Biomedical subjects

Jean-Luc Jouve

Publications and source records attributed to Jean-Luc Jouve.

17 recordsLinked to original sources

PubMed2007

Classification of chance fracture in children using magnetic resonance imaging.

STUDY DESIGN: MRI study of pediatric Chance fracture. OBJECTIVE: To evaluate bone and soft tissue lesions in pediatric Chance fracture. SUMMARY OF BACKGROUND DATA: Several descriptions and classifications have been already developed for Chance fracture, but mainly for adult. Furthermore, they are all based only on radiographic studies. METHODS: MRI and radiographs of 18 children with Chance fracture were analyzed before treatment. RESULTS: On MRI, in all cases, no abnormal signs were noted on the intervertebral disc. Six patients had a bone fracture going through the pedicle and the vertebral body. Twelve patients had a physeal injury located on the superior or on the inferior vertebral endplate. Three types of lesions could be identified according to the location of the lesion in relation to the pedicle. CONCLUSION: MRI is useful in the diagnosis of pediatric Chance fracture. It allows physeal injury to be clearly identified from disc injury.

Adolescent↗

PubMed2007

Locomotor skills and balance strategies in adolescents idiopathic scoliosis.

STUDY DESIGN: Locomotor balance control assessment was performed to study the effect of idiopathic scoliosis on head-trunk coordination in 17 patients with adolescent idiopathic scoliosis (AIS) and 16 control subjects. OBJECTIVE: The aim of this study was to explore the functional effects of structural spinal deformations like idiopathic scoliosis on the balance strategies used during locomotion. SUMMARY OF BACKGROUND DATA: Up to now, the repercussion of the idiopathic scoliosis on head-trunk coordination and balance strategies during locomotion is relatively unknown. METHODS: Seventeen patients with AIS (mean age 14 years 3 months, 10 degrees < Cobb angle > 30 degrees) and 16 control subjects (mean age 14 years 1 month) were tested during various locomotor tasks: walking on the ground, walking on a line, and walking on a beam. Balance control was examined in terms of rotation about the vertical axis (yaw) and on a frontal plane (roll). Kinematics of foot, pelvis, trunk, shoulder, and head rotations were measured with an automatic optical TV image processor in order to calculate angular dispersions and segmental stabilizations. RESULTS: Decreasing the walking speed is the main adaptive strategy used in response to balance problems in control subjects as well as patients with AIS. However, patients with AIS performed walking tasks more slowly than normal subjects (around 15%). Moreover, the pelvic stabilization is preserved, despite the structural changes affecting the spine. Lastly, the biomechanical defect resulting from idiopathic scoliosis mainly affects the yaw head stabilization during locomotion. CONCLUSIONS: Patients with AIS show substantial similarities with control subjects in adaptive strategies relative to locomotor velocity as well as balance control based on segmental stabilization. In contrast, the loss of the yaw head stabilization strategies, mainly based on the use of vestibular information, probably reflects the presence of vestibular deficits in the patients with AIS.

Adolescent↗

PubMed2007

Assessment of acute ankle sprain with os subfibularein children.

Children commonly present with acute inversion injuries of the ankle. Radiographs occasionally show small fragments under the tip of the lateral malleolus. The purpose of our study was to clarify their origin. A prospective standardized clinical examination and a magnetic resonance imaging were carried out. Among the 116 included patients, seven of them showed an os subfibulare. They presented more pains on the lateral ankle area than the other children. We found also more injuries on the anterior talofibular ligament. The os subfibulare could be secondary to an accessory ossification but the lateral area of the ankle would be likely to be injured.

Ankle Injuries↗

PubMed2006

Thoracolumbar hemivertebrae resection by double approach in a single procedure: long-term follow-up.

STUDY DESIGN: Retrospective review of patients records with clinical and radiographic assessment. OBJECTIVE: To evaluate the long-term result of thoracolumbar hemivertebrae resection using a double approach in a single procedure. SUMMARY OF BACKGROUND DATA: Thoracolumbar hemivertebrae resection by a combined posterior and anterior approach has been previously described, but this is the largest series of hemivertebrae reported. METHODS: From 1987 to 2003, a consecutive series of 34 congenital scoliosis or kyphoscoliosis due to thoracolumbar hemivertebrae were managed by hemivertebra resection using a combined posterior and anterior approach and short anterior and posterior convex fusion in the same day/same anesthesia. RESULTS: The mean age at surgery was 3.5 years. The mean follow-up period was 6.0 years. There was a mean improvement of 69.3% in the segmental curve from a mean angle of 34.8 degrees before surgery to 10.7 degrees at the latest follow-up assessment. The global scoliosis curve improved of 33.4% from 40.4 degrees to 26.9 degrees, respectively. Trunk shift was significantly improved. The mean final kyphosis was within normal values. CONCLUSIONS: This procedure is safe and offers a persistent correction with a short segment fusion. Surgery should be performed as early as possible to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.

