesis and to assess the relation between knee laxity and function. MATERIALS AND METHOD: We assessed retrospectively the results of 48 consecutive Miller-Galante with PCL retaining. Four patients were excluded: 2 died, 2 lost to follow-up. Forty-four prostheses were evaluated in 38 patients mean aged 65 (33-79). The preoperative HSS score was 41 +/- 12.4 [21-63]. All the components were cemented with patellar resurfacing (25 metal-backed, 19 polyethylene). Stressed X-rays with Telos device were performed to assess frontal and antero-posterior laxity. All radiographic measurements were carried out with a digitizer (Orthographics). RESULTS: After 6 years of follow-up, 8 prostheses (18.1 p. 100) were already revised because of: 1) 3 excessive anterior tibial translations and severe polyethylene wear; 2) 5 femoro-patellar disorders. These last 5 knees (4 patellar metal-backed) had a greater patellar thickness [(25 mm +/- 1.2) (p = 0.01)]. The mean HSS knee score for the 36 remaining prostheses was 73.8 +/- 11.3 (35-92). Only 5 patients were able to climb stairs without support. The mean mechanical axis was 2.3 degrees in varus, but 81 percent of the knees were at 5 degrees around neutral position. The mean laxity in valgus was 4 degrees +/- 2.3 degrees [1-10], and 4.1 degrees +/- 2.1 degrees [1-9] in varus. The mean anterior tibial translation was 5.3 mm +/- 5 [1-17] and posterior laxity was 4.7 mm +/- 2.5 [1-10]. HSS knee score was lowered by 9 points when frontal laxity (valgus + varus) was greater than 5 degrees (p = 0.01), and by 9.8 points when posterior laxity was 5 mm or more (p = 0.02). The mean thickness of the patella was 22 mm +/- 2.3 [16-27]. DISCUSSION: These results were unsatisfactory considering the high revision rate and the low functional score observed despite of a correct implant positioning. The major challenge for PCL retaining (i.e. free stair climbing) was achieved in few cases. The wide range of posterior laxity underlined the difficulties to control PCL tension. On the other hand, PCL tension has to be controlled as it could influence knee function. Patello-femoral disorders was the main reason for revision surgery and an insufficient patellar bone resection may be contributive. Sagittal anterior laxity was the second reason for revision and it should be carefully detected as it could drive to catastrophic polyethylene wear. CONCLUSION: The advantages of PCL retaining were not demonstrated with this low constrained design. Surgical control of PCL tension could give a wide range of posterior laxity. Sagittal femoral-tibial laxity and femoro-patellar disorders should be detected before severe polyethylene wear. These results advocates for: 1) more congruent designs with PCL retaining or for PCL substituting designs, 2) improvement of patello-femoral design.

Adult↗

PubMed1999

[Retrospective study of 23 arthrolyses of the elbow for post-traumatic stiffness: result predicting factors].

INTRODUCTION: The goal of the study was to determine the results of elbow arthrolysis for post-traumatic stiffness, and to identify factors governing the result of that procedure. PATIENTS AND METHODS: Between 1984 and 1997, 26 elbow arthrolysis were performed. Twenty-three patients were retrospectively assessed by an independent examiner, 3 patients were lost for follow-up. The mean age at surgery was 41 years. The traumatisms responsible for stiffness were: 5 elbow dislocations, 7 radial head fractures, 3 olecranon fractures, 8 humeral palette fractures. The surgical approach was 2 times posterior, 9 times lateral, 12 times combined (posterior and lateral). The surgical approach was chosen according to the preoperative analysis of the stiffness factors and the scars in case of previous surgery. RESULTS: At follow-up (85 months (12-144)), 5 patients were very satisfied, 17 patients were satisfied and one patient was not satisfied. Six patients had discomfort in daily gesture. Ten patients had no pain, 6 had pain while effort and 7 had climatic pain. Two ulnar palsies existing at arthrolysis did not improve after neurolysis and anterior ulnar nerve transposition. Range of motion increased in every sector of mobility, and at follow-up mean ROM was: 121 degrees flexion, -31 degrees extension, 69 degrees pronation and 65 degrees supination. The average absolute benefit in flexion-extension was about 38 degrees. The average relative (flexion-extension) benefit according to Merle d'Aubigné was about 44%. At follow-up, the average pronation-supination was higher than 100 degrees. The range of motion was not correlated to the type of injury, to the surgical management, nor to the type of rehabilitation program. Likewise, the delay between traumatism and arthrolysis had no influence on the result. On the other hand, the range of motion was directly correlated to the preoperative mobility and mobility obtained just after surgery (p = 0.001). However, the range of motion at follow-up was slightly decreased (5 degrees to 15 degrees) compared to the mobility obtained just after surgery. DISCUSSION: The final range of motion was mainly related to the severity of the preoperative stiffness. We noticed that few patients were bothered in daily gestures, in spite of a relative stiffness. The type of injury did not seem to influence the final result. Elbow arthrolysis remains a mobilizing technique giving reliable long-lasting results. CONCLUSION: The range of motion obtained after arthrolysis performed because of elbow post-traumatic contracture is mainly related to preoperative stiffness. By comparing with postoperative range of motion, a loss of 5 degrees to 10 degrees can be predicted.

