PubMed Health⌕ Search

Biomedical subjects

J Butel

Publications and source records attributed to J Butel.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Desmoid fibroma of soft tissues of extra-abdominal sites: review of the literature apropos of a case located at the posterior face of the thigh].

The authors report a case of desmoid fibroma on the posterior surface of the thigh in a woman during the post-partum period. This is a rare site for this tumour. CT scan combined with MRI appears to be useful for diagnosis. Treatment is strictly surgical, but depends on the histological benign nature and the local malignancy. Surgery is generally conservative with risks of recurrence and occasionally amputation is necessary.

Adult↗
PubMed1988

Prevention of postoperative venous thrombosis: a randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement.

A double blind randomized trial comparing subcutaneous enoxaparin (40 mg once daily) with standard unfractionated calcium heparin administered at a dose of 5,000 units every 8 hours in patients undergoing elective hip replacement has been performed. Treatment regimens began 12 hours preoperatively with enoxaparin, 2 hours preoperatively with standard unfractionated calcium heparin, and were continued for 15 days or until discharge. Venography was performed in all patients. Two hundred thirty-seven patients were included in the study: 113 received unfractionated heparin and 124 received enoxaparin. The incidence of proximal deep vein thrombosis was reduced from 18.5% in the unfractionated heparin group to 7.5% in the enoxaparin group (p = 0.014), and the incidence of total deep vein thrombosis was similarly reduced from 25% to 12.5% (p = 0.03). There were two major bleeding episodes and one minor bleed in the enoxaparin group compared to two minor bleeds in the unfractionated heparin group. Patients who received enoxaparin required fewer red blood cell transfusions and had a significantly higher hemoglobin on postoperative days 3 and 4. Thus prophylaxis with enoxaparin, 40 mg once daily, is simple, safe and more effective than standard low dose unfractionated heparin in preventing deep vein thrombosis in patients undergoing elective hip replacement.

Aged↗
PubMed1988

The isoelastic hip prosthesis followed for 5 years.

In 1981 and 1982, 58 patients (61 hips) received an isoelastic noncemented femoral component and a bipolar cup for nontraumatic hip disease. Three patients were lost to follow-up and 8 died, leaving 47 patients (51 hips) for review after a minimum of 5 years. There were seven failures--two infections, four technical errors, and one migration of an acetabular component. Of the remaining 44 hips, 42 scored good or better at review.

Adult↗
PubMed1988

[A hip prosthesis with a non-rigid femoral implant. The Butel iso-elastic prosthesis].

A new type of femoral prosthesis is described by the authors. This non-rigid implant respects the natural elasticity of bone and, because of this, avoids excessive stress protection of the bone. In addition, bone atrophy caused by rigid components and osteolysis provoked by cement are eliminated. Experimental studies and the clinical and radiological results five years after insertion seem to confirm the value of this concept.

Adolescent↗
PubMed1988

[Meniscal lesions in so-called "isolated" ruptures of the anterior cruciate ligament. Apropos of 59 cases].

Between December 1984 and March 1987, i.e. a period of 27 months, the authors operated on 59 "isolated" fresh ruptures of the ACL with routine evaluation of the posterior horns of the medial and lateral menisci. Lesions were investigated either by arthroscopy (23 cases) or by anterior arthrotomy with routine medial and lateral retro-ligamentous counter-incision (36 cases). This revealed 21 lesions of the medial meniscus (i.e. 35.5%) and 38 lesions of the lateral meniscus (i.e. 64.5%). Lesions of both menisci were present in 16 knees (27%) and only 16 knees (27%) were found to be free of any meniscal lesion. The majority of meniscal lesions were viable and could be sutured in 86% of cases for the medial meniscus and 87% of cases for the lateral meniscus. From the standpoint of operative technique, posterior lesions are relatively poorly visualized by arthroscopy (notably concerning the posterior horn of the medial meniscus though it is easier to assess the stability of the meniscus by this technique using the palpating hook. Lesions are well visualized by medial and lateral retroligamentous counter-incisions, but it is difficult to assess meniscus stability. Finally it should be noted that all of these ruptures of the ACL were dealt with by reconstruction of the central pivot either by suture and a strengthening procedure (semitendinous) or by ligament plasty from the outset.

Arthroplasty↗
PubMed1986

[Butel's hip screw-plate in osteosynthesis of fractures of the upper end of the femur. Apropos of 241 osteosyntheses (100 true cervical fractures and 141 fractures of the trochanter)].

