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H Judet

Publications and source records attributed to H Judet.

At least 19 recordsLinked to original sources
PubMed2001

Long-term results of free vascularized fibular grafting for femoral head necrosis.

The current authors report on the long-term results of free vascularized fibula transplantation for the treatment of idiopathic femoral head necrosis. Briefly, the technique introduced by the authors in 1978 involves the excision of the necrosed bone and its replacement by autologous cancellous bone taken from the iliac crest. The contralateral fibula with its nutrient vessels is introduced through the head and neck of the femur and the vessels are anastomosed microsurgically to the anterior circumflex artery and vein. The current study assesses 60 patients (68 hips) operated on from 1978 to 1985 with an average followup of 18 years (range, 15-22 years). The overall results were good in 52% of the patients. In relation to the stage of necrosis according to the classification system of Marcus et al, good results were achieved in 80% of the patients with Stages II and III disease. In relation to patient age, good results were obtained in 80% of the patients operated on before the age of 40 years. The long-term results indicate that the method of free vascularized fibula transplantation used by the authors is a valuable method for the treatment of idiopathic osteonecrosis of the femoral head for patients younger than 40 years of age with Stage II or III necrosis.

Adult↗
PubMed1993

[Free transfer of the vascularized fibula in pseudarthrosis and femoral bone loss].

The authors report their experience of femoral reconstruction by free fibular graft transfer. Twenty eight patients were operated on between 1977 and 1988. The average follow-up was 7 years and 3 months. The etiology of most of the cases was a post traumatic lesion (70 per cent). Loss of substance was found in 19 cases. 60 per cent of these were septic. The approach was usually posterior and vessels from the sciatic nerve were used. Union was obtained in 89 per cent of the cases. In 65 per cent of the cases union occurred in less than 1 year. In 1 out of 4 cases graft thickening was necessary and achieved by secondary bone grafts. The comparison of this technique with standard treatments evidenced a definite superiority of vascularized bone grafts in cases of septic pseudarthrosis and significant losses of bone.

Adolescent↗
PubMed1992

[Patelloplasty for extensive lesions of the patellar cartilage].

We have been able to review 100 cases of patelloplasty for extensive lesion of the patellar cartilage with an average follow up of 5 years. The technic for the procedure is described. The study of the results (64% of good and very good results) allow us the emphasize the criteria for best indications and technic. We prefer this technic to patellectomy or femoro-patellar prothesis in the cases of symptomatic degenerative arthrites with patellar excentration with special mention on the fact that it does not cut bridge to further procedure on the knee.

Arthroscopy↗
PubMed1991

[Reconstruction of loss of bony substance in limbs by free vascularized fibula transplant].

The authors present their experience of bone-loss reconstruction by a free vasculized fibular transfer. 62 cases were operated, with an average follow-up of 6 years (between 24 to 13 years). Studied were 15 upper limbs (10 humerus, 3 ulna, 2 radius), 28 femurs and 19 tibias. We found a male predominance: 46 cases and the average age was 33 years old. The etiology was often due to trauma: serious road traffic accidents (37 cases). 44 cases were septic and the average bone-loss was of 10 cm (between 4 cm to 30). The most frequent complications were due to fractures of the graft (10 cases) and stiffness (15 cases). Consolidation rate was of 87%: 8 were failures (3 upper limbs: 20% at femur level, 10% at tibia level). The average consolidation rate of the septic cases was of 81%, and the non-septic cases over 97.5%. It seems to be a good technique and in particular for septic cases using a basic orthopedic technique and microsurgical suture.

Bone Transplantation↗
PubMed1990

[Hip prosthesis].

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Hip Prosthesis↗
PubMed1989

[Stiffness of the knee of joint origin].

The knee usually loses its mobility following trauma, such as fracture of the femur, fracture of the upper extremity of the tibia, or fracture of the patella. We are concerned here only with joint stiffness, exclusive of any case presenting limited mobility of the knee articulation associated with retraction and/or adhesions of the entire quadriceps muscle of the femur. Forceful mobilization is strongly discouraged. The operation consists in removing all obstacles, one by one, the main ones being adhesion of the patella to the femur due to sclerosis of the cul-de-sac; adhesion of the lateral parts to the internal and external surfaces of the condyle, retraction of the patellar retinacula; finally, multiple intra-articular adhesions. This loosening procedure is studied here and its results are analyzed.

Humans↗
PubMed1989

[Late results of Mac Murray's osteotomy].

From a total of 817 cases, 133 cases were reviewed where a Mc Murray osteotomy had been carried out more than 10 years previously. Operative results were favourable, but the authors stress the very precise indications for this procedure. Deterioration occurred in one case where the indication appeared dubious. With the development of arthroplasty, this has replaced osteotomy in cases where a doubt exists. Mc Murray osteotomy remains indicated in conservative surgery and in particular the results of arthroplasty of the hip indicate that this very interesting alternative should not be forgotten.

Follow-Up Studies↗
PubMed1985

[Anterior approach in total hip arthroplasty].

The anterior approach to the hip is first between the tensor muscle of fascia lata and the sartorius muscle, then laterally to the vastus externus. Desinsertion of the fascia lata from the ilium is necessary in only slightly more than one half of the cases, and it is always limited. Access to the capsule is wide and, provided one works on an orthopaedic operating table, the manoeuvres required to dislocate the joint and expose the femoral head and neck, then the cotyloid cavity, are simple. Closure is easy, and because the trochanter has not been sectioned, early rehabilitation is possible.

Hip↗
PubMed1981

Vascular microsurgery in orthopaedics.

Three applications of free vascularised bone grafts are described. Free fibular grafts have been performed in 19 cases of avascular necrosis of the femoral head. The grafts are placed along the anterior femoral neck and into the femoral head with a microvascular anastomosis between the nutrient vessels of the fibula and the anterior circumflex pedicle of the hip. The operative technique is described but the post-operative follow-up is still too short to draw any definite conclusions. This operation has been performed in young patients in whom the only alternative would be a total hip replacement. Free vascularised transfers of iliac crest bone are described for bone defects such as infected non-unions of the tibia with soft tissue and bony loss. Free vascularised fibula grafts have also been employed with cancellous grafting for cystic defects such as fibrous dysplasia and large bone cysts. The use of free vascularised fibula grafts is also described in four cases of congenital pseuodarthrosis of the tibia.

Child↗
PubMed1981

[Revascularization of the femoral head for avascular necrosis (author's transl)].

The authors present an original technique for the treatment of avascular necrosis of the hip. The femoral head is dislocated and the articular cartilage is opened. The necrosed bone is excised and replaced by new cancelous bone. A fibula with the vascular pedicle is then introduced in the femoral head on its anterior aspect, and revascularized by microvascular anastomoses. Nineteen patients have been operated but the follow-up is not long enough. It will take several years before a complete assessment of the technique is possible.

Bone Transplantation↗
PubMed1980

[Patelloplasty].

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Humans↗