Biomedical subjects

Franck Accadbled

Publications and source records attributed to Franck Accadbled.

9 recordsLinked to original sources

PubMed2007

Classification of chance fracture in children using magnetic resonance imaging.

STUDY DESIGN: MRI study of pediatric Chance fracture. OBJECTIVE: To evaluate bone and soft tissue lesions in pediatric Chance fracture. SUMMARY OF BACKGROUND DATA: Several descriptions and classifications have been already developed for Chance fracture, but mainly for adult. Furthermore, they are all based only on radiographic studies. METHODS: MRI and radiographs of 18 children with Chance fracture were analyzed before treatment. RESULTS: On MRI, in all cases, no abnormal signs were noted on the intervertebral disc. Six patients had a bone fracture going through the pedicle and the vertebral body. Twelve patients had a physeal injury located on the superior or on the inferior vertebral endplate. Three types of lesions could be identified according to the location of the lesion in relation to the pedicle. CONCLUSION: MRI is useful in the diagnosis of pediatric Chance fracture. It allows physeal injury to be clearly identified from disc injury.

Adolescent↗

PubMed2007

Meniscal tears in children and adolescents: results of operative treatment.

The goal of this study was to evaluate the results of meniscal repair in children and adolescents by a retrospective case series. Twelve arthroscopic-assisted meniscal repairs were performed on 12 patients younger than 17 years of age (8-16 years, mean 13 years). The anterior cruciate ligament was torn in three cases. Eight lesions involved the lateral meniscus and four involved the medial meniscus; there were no discoid menisci. All patients were seen at an average of 3 years 1 month follow-up (range, 2-4 years 10 months). Three patients required subsequent surgery for partial meniscectomy. We evaluated the remaining nine patients by clinical examination, International Knee Documentation Committee clinical score, Lyshölm score, Tegner's activity, and by computed tomography arthrogram or magnetic resonance imaging. Seven patients were asymptomatic at follow-up, two reported occasional pain, and none had experienced symptoms of locking. Their average Lyshölm score and Tegner's activity were 96.3 and 6.6, respectively. Eight patients were International Knee Documentation Committee A and one was International Knee Documentation Committee B. Healing status was assessed at follow-up in eight patients by computed tomography arthrogram or magnetic resonance imaging: the tear was considered as completely healed in three patients. The apparent failure rate was 66%. Indications for meniscal repair in children are not actually established. The pejorative outcome of meniscectomy at a young age has led us to consider symptomatic meniscal tears for repair. Objective results of meniscal healing are poor. The method to assess healing of the repaired menisci objectively is still a matter of debate.

Adolescent↗

PubMed2006

Spinal cord monitoring in scoliosis surgery using an epidural electrode. Results of a prospective, consecutive series of 191 cases.

STUDY DESIGN: Retrospective analysis of a prospectively accrued series of 191 consecutive patients who underwent intraoperative neurophysiologic monitoring during scoliosis corrective surgery. OBJECTIVES: To compare the monitoring outcome of idiopathic and neuromuscular scoliosis. To demonstrate the usefulness of the epidural electrode. To report sensitivity and specificity of the monitoring method employed at a single institution. SUMMARY OF BACKGROUND DATA: Reports in the literature emphasized the difficulty to obtain data in neuromuscular patients. Multimodality spinal cord monitoring has been recommended. Despite their still debated composition, neurogenic motor-evoked potentials have proven their validity in clinical practice. METHODS: Somatosensory and neurogenic evoked potentials were attempted in all patients presenting for scoliosis correction between 1999 and 2005. Study patients were divided into 3 groups: group 1, idiopathic; group 2, neuromuscular; and group 3, miscellaneous origins. RESULTS: The use of the epidural electrode demonstrated significant usefulness in the ability of monitoring otherwise nonmonitored patients, especially in group 2. Inability to obtain any evoked potentials occurred in 4 cases (2.1%). Five cases were found to be true positives. An adapted and rapid intervention permitted to avoid new postoperative deficit in all cases. There was no instance of false-negative data. The overall method sensitivity was 100%, and specificity was 52.69%. CONCLUSIONS: The use of a single epidural electrode allowing somatosensory evoked potentials recording and spinal cord stimulation alternately is a safe and valid method of intraoperative monitoring.

Adolescent↗

PubMed2006

["In-toeing and out-toeing"].