Adult↗

PubMed1998

Inter- and intraobserver reproducibility in radiographic diagnosis and classification of femoral trochlear dysplasia.

Dejour's radiographic criteria are commonly used to diagnose and assess femoral trochlear dysplasia in case of patello-femoral instability. The aim of this study was to establish the intra- and interobserver reliability of these radiographic criteria. Sixty-eight lateral knee radiographs were examined independently by 7 observers (2 juniors, 5 seniors) to assess interobserver agreement, and the 2 juniors repeated the observations to test intraobserver agreement. These 68 true lateral views were harvested from clinical records of 64 patients who underwent a trochleoplasty because of patellofemoral instability. To evaluate the agreement on analytic data (morphologic type of trochlea) we used the kappa statistical method, and to evaluate the agreement on numerical data (depth and prominence of the trochlear groove) we used interclass correlation analysis. The "crossing sign" (between the trochlear groove and the anterior aspect of both condyles) was reliable since the probability of rating as normal a pathologic trochlea was only 3.1% (0 to 8.8%). In classifying trochlear morphology interobserver agreement was slight (kappa = 0.17) and intraobserver agreement was fair (kappa = 0.3). On the other hand, the measurements of the depth and prominence of the trochlear groove were more reliable since the interclass coefficients between observers were 0.62 and 0.38 respectively. The most frequent interobserver error was related to misdiagnosis of type II. To clarify Dejour's criteria we propose a diagnosis of type II only when 5 mm or more are measured between the intersections with the medial and lateral femoral condyles. We recommend the use of the prominence of the trochlear groove to evaluate the grade of bony trochlear dysplasia.

Adult↗

PubMed1998

[In vivo study of kinematics of the elbow using electromagnetic goniometer].

We used an electromagnetic goniometer to study the angular and translations displacements between the humerus and the 2 bones of the forearm. The electromagnetic gionometer allows acquisition of the coordinates and analysis of the 6 degrees of motion. To validate our external fixation apparatus, we used a fresh body upper limb. At first, a series of measurements was conducted with the apparatus. We then performed a series of measurements, by fixing the transmitter and receiver with external fixation pins directly inserted into the bones of the arm and forearm. To assess the reproducibility of our method, we chose a healthy subject. We performed 20 measurements over his right and left elbows. In order to study normal elbow kinematics, we performed measurements on 10 healthy subjects. The study of rotation showed that the apparatus was adapted to measure flexion-extension. It limited pronation-supination movement to about 26.7 degrees. Abduction was increased by 19.7 degrees by our apparatus during flexion-extension, but abduction was reliable within a 2 degrees range for pronation-supination. The sliding movements recorded during flexion-extension were reliable within approximately 3 mm for frontal translations, 6 mm for fitting, and 1 mm for external translations. For the sliding movements recorded in pronation-supination, frontal translations were reliable within about 7 mm, fitting was reliable within 1.9 mm and external translations were reliable within about 2.9 mm. During flexion-extension of the elbow, flexion-extension, frontal translations and external translations were reproducible. The reproducibility test showed that only 6 measurements were reproducible. The kinematic elbow study of a healthy subject showed that the average amplitude of flexion-extension was close to the measurement observed with the manual goniometer. The results in the healthy subject showed that the elbow is more stable during pronation-supination than during flexion-extension. This preliminary study should allow us, in the near future, to study elbow prosthesis kinematics.

Cadaver↗

PubMed1998

[Treatment of humeral fractures by Marchetti nailing. Apropos of 45 cases].