Adolescent↗

PubMed2006

Lumbosacral hemivertebrae resection by combined approach: medium- and long-term follow-up.

STUDY DESIGN: Retrospective review of patients records with clinical and radiographic assessment. OBJECTIVES: To evaluate the long-term result of lumbosacral hemivertebrae resection using a combined approach. SUMMARY OF BACKGROUND DATA: Lumbosacral hemivertebrae resection by a combined posterior and anterior approach have been previously described, but only one study is concerning such a large series of hemivertebrae. METHODS: From 1980 to 2001, a consecutive series of 17 congenital scolioses due to lumbosacral hemivertebrae were managed by hemivertebrae resection using a combined approach and short anterior and posterior convex fusion. RESULTS: The mean age at surgery was 4.9 years. The mean follow-up period was 7.6 years. One postoperative complication was encountered: a patient had motor deficit and recovery was incomplete. The mean segmental scoliosis curve was 27.5 degrees before surgery, 10.7 degrees after surgery, and 8.9 degrees at the latest follow-up assessment. This represents a mean improvement of 61.1% after surgery and of 67.6% at the latest follow-up. The total main scoliosis curve improved from 28.4 degrees to 12.7 degrees and 11.4 degrees , respectively. It represents a mean improvement of 55.3% and 59.9%, respectively. The mean final lordosis was within normal values. CONCLUSIONS: This procedure offers a persistent correction with a short-segment fusion. The early surgery is able to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.

Child↗

PubMed2006

[Scoliosis in children].

The diagnosis of scoliosis is based on the association of kyphosis, vertebral rotation, and lateral deviation of the spine. The clinical examination has to be rigorous in order to rule out a potential etiology for this tridimensional deformity. The assessment of the growth, and of the progressive nature of the scoliosis, is essential before any treatment. For minor deformities, a simple clinical monitoring will be necessary. On the other hand, for moderate deformities, a non-surgical treatment with brace will be recommended. Finally, for severe deformities, the treatment will be a surgical treatment. Surgery will consist of a spinal arthrodesis.

Arthrodesis↗

PubMed2006

Lipoblastoma and lipoblastomatosis.

We report two cases of lipoblastoma of the buttock in a 10-month-old boy and a 20-month-old girl, the first with rearrangement of chromosome 8 and the second without cytogenetic abnormality, and one case of lipoblastomatosis of a leg in a 6-month-old boy with a normal karyotype but with a rearrangement of the PLAG1 gene. Lipoblastoma and lipoblastomatosis are two different presentation of the same rare benign soft tissue mesenchymal tumour arising from fetal white fat and occurring almost exclusively in young children under 3 years. These neoplasms have no malignant potential but may recur in cases of incomplete resection. Histological diagnosis sometimes used to be difficult because of the close resemblance of the lesion with myxoïd liposarcoma. Nowadays, cytogenetic analysis may contribute to the diagnosis by showing abnormalities of the long arm of chromosome 8, leading to rearrangement of the PLAG1 gene. Actual advances in cytogenetic molecular analysis may aid in accurate diagnosis.

Buttocks↗

PubMed2006

Lumbar hemivertebra resection.

BACKGROUND: A single lumbar hemivertebra can be expected to cause progressive scoliosis. The aim of this study was to evaluate the results of a lumbar hemivertebra resection and short-segment fusion through a combined posterior and anterior approach. METHODS: From 1987 to 2002, a consecutive series of twenty-one patients with congenital scoliosis or kyphoscoliosis due to a lumbar hemivertebra were managed by resection of the hemivertebra through a combined posterior and anterior approach and with the use of a short anterior and posterior convex-side fusion. RESULTS: The mean age at the time of surgery was 3.3 years (range, twelve months to 10.2 years). The mean followup period was 8.6 years. There was a mean improvement of 71.4% in the segmental scoliosis curve from a mean angle of 32.9 degrees before surgery to 9.4 degrees at the time of the latest follow-up assessment, and a mean improvement of 63.9% in the global scoliosis curve from 34.1 degrees to 12.3 degrees. The mean final lordosis was within normal values. CONCLUSIONS: Excision of a lumbar hemivertebra is safe and provides stable correction when combined with a short-segment fusion. Surgery should be performed as early as possible to avert the development of severe local deformities and prevent secondary structural deformities that would require a more extensive fusion later.

