[A new variety of chondrosarcoma: so-called "chondroblastic" sarcomas or "clear cell" chondrosarcomas. Pathology and electron microscopy in 5 cases (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Postel.
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In this study the authors compared the mortality of fractures of the neck of the femur treated by femoral prostheses with early walking compared with trochanteric fractures treated by a nail plate and non-weight bearing activity for 2 to 3 months. The mortality in the two series (about 20 per cent) was the same. The authors then compared two series of fractures of the femoral neck, one treated by Moore's prosthesis without cement and the other by an alternative type of femoral prosthesis with cement. They conclude that the mortality was the same in the two groups but that the cemented prosthesis had better functionnal results. Long-term tolerance of the acetabulum was the same in the two types of prosthesis. Total hip replacement is very rarely indicated in recent fractures of the femoral neck.
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The authors have treated one hundred fractures of the femur of metastatic origin. They conclude that surgery, when technically possible, should always be undertaken. Internal fixation gave better results than prosthetic replacement of the upper end of the femur. Intramedullary nailing can be followed by radiotherapy and shaft fractures may unite after such treatment. The treatment of the primary lesion must be started as soon as possible by radiotherapy or chemotherapy.
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The authors have treated 16 cases of tumours of the upper end of the femur by resection over at least 12 centimetres and insertion of a massive prosthesis. The tumour was secondary in 9 cases and primary in 7. This treatment was used for metastases where conservative surgery was impossible or had failed. In primary tumours, when the excision was very extensive, the main problem was of stability of the prosthesis and its long-term future. A new type of total massive prosthesis, designed by the authors after biomechanical studies, is described.
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The authors describe the technique that they have used in approximately 500 intertrochanteric osteotomies of the femur. The technique was satisfactory in the production of bony union but in ten per cent of cases there were errors of correction of 5 degrees or more. An analysis of errors related to the radiological technique used showed that a number of conditions (flexion, abduction) modify the angles of inclination and anteversion. A number of instances of degenerative arthritis had been incorrectly attributed to increased coxa valga. An analysis is made of the difficulties encountered when correction is required in two planes, especially when there is fixed flexion or significant anteversion. Some suggestions are made concerning improvements in technique.