PubMed Health⌕ Search

Biomedical subjects

M Duhaime

Publications and source records attributed to M Duhaime.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Prognosis of fractures of the femur neck in children].

Fractures of the hip in children have always had a reserved prognostic resulting from their numerous complications. A retrospective study of hip fractures treated at Sainte-Justine Hospital Montreal, has permitted a better understanding of these fractures in regard with appropriate therapeutic measures. 28 fractures of the femoral neck were retained for this study. Fractures were classified along the Delbet classification, treatment was generally surgical in displaced fractures, and results were based on the Ratliff evaluation. Of the 3 traumatic epiphyseal injuries, 2 showed slight displacement in young children and the result is good, while the third case showed avascular necrosis. Only 53% of the 17 transcervical fractures have a good result. Of the 13 displaced fractures, 6 showed signs of avascular necrosis. In these cases, the prognosis is unpredictable and unrelated with the age of the patients. 7 of the 8 basicervical fractures have a good result (88%). A better comprehension of these fractures and of the vascularisation gives better knowledge of the significant difference of prognosis in type II and type III fractures.

Adolescent↗
PubMed1982

Roentgenographic study of cavus foot deformity in Friedreich ataxia patients: preliminary report.

The preliminary results based on a three year retrospective study in cavus foot deformity of forty-four Friedreich ataxia patients regularly seen at the Neuromuscular Disease Clinic of Sainte-Justine Hospital have been presented. An accurate "weight-bearing" foot stereoradiographic technique has been recently developed by our group. Since the follow-up period with this device is not sufficient to provide statistical information, the conventional non-weight bearing technique has been utilized in this study to enable a possible comparison between the radiographs of ambulant and non-ambulant patients. Due to the present technique, the results of this study must be interpreted with caution. For 132 pairs of radiographs, 28 parameters have been analyzed. Four of these, namely the calcaneal inclination angle, the first metatarsal inclination angle, the inferior cortex of calcaneus-first metatarsal angle and the first-fifth metatarsals angle, were of particular interest. From these parameters, a preliminary quantitative description of cavus foot deformity in Friedreich's ataxia has been attempted. Three stages of evolution have been tentatively identified for this type of neurological disorder.

Adolescent↗
PubMed1982

Kinematics of the foot.

Orthogonal stereoradiographs are frequently utilized in determining three-dimensional geometrical parameters of human body segments. They have been applied here in the estimation of the length and elongation of the ligaments of the normal foot. Three small spherical metallic markers were respectively encrusted into the tibia and fibula, the seven bones of the tarsus and into the five metatarsals of an amputated lower limb to identify uniquely their spatial location. The foot was then positioned on a rotating platform. Standardized antero-posterior and lateral radiographs were taken. Afterwards the foot was dissected and the proximal and distal insertions of most of its ligaments were located by means of spherical markers. A second series of orthogonal radiographs were taken of each of the fourteen bones. The radiographs were digitized. The length of each ligament and elongation for a simple and complex movements were calculated by means of a computer program. The results of a simple movement of rotation representing a normal 20 degree dorsiflexion at the talocrural joint and of complex movements of rotation stimulating an abnormal high arch such as encountered in Friedreich's ataxia are presented and discussed.

Ankle Joint↗
PubMed1982

Cubitus varus deformity following supracondylar fractures of the humerus in children.

A retrospective study of 63 patients with cubitus varus deformity following supracondylar fracture of the humerus was carried out in order to identify the causes of cubitus varus, to define the best method for prevention, and to evaluate the indications for and results of treatment of the established deformity. There was no evidence of growth disturbance in any of our patients after a mean follow-up of 5 years postfracture. Cubitus varus was found to be secondary to medial tilting of the distal fragment. Failure to recognize this initial or subsequent medial tilt during early treatment of the fracture was the major factor in the development of cubitus varus deformity, thus explaining the average delay in diagnosis of 6 to 10 weeks postfracture. Since all patients regained essentially normal use of the upper extremity after the fracture, cosmesis was the primary indication for corrective surgery. Fifteen supracondylar osteotomies are reported with 33% unsatisfactory results. Prevention of this deformity by careful clinical and radiological evaluation during initial treatment of the supracondylar fracture is emphasized.

Child↗
PubMed1981

[The evaluation of the Harrington technique in the treatment of double-curved scoliosis (author's transl)].

Double-curved scoliosis was present in 18.5 of 750 scolioses operated on at the St. Justine Hospital in Montreal. 128 cases were reviewed with a follow up of more than 3 years. Pre-operative curves measured 61 and 58 degrees on average and post-operative curves measured 27 and 23 degrees. At the time of review, the curves were 39 and 36 degrees. The loss of correction varied with the age of the patient and the severity of deformity. The technique of early ambulation improved the post-operative results. However, it was concluded that compression rods did not provide a better correction of the curve or of the thoracic kyphosis.

Adolescent↗
PubMed1980

Pathomechanics and management of scoliosis in Friedreich ataxia patients: preliminary report.

The preliminary results based on a one year study on the evolution and management of scoliosis are presented. Twenty-one patients were followed in the Neuro-Muscular Disease Clinic at Ste-Justine Hospital where standardized spinal radiographs were taken periodically with the Scoliosis Chariot and the Throne. The short period of observation as well as the relatively small number of Friedreich ataxia patients followed requires that these results and the following remarks be interpreted with caution. Pathomechanics -- Between the age groups I (5 - 10 years) and II (10 - 15 years), a substantial increase in the Cobb values occurs. Associated with it, an increase was observed in the thoracic and thoracolumbar projected surface area indices. The relative rotation between the thoracic and lumbar segments was presumed to be the cause of the sudden increase in the Cobb measurements. For the non-ambulatory patients, a decrease in the lumbar lordosis towards a thoraco-lumbar kyphosis as well as a sudden increase in the sacral angle and a drop in the lumbo-sacral angle were associated with the seated posture assumed by the patient. Management -- Prevention of the progression of established curves was our main objective. Careful examination of the spine, depending on the age of the child, in our preliminary study, stimulated early orthopaedic treatment in any curve of 20 degrees or more. There was always concern for curves of 30 degrees or more. In the growing child, bracing was recommended. In the older child, the curve was usually stable after sixteen years of age. Surgery was usually attempted in curves over 40 degrees in the growing child. The same curve was usually stable after the growth period. For the non-ambulatory patients, the present study suggested the prescription of a molded seat with the following characteristics: i) a posterior lumbar support, ii) low thoracic lateral supports and iii) a slight inclination of the seating system. This was presumed to be beneficial in maintaining stability of the spine. Presently, an evaluation of such a device is under investigation.

Adolescent↗