[Complete sensorimotor paraplegia following fractures of the thoracic spine from T1 to T10. Apropos of 9 cases].
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Biomedical subjects
Publications and source records attributed to J Bejui.
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The dissection of 18 knees taken from fresh cadavers has led to a detailed description of the semimembranosus muscle (musculus semimembranosus). It is exclusively tibial with its three tendons rendering the muscle functional, whatever the position of the knee may be. There are other attachments, sometimes described are merely expansions extending to the menisco-tibial and menisco-femoral formations, from which this distal termination must be distinguished. Electromyography performed on 17 specimens confirms that this muscle serves more as a brake on outer rotation than an inner rotator muscle, especially when the hip is flexed and the knee stretched.
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Division of the anterior cruciate ligament in dogs usually leads to degenerative arthrosis of the knee after a few weeks. The authors have replaced the anterior cruciate ligament in 7 dogs by an artificial ligament made of carbon fibre. The results were analysed after seven months. In all cases the artificial ligaments had been affected in spite of good clinical behaviour. The fibrous invasion of the carbon fibres was poor. Most of the knees had cartilaginous lesions of the arthrotic type, the synovium was the site of foreign body reaction surrounding deposits of carbon and some carbon deposits were found in lymph glands in the inguinal region.
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102 cases of fractures of the odontoid process have been seen by the author - 73 recent cases and 29 old ones. It was important to distinguish basal fractures (29 cases), which all united after conservative treatment by reduction and skull traction for six weeks followed by a plaster cast for six to eight weeks, and fractures of the body (44 cases). 41 body fractures were treated conservatively, of which 6 died and only 20 united. The authors consider that treatment by skull traction must always be tried. An eventual indication for surgery can be made at about the 20th day if displacement is found to be present in spite of treatment. Fusion in these cases must be limited to C1-C2. It is best obtained by a combination of wiring and grafting.
A macroscopic and microscopic anatomical study of the knees of 10 Beagles showed that thin osteo-chondral autografts taken from another joint healed perfectly macroscopically and almost perfectly histologically, if they fitted very well (figure 2). Rib cartilage grafts fitted perfectly to a dog's knee were not successful unless the perichondrium was turned towards the bone, in which case cartilage proliferated on the surface (figure 4). There was very little loss of substance but trans-chondro-osseus perforation also revealed a chondrogenic mode (figure 4). No trace was found in the literature of work concerning a comparison of these two types of grafts in the same experiment.
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After trochanteric fractures, the rate of survival of old patients was best when treated by the Ender method: 15% died during 3 months following the fracture. The procedure is uneasy and an excellent radiologic technique is necessary. The position of the proximal end of the first nail in the femoral head is most important. Excessive external rotation was frequent, but little desabling. Secondary displacement of the nails toward the distal end occurred in 25% of the cases and was difficult to avoid but remained moderate. The procedure is indicated in old people with porotic bones. It should not be done in subtrochanteric fractures.
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