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M Dutoit

Publications and source records attributed to M Dutoit.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Hallux valgus: the McBride procedure or subcapital osteotomy?].

The authors compared the long term follow-up (mean duration 19 years) of 96 patients operated on for hallux valgus, 52 by the McBride procedure, 46 by a Hohmann procedure. Clinical results considered 4 criteria: deformity, pain, mobility and satisfaction. Dorsoplantar weight bearing X-ray compared anatomical results. This study showed that patients were subjectively more satisfied after McBride operation (p = 0.0001) even if the deformity was radiologically better reduced by osteotomy (p = 0.006). This discrepancy between subjective and radiologic results was related to the fact that X-rays represent only the static morphologic reflect of a more complex pathologic entity: radiology can only partly explain the functional discomfort of the patients. The modified McBride procedure was better suited to patients presenting a painful HV. Osteotomy was more suited to bunions causing little pain. Indications for each of these procedures should be based more on patient's history and clinical examination than on X-rays.

Adult↗
PubMed1991

Epidermal and urethroid penile cyst.

The authors describe a 74-year-old man who presented with a 2-cm nodule on the ventral face of the penis, showing histologically a cyst lined by both epidermal and urethroid epithelium. The authors discuss the various histological forms of raphe median cysts of the penis.

Aged↗
PubMed1991

[Dorso-lumbar spinal compression fractures in the child. Follow-up at the termination of development].

Between 1970 and 1985, we count 32 children with compressive fractures of the vertebral column. None of them undergo a surgical procedure. We examine 24 of these 32 children with a mean delay of 10.5 years. Most of the fractures were referring to sporting activities and home games. The main localization was dorsal (T6) and upper-lumbar (12). The mean reduced height of the ventral portion of the vertebra was 27%. Some 10 years later, two third of the patients have some persistent pains and half of them daily. Most of the aches concerned children of more than 12 years when trauma occurred and those who developed a scoliosis during evolution. Wonder the global static of the rachis is little concerned in most of these children. Therefore compressive vertebral fracture of the youngster should be reduced and fixed by a corset. But the immobilization shouldn't be longer than 2 months, accompanied by appropriate gymnastics and followed by a quick renewal of the sporting activities.

Adolescent↗
PubMed1990

[The fate of children undergoing bone lengthening in congenital hypoplasia of the legs].

This retrospective study was conducted on 26 patients, 14 women and 12 men whose average inequality prognosis was 8.5 cm. They have been reviewed after they were more than 20 years old (mean 23.8 y). Between 1962 and 1979 these 26 patients have had 38 lengthening procedures with various methods. The results were evaluated after clinical examination and X-rays. The average radiological discrepancy was 1.5 cm at the follow-up. On the X-rays, the deterioration was rare for the hip point, more frequent for the knee and very frequent for the ankle and the foot. If the socio-professional integration was satisfactory, many problems remained unsolved at the review. The matter was the aspect of the lengthened limb considered as unesthetic and ugly by 22 patients. 20 of the 26 patients had problems to put on shoes. On the other hand two patients out of three had a relative intolerance to effort, cutaneous troubles probably in conjunction with vascular and trophic insufficiency with many concern for the future.

Bone Diseases, Developmental↗
PubMed1989

[Salter's innominate osteotomy. 20 years later...].

This is a retrospective review of nineteen innominate osteotomies with an average follow-up of 20, 6 years. These osteotomies were done mainly for treatment of late diagnosed congenital hip dislocation, or occasionally for persistent subluxation after orthopaedic treatment. The mean age at diagnosis was 2 years 2 months, at operation 3 years 5 months. We performed eight combined open reduction and pelvic osteotomies, eight associated pelvic and femoral varisation derotation osteotomies and only 3 isolated pelvic osteotomies. At follow-up the Charnley hip's score is 5.7 for pain; 5.4 for gait and performance, 5.6 for mobility. We found 15 hips without any significant pain and only 4 hips with mechanical pain. The Xray evaluation shows an average CE angle at 28.5 degrees, AC angle at 16 degrees and anterior coverage on "faux profil de Lequesne" at 40 degrees; 4 hips show arthritic changes, 4 others had important deformation of the head of the femur, but without diminution of the height of articular space. 6 hips (1/3) in 4 patients must be reoperated in adolescence because insufficiency of coverage of the head of the femur: 3 because technical errors and 3 because osteonecrosis with progressive cervicocephalic valgus. This historical serie with a very important follow-up, demonstrate that between 1/3 and 1/2 of cases have some kind of problems mainly radiological. The quality of results depends on the respect of the conditions and technique described by Salter, early diagnosis and absence of osteonecrosis eventually caused by prealable orthopaedic treatment.

Activities of Daily Living↗
PubMed1987

[L4/L5 spondylolisthesis following reduction and stabilization by anterior and posterolateral graft of L5/S1 spondylolisthesis with major displacement].

40 children and adolescents, recurrence of a spondylolisthesis after posterior or even postero-lateral fusion is a well known fact. Anterior fusion added to the posterior graft is said to prevent such and occurrence. We report a case of a L4/L5 listhesis which followed near complete reduction of a 70% L5/S1 slip fixed by a combined approach. We think this is due to the persisting lumbo-sacral postural abnormalities and that while reducing and fixing the spondylolisthesis one should restore physiological posture to prevent this recurrence at the same level or at a higher one.