Between 1995 and 1997 we implanted 45 Marchetti nails. These nails were implanted for traumatic fractures in 39 patients, but also for pathologic fractures in 5 patients. Among these 39 patients, 7 were lost of view, the average age was 60 years. Among these 39 patients, 4 have got an other treatment before which failed. 10 fractures were placed D1, 8 fractures placed D2, 5 fractures placed D3, 16 fractures placed D4 according to the classification of Hackethal modified by De la Caffinière. The fracture type was classified according to A. O. classification: 7 A1, 11 A2, 7 A3, 2 B1, 6 B2, 1 B3, 4 C1, 1 C2. Among the 32 patients reviewed with an average of follow-up of 11 months, we have observed 5 very good results, 14 good results, 6 passable results and 3 bad results (classification of Stewart and Hundley). The average length of consolidation was 3 months. At follow-up the average elbow mobility was 129 degrees. Among the 3 bad results, there were 2 pseudarthrosis, in D4 zone. We have got 3 supracondylar fractures during the removal of the nail and 2 impactions of the metaphysis fracture. 5 patients had a nailing for pathologic fractures, one of them bilateral (4 women and one man, average age 65 years). Only two patients were reviewed, the fracture healed without any difference with the traumatic group. Contrary to other nailing, this materiel respects the rotator cuff. The global functional result was good.

Adolescent↗

PubMed1998

[Radiographic course of 39 rheumatoid wrists after synovectomy and stabilization].

Between 1984 and 1995, 39 patients underwent wrist synovectomy-stabilisation. Among these patients, 5 had died and 2 could not rectum for review. These 7 patients were excluded from the study. 32 patients were therefore included in the study. These patients had an average age of 50 years, with an average follow-up of 65 months. We used the Larsen classification to assess wrist osteo-articular involvement. To evaluate carpal instability, we measured: the carpal height with the Mac Murtry index, Shapiro's angle and the modified Shapiro's angle (the angle between the radial diaphysis and the second metacarpal diaphysis), the angle of finger ulnar deviation, the carpal ulnar deviation with the ulnar deviation index of the carpus, the radial deviation with the radial deviation index of the carpus, the carpal frontal dislocation. Carpitis continued to develop and Larsen's grade deteriorated in 50% wrists despite surgery. The average value of the radial sliding index of the carpus increased from 0.11 to 0.15: this showed an average ulnar sliding of 2.2 mm. The average Shapiro's angle increased from 118.2 degrees to 125 degrees. At follow-up, we observed anterior translation of the carpal bones and an increased distance between the proximal and distal carpal rows. The distance between the proximal and distal rows of the carpus appeared to be corrected by extensive synovectomy. Radio-carpal and mid-carpal synovectomy increased the carpal ulnar sliding. The modified Shapiro's angle was corrected by transfer of the extensor carpi radialis longus onto the extensor carpi radialis brevis. In contrast with other operations without stabilisation, the Sauvé-Kapandji procedure limited ulnar sliding and radial tilting of the carpus. Stabilisation of the carpus therefore participates in control of ulnar deviation of the long fingers. Transfer of the extensor carpi radialis longus onto the extensor carpi radialis brevis seems effective on wrist relaxation, by medialization of the traction force of the extensor carpi radialis longus. Our results with of Larsen stage IV were encouraging. The indication for wrist arthrodesis could be limited to stage IV with radio-carpal dislocation or stage V.

Adult↗

PubMed1998

[Fracture of the scaphoid carpal bone secondary to an intraosseous cyst. Apropos of a case].

The authors report a cases of scaphoid fracture secondary to an intraosseous cyst in a young patient performing a high-risk sport. Intraosseous synovial cyst is a frequent and usually asymptomatic disease. Its aetiology remains controversial. No cases of fracture have been previously described. Our patient may have presented several risk factors for scaphoid fracture secondary to a synovial cyst.

Adult↗

PubMed1997

[Arthrodesis of the wrist in inflammatory arthropathy. Effects of fusion of intracarpal joint spaces on functional results].

We retrospectively analysed 25 wrist arthrodeses performed in 23 patients because of inflammatory joint disease (21 rheumatoid arthritis, 1 case of Still's disease, 1 case of psoriatic arthritis) to assess: 1) the functional result, the position and the fusion rate; 2) the correlation between the radiographic features and the results on pain. The results were evaluated after an average of 56 months (12-121) by an observer not involved in surgery. 8 wrists were pain-free, 12 caused occasional pain, 4 caused frequent pain and 1 wrist was responsible for continuous pain at follow-up. The position of the arthrodesis was acceptable in the sagittal plane (mean extension 4.3 degrees), but with a slight ulnar tilt (mean ulnar tilt 12.8 degrees). Fusion was achieved in all cases after a mean of 8.2 weeks (5-16). All the intracarpal joints had united in only 8 cases, while the scaphotrapezo-trapezoid joint had not united in 17 cases, but fusion was spontaneously obtained in 8 cases. We identified 5 non-unions between lunatum and triquetrum, 5 non-unions between hamatum and capitatum and 3 non-unions between triquetrum and hamatum. Pain at follow-up was related to non-union of triquetro-lunate joints (p = 0.035). Wrist arthrodesis remains appropriate for severe lesions of the rheumatoid wrist in order to restore function and relieve pain.

Adolescent↗