[Apropos of, Subtrochanteric fractures. Comparative study of gamma nail and angular osteosynthesis with lateral cortical support].
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Bone Nails↗
Biomedical subjects
J C Lahoud
Publications and source records attributed to J C Lahoud.
[Sub-trochanteric fractures. A comparative study between gamma nail and angular osteosynthesis with lateral cortical support].
PURPOSE OF THE STUDY: Treatment and outcome of sub-trochanteric fractures are at the origin of many problems. The aim of this study was to evaluate the superiority of the "Gamma Nail". MATERIAL AND METHODS: Two homogenous groups of patients were studied. Each group had 40 patients. The osteosynthesis performed in the first group (Group I) was an "angular" type with lateral cortical support (Nail plate, blade plate, dynamic screw). The second group (Group II) received the "Gamma Nail" implant. The 4 criteria employed to compare the 2 groups were: operatory (duration, blood loss, support-free walking); clinical (walking, pain, anatomy); radiological (reduction and healing); and finally complications and failures. RESULTS: The average operative duration in group I was 3 hrs vs 1 hr in group II. 90 per cent of group I received transfusions with 3 bloods units vs 40 per cent of group II, received 1 blood unit. Support-free walking was authorized 3 months later in group I, and immediately in group II. The results were identical for clinical criteria. The average time for radiological bone healing was 3.5 months in group 1 and 2 months in Group II. 12 complications occurred in group I and 3 in group II: 7 cases of dismantling, 4 non unions and 1 serious deep infection in Group I. In group II: 2 cases of dismantling and a diaphysis fracture beneath the nail. These complications were found in the beginning of our experience with the Gamma Nail. DISCUSSION: 30 per cent of patients in Group I were affected by complications vs 7.5 per cent in group II (with p = 0.01). The duration of surgery, blood loss, and support-free walking delay demonstrated the superiority of the Gamma nail technique. CONCLUSION: This study confirms the superiority of the Gamma nail for the treatment of sub-trochanteric fractures.
Adolescent↗
[Locking of the metacarpophalangeal joint of articular origin. Review of the literature and case report].
We report a case and review concerning literature of intrinsic locking of the metacarpophalangeal joint. These lockings are usually due commonly to degenerative arthritis of the joint, rarely to an abnormal shape of the head of metacarpal or intraarticular loose bodies. They should be differentiated from the extension lag of proximal interphalangeal joint usually encountered in "trigger finger" due to stenosing tenosynovitis. Conservative treatment must be careful and may fail or be complicated. Surgical treatment is effective, best done via an anatomical approach depending on the pathologic findings and the metacarpophalangeal joint locking etiology.
Adult↗
[False aneurysm of the femoral artery complicating exostosis].
A case of false aneurysm of the femoral artery due to an exostosis of the distal end of the femur is reported. The clinical diagnosis was confirmed by sonography and, especially, by a digitalized arteriography. The CT-scan showed the perforation of the arterial wall by the exostosis. The surgical operation involved the resection of the exostosis, the excision of the edges of the arterial lesion along with a venous patch. This type of complication due to an exostosis is quite rare and the discussion runs about the opportunity of systematic surgery of osteochondromas sitting close to a vascular course.
Adolescent↗