Child↗
PubMed1987

[Long-term development of tibio-astragalus arthrodesis].

Twenty-eight arthrodeses of the ankle have been reviewed with a mean follow-up of nine-and-a-half years. The arthrodeses were all carried out using the same technique of osteotomy of the lateral malleolus and fixation with a Charnley compression device. The main indication for fusion was post-traumatic arthritis. The number of complications, most of them benign, was not negligible and amounted to 42 per cent, including superficial infections, skin necroses and lesions of the posterior tibial nerve. Revision operations were needed in 17.5 per cent of cases during the year after operation, most of them for malposition. The clinical results were satisfactory in three-quarters of the cases and poor in one-quarter. Radiological changes in the joints distal to the fusion were relatively marked in the subtaloid joint and slightly less in the midtarsal joint. Theses changes are a source of concern for the future because of their pre-arthritic appearance and their progressive nature. Adaptive hypermobility of the midtarsal joint was seen in only one-third of the cases. The changes were greater when the hindfoot was in equinus, a position which was often aimed for in this series. The author advises internal fixation with screws and discusses the future potential for arthroplasty.

Adolescent↗
PubMed1986

[Valgus deformities of the ankle in children].

In children valgus deformities of the ankle joint are usually due to neurological conditions (spina bifida, poliomyelitis, spasticity). The deformity is characterized by a shortened fibula, wedging of distal tibial epiphysis and valgus tilt of the talus. Other conditions producing similar deformity include congenital and acquired fibular pseudarthroses, multiple exostoses and some cases of tarsal synostosis. Early treatment of a progressive valgus in multiple exostoses is mandatory. The author describes a case of ankle valgus following an undiagnosed traumatic section of tibialis posterior tendon. After predictable failure of a Grice procedure, a persisting good correction was obtained by fibula lengthening combined with talus reposition and fixation on os calcis.

Ankle Joint↗
PubMed1986

[Stapling using Blount's technic in idiopathic frontal deviations of the lower limbs in children].

Growth plate stapling using Blount's technique is still under discussion in its application to adolescent's lower limbs axial deformities. To establish its validity, we present a review of 18 stapling cases, 15 for valgus knees and 3 for genu varum. Mean follow up is 5 years 9 months. We analyse chronological age, bone age, clinical measurements, standing X-rays, as well as the site, time of insertion and removal of staples in these children all with symetrical involvement. Full correction of genu valgum is obtained in 30% of cases, partial correction in 30%, but varus deformity is never completely corrected. Undercorrection is as frequent as overcorrection, valgus being twice converted to significant varus. Immediate complications are few and benign, but long term sequellae of various consequence numerous. We think that this technique should be abandoned for genu varum. results when applied to valgus knees are unpredictable due to the inaccuracy of estimation of bone age and remaining growth potential, rendering impossible the exact timing of staples insertion and removal, need to avoid either definitive epiphysiodesis or deformity recurrence through rebound effect.

Child↗
PubMed1985

[Lamellar rotation osteotomy of the tibia in children].

The authors describe the technique and results obtained by a derotation osteotomy of the tibia in children. The method is simple, reliable and does not require internal fixation. It is suitable for dealing with deformity following poliomyelitis, and may also be used to treat tibial torsion which fails to correct with growth in children who are otherwise healthy.

Adolescent↗
PubMed1985

[Surgical treatment of scoliosis of 100 degrees and greater in children and adolescents (neurological and myopathic scoliosis excluded). Apropos of a series of 66 cases].

In a retrospective study the authors had compared the results obtained in two series of identical scoliosis. All were examined after a two year minimal follow-up. Group A. There were 31 children operated on between 1966 and 1972. The average initial curve measured 111 degrees, and the average follow-up was eight years. In this group there was no preoperative preparation, and a Harrington rod was accompanied by cancellous grafting. The average correction was 34 degrees. Four paraplegias were seen, three of which recovered. Group B. There were 45 children operated on between 1973 and 1980. The average initial curve was 170 degrees and the average follow-up was 4.5 years. In this group, there was pre-operative use of a Halo cast routinely. In 14 children, Harrington rodding was supplemented by anterior fusion to correct associated kyphosis. The posterior Harrington rodding was completed by tibial grafting. The average correction was 47 degrees, without any neurological complications. It was noted that after one year, pulmonary function was not impaired to a greater extent after an anterior fusion than after a purely posterior fusion. Two-thirds of the cases gained considerable cosmetic benefit.

Adolescent↗
PubMed1984

[Primary synostosis of the tarsus in children. Apropos of 32 cases in 20 patients].

The authors have studied 32 tarsal coalitions in 20 children. Twenty two were between the talus and the calcaneum, 4 were medial and 6 were rare varieties. The diagnosis is often missed because 40 p. 100 of the children with tarsal coalition had no complaints. The indirect radiological signs have been analysed and precise techniques described for detecting the coalition. Only 11 feet were operated on. On 4 occasions the coalition was simply resected. This always gave a good functional result and good mobility was obtained in the subtaloid joint in 2 cases. The other cases were treated by triple arthrodesis. The authors consider that an earlier diagnosis would lead to better prevention of secondary deformities. The best indication for simple resection is in coalition between the calcaneum and the navicular.

Adolescent↗