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Biomedical subjects

G Saillant

Publications and source records attributed to G Saillant.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of lower cervical spinal injuries--C3 to C7.

Injuries of the lower cervical spine are categorized according to the morbid anatomy of the lesion. Most often, such injuries are successfully treated by surgery through a posterior approach. After anatomic restoration, internal fixation with plates and screws provides for stability and arthrodesis. Of 221 cases of lower cervical spine injuries, posterior stabilization was accomplished in 89%. There was no secondary displacement in 85% of cases.

Cervical Vertebrae↗
PubMed1992

[Stress fractures of the tarsal navicular. Apropos of 20 cases].

Twenty cases of tarsal navicular stress fractures were observed in 17 patients. These fractures are rare, often go unrecognized, and are reputed to unite with difficulty. A clue to diagnosis was given by the description (young athletic person in sports involving sudden starts and stops). The lesion was not always visible on X-rays of the foot in supination and dorsal flexion (only 10 out of 20 in this series). Use of tomography and tomodensitometry was essential. Treatment was based on compressing the fracture with a screw without grafting or freshening, followed by immobilization of the foot with a cast and no weight bearing for 45 days. Union occurred in 19 out of the 20 cases. Thirteen patients were able to practice their sport without a loss of performance after a period ranging from 3 to 14 months. Treatment varied given the risk of spontaneous non union: incomplete fractures discovered early often responded to orthopedic treatment; fractures associated with large intra-osseous lytic lesions required addition of bone grafting. These fractures can be prevented through the use of inner arch supports especially if a predisposing factor exists such as a short first metatarsal bone.

Adolescent↗
PubMed1991

[Achilles tendinitis].

Achilles tendinitis is particularly frequent in athletes. In fact, this entity is made up of various anatomical lesions located in Achilles tendon or at the point where it is attached to the calcaneum. The diagnosis is basically clinical, and it is confirmed by carefully selected paraclinical examinations. Management essentially relies on rest associated with adequate physiotherapy and, when required, with other adjuvant treatments. Management also rests on the prevention of recurrences and on the suppression of the frequently found sport-related causal agent. Surgical treatment is seldom indicated, and only when medical treatment has failed, usually in high-level athletes.

Achilles Tendon↗
PubMed1991

Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases.

Spinal epidural lipomatosis associated with Cushing's syndrome is an uncommon complication (11 reported cases). Two additional symptomatic cases with neurologic deficit are described. Steroid treatment was systemic in the first case and local with epidural injections in the second. The second case is unique because no similar observations have yet been reported. In most cases, a preoperative computed tomographic scan establishes the diagnosis by demonstrating dural compression by an adipose mass. Myelography is far less specific. In some cases, the exact diagnosis is made at the time of surgery. The treatment is primarily surgical, with laminectomy over the length of the compression and the removal of the compressing fat. Neurologic recovery is dependent on two factors: the level of the compression and the adequacy of decompression.

Epidural Neoplasms↗
PubMed1991

[Old traumatic lesions of the dorsal and lumbar spine].

The authors present 71 cases of malunion or old traumatic lesions. They result from an unadapted initial surgical or functional treatment. The pain symptoms are in the form of vertebral pain or nerve root pain, often associated with signs of neurological deficit. The authors emphasize the stability or instability of the lesion in order to assess its reducibility. The radiographic exploration (dynamic views, MRI, CT, medullary arteriography) would serve as a guide for the treatment strategy. The authors do not report any case of permanent postoperative neurological aggravation. Three surgical options are analyzed (anterior approach, posterior approach and "three-stage" surgery). An enlarged posterior approach enables treatment and reduction of all malunions, except if a medullary feeder artery is present on the site of the lesion. The pain symptoms improve in 87% of all cases. The authors do not report any permanent postoperative neurological aggravation.

Adolescent↗
PubMed1991

[Treatment of complete lumbar disk herniation by percutaneous discectomy].

Percutaneous diskectomy is a new treatment used in surgery of the spine for the treatment of herniated lumbar disks. The idea is to carry out an exeresis with a posterolateral percutaneous approach on a part of the herniated intervertebral disk; while always remaining outside the spinal canal. This technique eliminates the risks of fibrosis or arachnoiditis. It is carried out under local anesthesia, reduces the surgical insult and requires only a short stay in hospital. Between 1984 and 1988, 188 operations using this technique were carried out on L3-L4, L4-L5 and L5-S1. Of the first 100 cases studied, we note: 71% good and very good results for radiculalgia after a time lapse of more than a year, 51% good and very good results for low back pain; 16% of the patients required a surgical approach after percutaneous diskectomy. The authors specify the advantages and the indications of this surgical technique, which complements the traditional lumbar intervertebral disk surgery.

Back Pain↗
PubMed1978

[Screw-plate with translation for high femoral osteotomy (author's transl)].

A plate designed from the model used by R. Judet for fractures of femoral neck is presented. It is adapted to the fixation of high femoral osteotomy with internal translation, affected or not with valgus or varus. The screwing of the plate, when in place, realizes systematically a compression at the level of the osteotomy. The system is very stable and enables the begining of reeducation without delay.

Bone Plates↗
PubMed1978

[Severe strains of the cervical spine operated on by a posterior approach (author's transl)].

The authors have operated on 18 cases of severe strain of the cervical spine (six cases of C1-C2 and 12 cases of level cervical spine). They point out the difficulty of an accurate diagnosis in emergency. They emphasize the importance of flexion-extension X-rays when conventional X-rays are not strictly normal. After an analysis of the results they suggest that recent cases should be treated by posterior grafting at the level of C1 and C2, posterior plating at lower levels. Old and irreducible cases should be treated by osteotomy and anterior grafting: banding with grafting at C1 and C2, posterior screwed plating at the inferior cervical level.

Adolescent↗
PubMed1978

[Experimental transection of the spinal cord (author's transl)].

Twenty-three dogs underwent a complete transection of the spinal cord at L 1 level. Section was followed in eighteen animals by reconstruction effected through suture of the arachnoide with the aid of monofilament 10 X 0 thread. The operation was in all cases concluded by an osteosynthesis with metallic material in order to prevent any movements in the operated site, and a tight dural closure was achieved in order to prevent propagation of any epidural hematoma or secondary granuloma. This technique did not prevent an unfavorable evolution of the suture, which demonstrated three different morphological features:--necrosis of the spinal cord cut ends with secondary formation of a transverse cyst;--secondary infiltration of the operated focus by a fibrous scar growing from the inner aspect of the dura;--failure of axon regeneration through this fibrous block in spite of noteworthy proliferation of axons coming from the dorsal roots. A critical analysis of those results led to a comparaison with various previous works on the same subject. The most recent of these works have led to promising prospects which need confirmation.

Animals↗
PubMed1977

[Severe ligamentous injury due to trauma of the mobile spinal segment of the cervical column (author's transl)].

The mobile spinal segment includes anatomically, all the soft parts which lie between two neighbouring vertebrae. Its involvement in trauma is not always obvious on initial X Ray. However, the course may lead to complete vertebral dislocation. The initial diagnosis is based on opening of the joint spaces, study of the mobility between two vertebrae by dynamic radiography. The distinction between a benign and a severe ligamentous sprain may thus be made. The attitude in cases of mobile spinal segment involvement, i.e. severe ligamentous injury, should include arthrodesis of the mobile segment affected and this is discussed here.

Adolescent↗