From birth to the end of growth, a femoral detorsion associated with a lateral tibial torsion can be observed. The absence or the exaggeration of this phenomenon leads to rotational abnormalities of the lower limbs called by parents as " in-toeing or out-toeing ". This represents one of the most frequent motives for consultation in pediatric orthopedics. The analysis of the respective position of knees and feet during walking and the measurements of femoral and tibial torsion allow the diagnosis of rotational abnormalities. During growth, the degree of these anomalies may increase or decrease spontaneously. As there is no evidence of a relationship between rotational abnormalities and arthritis, there are no preventive orthopaedic or surgical treatments. However, at the end of the growth, the persistence of functional symptoms leads to femoral or tibial derotation osteotomies.

Abnormalities, Multiple↗

PubMed2005

Percutaneous Ethibloc injection in the treatment of primary aneurysmal bone cysts.

The effects of percutaneous Ethibloc (Ethicon/Johnson & Johnson, St-Stevens-Woluwe, Belgium) injection into primary aneurysmal bone cysts were analysed. Two patients with a venous drainage after injection of a medium contrast were excluded. Twelve patients underwent at least one percutaneous injection of Ethibloc. The average follow-up period was 5.1 years. At final follow-up, six patients had complete healing of the cyst, three had partial healing and three, who had no response, were treated by curettage and bone grafting. Complete healing was observed for all the aggressive lesions. No major complications were noted. Ethibloc injection may be performed as a primary treatment of aneurysmal bone cysts if the technique is followed with precision.

Acetaminophen↗

PubMed2004

Congenital pseudarthrosis of the clavicle: a histopathological study in five patients.

Congenital pseudarthrosis of the clavicle is usually situated on the right clavicle. Pathological data on pseudarthrosis are scant. The histological analysis of five cases treated by 'en bloc' surgical resection are reported. Enchondral ossification was observed on both sides of the resected pseudarthrosis in two cases. Less characteristic enchondral features were noted in three cases. These findings confirm that the pseudarthrosis is due to the failure of coalescence of the two primary ossification centers of the clavicle.

Adolescent↗

PubMed2003

Prenatal sonographic diagnosis of the congenital dislocated spine: a case report.

STUDY DESIGN: A case of congenital dislocated spine diagnosed by prenatal sonography is reported. OBJECTIVES: To report the first documented case of prenatal diagnosis, to point out the characteristic features of prenatal sonography of congenital dislocation of the spine, and to show the results of a careful management of birth in cases of congenital dislocated spine. SUMMARY OF BACKGROUND DATA: The congenital dislocated spine consists of an anterior defect in formation of the vertebrae with a displaced vertebra and angulation of the neural canal. Instability and the consequent possibility of neurologic damage are the major features of this rare entity. Early intervention is essential to prevent an irreparable neurologic deficit. METHODS: Pre- and postnatal imaging was reviewed. Early postnatal treatment is described. RESULTS: Prenatal diagnosis of the congenital dislocated spine can be detected with sonography and confirmed by radiography and magnetic resonance imaging. CONCLUSIONS: Prenatal diagnosis of the congenital dislocated spine is of the utmost importance for parental counseling and obstetrical management.

Female↗

PubMed2002

Osteoid osteoma of the elbow in children: a report of three cases and a review of the literature.

Although osteoid osteoma is a relatively common lesion, it is rarely found at the elbow. We report three cases of osteoid osteoma of the olecranon fossa in patients under the age of 15 years. Diagnosis was delayed because of nonspecific clinical and radiological features. The three patients suffered from synovitis due to flexion contracture while at the same time prosupination remained normal. Only one patient complained of specific nocturnal pain. All cases had a latency between the onset of symptoms and the appearance of radiological signs. Open surgical excision of the nidus resulted in relief of pain in all cases and motion recovery in two cases. Diagnostic difficulties and treatment options are discussed.

Adolescent↗

PubMedDate not supplied

One-step treatment for evolved Blount's disease: four cases and review of the literature.

In infantile tibia vara, the presence of superomedial bridge and sloped plateau requires several problems to be addressed: correction of varus deformity and internal tibial torsion, prevention of recurrences, restoration of normal joint congruity, and prevention and correction of limb length discrepancy. Four patients were treated as follows: percutaneous epiphysiodesis of the superolateral tibia and proximal fibula, elevation osteotomy of the medial tibial plateau, osteotomy of the fibula, and dome-shaped metaphyseal osteotomy of the tibia, followed by progressive lengthening. Osteosynthesis was achieved by an Ilizarov frame (average 6 months). Latest follow-up (average 6 years 10 months) showed that all patients were satisfied, with normal limb length and alignment and correct articular surface congruence. Correction of limb alignment, restoration of joint surface congruity, prevention of recurrence, and treatment of limb length discrepancy are all dealt with in the same procedure.

Child↗