[What good are antibiotics? Apropos of the alleged preventive role of antibiotic therapy in the installation of total hip prostheses].
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Biomedical subjects
Publications and source records attributed to J Sommelet.
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A statistical study of 1200 McKee-Farrar cemented total prostheses of the hip demonstrated the importance of a horizontal position of the cup and a valgus position of the prosthetic stem, in avoiding aseptic loosening of the prosthetic parts. A new test (the Cramer test) showed that a statistical bond exists between the position of the prosthesis and the occurrence of aseptic loosening.
The Shoulder Radiographic Evaluation ("Complet Radiologique de l'Epaule") is completed by four positions: Standard A-P, Axillary axial view, Profil of the scapula, A-P in arm abduction. This paper focuses on the radiographic examination of the components of scapular girdle and shoulder articular complex. Several positions are described as routine positions in trauma. This radiographic procedure is of helpful interest for clinical, therapeutic and forensic applications.
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The authors describe 45 cases of rupture of the extensor apparatus of the knee (excluding fracture of the patella). Some new ideas are put forward concerning the frequent cause by road accidents and the contribution of certain predisposing features which cause degenerative changes of the tendon. Operation was performed in all cases. The extensor apparatus was reconstructed by suture, cerclage or reinsertion, together with the use of procedures described by Mac Laughlin and Scuderi. The results are presented in detail. 90% are very good or good but complications during operation or in the post operative phase were frequent and occurred in 27% of the cases.
A case of simultaneous rupture of three tendons is reported in a patient who had suffered a bilateral nephrectomy six years earlier and was on chronic haemodialysis. The quadriceps tendon and the patellar tendon were repaired surgically. The rupture of the tendo Achillis was left untreated. Six days later a parathyroidectomy was performed; nine months later recovery was excellent. A review of the literature has been made. The role of hyperparathyroidism in the strength of the bone-tendon junction is discussed.
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The result of mechanisation and technical improvements in industry, wounds by high pressure pistols are very serious. They are often neglected at first for they may be undiagnosed. To the toxicity of the injected product, which diffuses far from the minimal point of entry, may be added the destructive effect of the high pressure on the cell spaces of the hand, which are narrow and inextensible. Surgical treatment includes the association of antibiotics, anti-inflammatory drugs, analgesics and wide removal of the affected tissues as well as the foreign material. Active physiotherapy after immobilisation in a functional position, will permit recovery of satisfactory movements. Amputation is unfortunately often necessary, thus great efforts should be made to prevent work accidents.
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