Butel's hip plate was used for osteosynthesis of 241 fractures of upper end of femur (100 true cervical - 141 trochanteric and subtrochanteric fractures). Results for true cervical fractures were assessed as satisfactory in 89.5% of cases, with only 3 pseudarthroses and 4 cases of femoral head necrosis (2 septic, 2 aseptic), a total complication rate of 7.5%. These clinical results confirm the value of screw fixation at several cephalic anchorage sites (demonstrated biomechanically) in true cervical fractures. Results in trochanteric and subtrochanteric fractures were rated as satisfactory in 86.9% of cases, complications including 2 ruptures of plate, 1 sepsis and 4 early loosening of plate. The latter sequela was avoided by an improved choice of indication for the procedure and by substitution of this compound material (screw-plate) for a monobloc piece ("anti-loosening cervicocephalic screw apparatus"), in compound fractures of trochanter.

Adult↗
PubMed1986

[Latarjet's surgery in recurrent anterior dislocations of the shoulder. 117 cases with an 8-year follow-up].

One hundred and seventeen shoulders in 113 patients were treated surgically for recurrent anterior dislocation of the shoulder by the Latarjet procedure - transplantation of the coracoid process to the anterior border of the glenoid fossa. 67 p. 100 of the patients engaged in sport and 33 p. 100 did not. The usual lesions found at operation were separation of the capsule from the anterior rim of the glenoid in 59 p. 100, a lesion of the glenoid labrum in 65 p. 100 and damage to the glenoid fossa short of a fracture in 18 p. 100. Postoperative complications were rare and usually mild, except in two cases of osteoporosis of the coracoid transplant and two fractures of the bone block. There was slight limitation of lateral rotation in 48 p. 100, of abduction in 14 p. 100 and of medial rotation in 4 p. 100. The results at follow-up were rated as excellent in 68 p. 100 (72 cases), good in 21.7 p. 100 (23 cases), with slight pain and limitation of lateral rotation of less than 20 p. 100 and fair in 6.6 p. 100 (7 cases). In these cases, the Latarjet procedure had been performed for postoperative recurrence after a previous surgical procedure. There were 4 poor results.

Adult↗
PubMed1986

[Fractures of the lower end of the humerus in adults: influence of per- and postoperative tactics on results. Apropos of 70 osteosyntheses].

Results in 70 cases of osteosynthesis of lower end of humerus in adults were analyzed as a function of the fracture line, and the operative (approach route, type of support, attitude towards ulnar nerve transposition) and postoperative (with or without plaster immobilization) tactics. Best results were obtained in simple joint fractures (condyles, capitellum, Hahn Steinthal) with a good outcome in 89% of cases, while prognosis was poorer (68.5% of delayed good results) in more or less comminuted supra- or inter-condylar fractures (41 cases). Results are better in these latter types of fracture when an extra-articular trans-olecranon posterior approach is used. Ulnar nerve transposition was performed 43 times without adverse effects and osteosynthesis by 2 posterior screw plates (one on external and one on internal column) in 50% of cases. Valid comparison of results with or without postoperative plaster immobilization was not possible since only 8 patients were not plastered.

Adolescent↗
PubMed1985

[Role of intermediate sealed prostheses in the treatment of fractures of the trochanter major in the elderly. Apropos of a continuous series of 110 prosthesis].

Between January 1980 and July 1983, 265 fracture of the trochanteric region in elderly patients were treated in Prof. J. Butel's department. Prior to 1980, 75% of the cases were treated with Ender's pin. However, the high failure rate of this procedure (especially in the case of complex fractures) led the authors to select the indications for this operation much more carefully. In the present series of 265 cases, there were: 110 intermediate sealed prostheses, 136 Ender's pin 19 direct osteosyntheses. At the present time (and for the last 2 years) the indications are distributed in the following way: 50% intermediate sealed prostheses, about 40% Ender's pin and 5 to 10 direct osteosyntheses. The ideal indication for intermediate sealed prosthesis is a unstable fracture of the greater trochanter (complex trochanteric fractures, fractures with a large 3rd fragment separating the lesser trochanter, trochantero-diaphyseal fractures) in autonomous elderly patients over the age of 75. This operation allows immediate weight-bearing and the operative mortality is barely more than with other techniques (21%) with very satisfactory results (more than 80 of good and very good results).

Aged↗
PubMed1985

[Trochanteric fractures in the elderly: Ender nails, prostheses or direct osteosyntheses. Apropos of a continuous series of 265 cases].

The results of 265 trochanteric fractures in the elderly treated between 1980 and 1983 have been analysed. Among them, 136 were treated by Ender's nailing, 110 by prostheses and 19 by internal fixation. In an earlier study, Ender's nailing had been used in 75 p. 100 of cases. The conclusions were that the increasing use of a prosthesis has brought about an improvement in the results-80 p. 100 satisfactory in the present series compared with 54 p. 100 in the preceding one. The mortality rate was comparable after Ender's nailing and prostheses. Ender's nailing is indicated in stable fractures and, in unstable fractures, internal fixation is indicated in very active persons, Ender's nailing in non-ambulatory patients and prostheses in elderly patients with sufficient walking ability.

Aged↗