Child↗

PubMed2005

Anatomical study of the proximal femur in the fetus.

Two angles effectively describe the upper femur geometry: The neck shaft angle (NSA) and anteversion (AV). AV and NSA decrease from birth until they reach their adult values, but little work has focused on in-utero life. Our aim was to determine if and how AV and NSA change through the fetal life. Eighty-seven femurs from 44 formalin preserved fetuses were sampled to achieve a biometry. Correlation tests and linear regression showed that AV was highly correlated with age: AV increases during the second half of gestation. No conclusion can be given concerning NSA. It is speculated that these changes may be caused by mechanical stresses.

Biometry↗

PubMed2005

An anatomical and biometrical study of the femoral trochlear groove in the human fetus.

We performed a biometric analysis of the femoral trochlear groove in the fetus and compared our findings with those observed in adults. We studied 44 formalin-preserved fetuses (13-38 weeks) and used digitized images to obtain measurements (alpha angle of the groove, trochlear slopes thetaL and thetaM). A comparison of means between our series and adults was achieved. For each angle of the distal epiphysis (alpha, thetaL, thetaM) there was no significant difference between our fetal series and adults. This is the first biometric study of fetal trochlea. The morphology of the lower femur appears to be the same in the fetus and the adult.

Adult↗

PubMedDate not supplied

Growth plate behavior after desepiphysiodesis: experimental study in rabbits.

The aim of this work was to study the potential healing of the growth plate in the case of a central desepiphysiodesis. A central defect was made in the distal femoral growth plate of thirty 3-week-old rabbits. In group A the growth plate defect was left empty as control. The defects of group B were implanted with a polymeric cylinder fixed in the metaphysis with a pin. In group C the cylinder was fixed in the epiphysis. Two months after implantation, clinical, radiologic, and histologic analyses were carried out. In group A, the mean shortening was 12.63%; it was 4.9% in group B and 1.54% in group C. Histologic analysis showed constant appearance of an epiphysiodesis after migration of the implant in the metaphysis. No regeneration of the growth plate was observed. Prevention of migration of the interpositional material is recommended to avoid recurrence of an epiphysiodesis.

Animals↗

PubMedDate not supplied

Hip flexion contracture and lumbar spine lordosis in myelomeningocele.

The objective of this study was to assess the correlation between hip flexion contracture (HFC) and the sagittal alignment of the lumbar spine in ambulatory children with myelomeningocele. Ambulatory patients with myelomeningocele are generally free of scoliosis or kyphosis. Among them, some develop increased lumbar lordosis. It is postulated that HFC and increased lumbar lordosis may be correlated. Thirty-eight patients, with a mean age of 12.7 years, were evaluated. Standing lateral spine films were obtained and the lumbar lordosis was measured using the Cobb method. HFC was measured using the Thomas test. A statistically significant correlation was found between the lumbar curve and HFC. High values of lumbar Cobb angle (hyperlordosis) were correlated with high values of HFC. These results show a correlation between HFC and increased lumbar lordosis in ambulatory myelomeningocele patients.

Adolescent↗

PubMedDate not supplied

Focal fibrocartilaginous dysplasia ("fibrous periosteal inclusion"): an additional series of eleven cases and literature review.

Focal fibrocartilaginous dysplasia (FFCD) is a benign condition first described in 1985 as a cause of tibia vara. We are reporting on 11 cases. The lesions involved proximal tibia (9 cases), distal femur (1 case), and distal ulna (1 case). We believe that this entity represents a bony anchor preventing natural sliding of the periosteum during growth (an "epiphysiodesis-like" effect). For the tibia, we believe this is the pes anserinus. We are suggesting that this entity be called a "fibrous periostal inclusion." Treatment indications result from this concept: (1) for tibial lesions with a metaphyseal-diaphyseal angle less than 20 degrees observation for 6 to 12 months; (2) if the deformity improves, the tether likely broke spontaneously, and no treatment is required; and (3) curettage early if the deformity worsens. This will be followed by rapid correction into physiological valgus (tibia) and prevent the need for osteotomy. Early curettage for other less common locations is recommended.

