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J P Franceschi

Publications and source records attributed to J P Franceschi.

10 recordsLinked to original sources
PubMed1992

[Post-operative iatrogenic hallux varus. Surgical treatment. Apropos of 19 cases].

The post operative iatrogenic hallux varus associates varus, big toe's dorsal flexion and supination. The pathogeny is dominated by musculo-tendinous lack of balance created by the initial operation and excessive exostosectomy. The authors have nineteen times surgically corrected this deformation. The procedure included in all cases, a medial arthrolysis; five times associated with a screwed capito-metatarsal osseous shelf (or graft) (when there was a metatarsal's head maiming); thirteen times associated with a metatarso-phalangeal arthrodesis (in cases of impaired joint surfaces). The authors analyse, besides, without excluding them the other surgical procedures for hallux varus, and particularly tendinous transfers. The results show the necessity of a perfect etiopathogenic analysis of the deformation.

Adult↗
PubMed1992

Serum and synovial fluid osteocalcin in rheumatic diseases.

The mechanisms involved in juxta-articular bone destruction are poorly understood. Osteocalcin or gamma-carboxyglutamic acid (GLA) protein is a small non-collagenous bone protein. It is a sensitive marker of osteoblastic bone formation. Its seric variations in the serum in such rheumatisms as rheumatoid arthritis remain unclear. Further information on local osteoblastic activity may be obtained by assaying the level of osteocalcin in the synovium. Its serum level can be evaluated by radioimmunoassay. The same method can be used in the synovial fluid. Paired serum and synovial fluid samples have been assayed from 63 patients, 33 patients with inflammatory arthritis (rheumatoid arthritis, psoriasis, chondrocalcinosis, pyogenic arthritis) and 30 patients with mechanical joint effusion (osteoarthritis, meniscal lesions). Serum levels of osteocalcin were the same in the inflammatory group (m: 8.69 +/- 0.68 ng/ml) and in the mechanical group (m: 10.2 +/- 0.67 ng/ml). In the synovial fluid, the levels of osteocalcin were significantly lower in the inflammatory group (m: 3.27 +/- 0.40 ng/ml) than in the mechanical group (m: 6.91 +/- 0.47 ng/ml). The same results were obtained with the ratio of synovial fluid osteocalcin on serum osteocalcin. There was a significant correlation between serum and synovial fluid osteocalcin and an inverse correlation between synovial fluid osteocalcin and the number of synovial fluid cells. The present study suggests that periarticular osteoblastic depression, among patients with inflammatory arthritis, is likely.

Adult↗
PubMed1991

[The rafter osteotomy of the first metatarsal with immediate weight bearing in the treatment of anterior and medial pes cavus in adults].

The difficulty of the exact adjustment of the first metatarsal's raising by dorsal cuneiform cutting and osteosynthesis, brought the authors to prefer proximal rafter osteotomy of the first metatarsal in the treatment of adult's anterior and medial pes cavus. Early weight bearing with a plaster cast or a wooden-shoe allowed the spontaneous raising of the metatarsal and an equal distribution of load between all the metatarsals. The excellent results reached by that single procedure in nine cases during ten years justify to suggest it for treatment of adult's anterior and medial pes cavus.

Adolescent↗
PubMed1991

[Value of the technique of cellular lysis by thermic shock in the isolation of bacteria causing osteoarticular infections].

The purpose of this work is to compare, a conventional technique, for bacterial isolation, with a lysis-centrifugation method using a rapid freezing in liquid nitrogen, followed by decongelation at 37 degrees C for bone and joint samples. The bone and joint specimens were biopsies and punctions (35 cases) or fistula (10 cases). The residual antibiotic activity of the sample was determined using a susceptible strain of Micrococcus luteus and of Staphylococcus epidermidis. Among the 45 samples, 20 were sterile with both methods among which 8 exhibited a residual antibiotic activity which may have contributed to isolation failure. In 12 cases, bacterial isolates were obtained with both methods. Cultures were obtained from 13 samples with the lysis centrifugation method alone. The isolates were 4 Staphylococcus aureus, 8 coagulase-negative Staphylococcus and 1 Acinetobacter sp. These results suggest that the intracellular location of bacteria may be responsible for the negative cultures from bone or joint specimens.

Aged↗
PubMed1991

[Surgical treatment of ruptures of the rotator cuff].

This study analyses the results of 30 surgical repairs of the rotator cuff. The basic problem was degenerative pathology in which medical treatment had been tried previously in all cases. The type of treatment was based upon preoperative evaluation and arthro-CT scan in particular. Results were invariably good, with regression of pain and recovery of activity. Muscle power was significantly correlated with the value of the tendon repaired, this being reflected overall by incomplete recovery.

Adult↗
PubMed1991

[Bacillary trochanteritis. Apropos of 30 cases].

Tuberculous trochanteritis is rare. The authors report 30 cases, 2/3 of which were seen in sanatoria. They occurred in four cases out of five in patients with long standing tuberculosis but were sometimes the presenting feature. Development of an abscess of the trochanteric serous bursa is a virtually constant complication. Their minimal functional consequences and slow progression endow them with an apparently benign nature which masks the risk of secondary complications (4 cases of coxalgia). Radiological appearances, minimal in early forms, are currently becoming more abundant by virtue of new medical imaging techniques. Specific antibiotic therapy is adequate in two cases out of three, completed in advanced and aggressive forms by local procedures dominated by surgical excision (13 cases).

Adult↗
PubMed1991

[Pigmented villonodular synovitis of joints. Apropos of 16 cases. Surgical aspects. Contribution of nuclear magnetic resonance imaging].

This study of 16 cases of pigmented villonodular synovitis of joints treated by the same surgical team involved 6 cases of the localized or nodular form and 10 cases of the diffuse form. The knee was the commonest joint involved (12 cases), with involvement of the hip (3 cases) and foot (1 case) being rarer. Bone invasion is usual when the joint is narrow (hip, foot) but is rarer in the knee where joint capacity is greater (5 cases out of 12). Clinical symptomatology is rarely typical. Hemarthrosis, the most suggestive sign, was found in only two cases out of twelve. While the final diagnosis must always be based upon histology, great help may be provided by modern techniques such as arthroscopy, computed tomography and above all MRI, the presence of hemosiderin being shown by a low signal in T1 which decreases even further in T2. Treatment is based upon surgical synovectomy, with advanced osteoarticular lesions requiring joint replacement.

Adult↗
PubMedDate not supplied

[Hemopigmented villonodular synovitis].

Pigmented Villonodular Synovitis (PVNS) in an infrequent tumoral like disease and there are only a few MRI studies published. Concerning our series of five cases compared with the literature, the readers attention is drawn to the etiologies still under debate and to the respective contribution of the different imaging methods. MRI known for its high sensibility, but also for its low specificity in tumoral pathology, has turned out to be, in the case of PVNS, quite remarkable in both regards. The RMI aspect is quite well correlated to the histological structure of this synovial hyperplasia and to its evolution: highly vascular mass at the beginning and then low cellular density stroma, fibrous, with deposition of hemosiderin. In our five cases, as in almost all those previously reported in the literature, MR imaging shows heterogeneous areas of decreased signal intensity on T2 weighted sequences and on two of our cases after administration of gadolinium. Still the same MR aspects can be found in rheumatoid, hemophilic arthritis, as well as synovial chondromatosis, and therefore the clinical background and findings as well as plain films become essential. MR imaging should be the first examination to be undertaken after plain films, leading in most cases to a precise local preoperative assessment.

Female↗