Bone Diseases↗

PubMedDate not supplied

Antimosquito precautions and medical chemoprophylaxis in French children with malaria.

BACKGROUND: France is the European country with the highest number of imported malaria cases (7,500 in 2000). The aim of this prospective study was to evaluate the nature and efficacy of prophylactic measures in children under 15 years of age referred for malaria. METHODS: Post travel questionnaires were given to the parents of malarial children in the emergency room. The study took place in two university hospitals in Marseilles, southern France, from August to October 2001. RESULTS: Eighty-eight children under 15 years of age were included in this 3-month period. Most of them had been infected in Comoro archipelago. Almost two-thirds used bed nets, but only 47% did so every night. Sprayed bed nets were used by 23%. Average compliances with cutaneous repellents, bedroom repellents and long-sleeved clothing were 32%, 24% and 26%, respectively. Air conditioners were uncommon. Only 22% of the children used chemoprophylaxis correctly, according to French recommendations. Five percent did not use any chemoprophylaxis, and 61% reported non recommended drug use. Although all the children traveled to chloroquine-resistant areas, chemoprophylaxis with mefloquine was less common than that with chloroquine + proguanil. No child fully complied with French recommendations concerning both anti mosquito measures and chemoprophylaxis. CONCLUSIONS: Insufficient use of antimalaria precautions by traveling families is associated with the high incidence of pediatric imported malaria in southern France. Travelers' education should be increased to allow the optimization of malaria prophylaxis.

Adolescent↗

PubMedDate not supplied

Progressive forearm lengthening with an intramedullary guidewire in children: report of 10 cases.

Indications for forearm lengthening are rare. Between 1994 and 1999, 10 forearm lengthenings were performed in seven children for functional reasons and/or esthetic discomfort. Only one of the two forearm bones was involved in the procedure in all cases. The technique consisted of a transverse osteotomy and progressive distraction after intramedullary nailing. When a bone axis correction was needed, it was performed with a substraction osteotomy in the initial osteotomy site. The distraction device was removed when bone healing was achieved. The authors noted the various complications and assessed the amount of elongation, bone healing, and potential bone axis deviation. Mean follow-up was 4.5 years. Mean elongation was 30.8 mm. Four bone grafts were needed for delayed union. No bone axis deviation was noted. An initial axial correction osteotomy allows an easier lengthening procedure. Use of an intramedullary wire avoids axis deviation. This technique can be helpful in malformative pathologies.

Adolescent↗

PubMedDate not supplied

Lateral humeral condyle fractures in children: a comparison of two approaches to treatment.

The treatment of lateral condyle fractures in children remains controversial. This study investigates whether minimally displaced lateral condyle fractures should be treated surgically and compares different techniques of operative management. The authors retrospectively reviewed medical charts and radiographs of 97 children from two international centers whose therapeutic modalities differed, noting demographic data, fracture features, treatment modalities, complications, and clinical and radiographic results. Long-arm immobilization alone resulted in additional fracture displacement and a higher number of nonunions than did surgical management. The authors conclude that displaced fractures should be fixed surgically with two smooth or threaded Kirschner wires; they can pass through the ossific nucleus of the capitellum if necessary, but they must engage the far cortex. If patients are likely to be noncompliant with treatment, the wires should be buried under the skin to avoid the risk of infection, but this procedure necessitates a second surgery for removal of fixation.

Bone Wires↗

PubMedDate not supplied

Anatomic study of femoral patellar groove in fetus.

The authors performed a biometric analysis of the femoral patellar groove in fetus and compared their findings with those observed in adults. Forty-four formalin-preserved fetuses were studied (13-38 weeks). Digitalized images were used to obtain measurements (alpha angle of the groove, trochlear slopes thetaL and thetaM). A comparison of means of independent samples between our series and adults was performed. For each angle of the distal epiphysis (alpha, thetaL, thetaM) there was no significant difference between this fetal series and adults. This is the first biometry of the fetal patellar groove. The morphology of the lower femur appears to be the same in fetus and adults. The results of this study suggest that the anatomic characteristics of the patellar groove could have been integrated into the genome during the course of evolution. This would be in favor of a genetic origin of patellar groove dysplasia.

Adult↗