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Biomedical subjects

P Burdin

Publications and source records attributed to P Burdin.

At least 19 recordsLinked to original sources

[Early weight-bearing after osteosynthesis by THS hip screw in cervico-trochanteric fractures].

A second generation hip screw was designed in the laboratory to allow unlimited immediate weight-bearing in elderly patients with cervico-trochanteric fractures. The use of this device in 300 operated patients demonstrated that it provided the same capacity for weight-bearing as total hip prostheses, but with a lower morbidity and better and longer lasting functional results. Thus, in patients with a mean age of 77 years, one half of whom suffered from an unstable fracture: the operation was minimally traumatic (reduction on an orthopaedic table, no surgical access to the fracture site, operating time less than one hour); complications were consequently rare (no deep sepsis, no dislocation) in contrast with 5 to 10% of deep sepsis or dislocation with prostheses; early unlimited weight-bearing was permitted by the 5th day in every case and was achieved by the 10th day in more than 80% of cases (30% of whom were able to walk unassisted with crutches); an essential point, the design of the material prevented dismantling on weight-bearing and preserved the morphology of the hip (telescoping of the fracture site never exceeded 20 mm, mean:11 mm). Consolidation was obtained in every case by 6 to 8 weeks. The mortality at 3 months was identical to that observed with prostheses (18%, related to physiological age). The length of hospital stay and the duration of rehabilitation were considerably shortened, as 37% of patients returned to their previous residence by the 45th postoperative day. This resulted in a marked saving in medical costs for each patient (as patients previously returned home after an average of 145 days).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[Experimental study of primary fixation of screw-ring acetabular components. Role of initial screw-cutting].

Three types of screw-ring acetabular components were implanted to determine the characteristics of their holding power and to study the influence of screw-cutting. The acetabular components were screwed into vinyl polychloride foam. Their resistance was measured. The optimal value of the locking screw couple and the value of the couple beyond the one at which the acetabular component loosened were determined. One of acetabular components was screwed in with and also without preliminary screw-cutting. Its resistance to wrenching was measured in both situations. The resistance curve at wrenching was characteristic of each screw-ring acetabular component. The resistance to wrenching was significantly higher (p < 0.01) for a given acetabular component if it was screwed into a largely open block of foam at its bottom. The screw-cutting allowed for a significantly higher resistance to wrenching (p > 0.05). It allowed for the screwing in with the least effort and for a better perception of the tightening. Knowledge of the comportment of screw-ring acetabular components once installed, usage of preliminary screw-cutting and recourse to a dynametric key are the means of improving the installation of screw-ring acetabular components.

Acetabulum

[Functional result and outcome of total condylar knee prosthesis].

Total condylar knee prosthesis is gradually proving fully reliable. It is an "all or nothing" type of surgery, with either good or bad results depending on the occurrence of complications, notably tibial decementation. With the experience acquired it may be said that the much dreaded wearing off of polyethylene components is not responsible for failures of total knee prosthesis.

Humans

[The combined luxation of the trapezoid and 2nd metacarpal bones. Apropos of a case].

The authors report a case of posterior dislocation of the trapezoid bone together with the second metacarpal. Among the 25 cases of trapezoid dislocations reported in the literature, no similar case has been found. The patient was seen 4 months after the injury and there was also a scaphoid instability. Open reduction and a scapho-trapezio-trapezoid arthrodesis were performed. The diagnosis, the mechanism and the treatment of this very unusual injury are discussed.

Adult

Two cases of plant thorn synovitis. Difficulties in diagnosis and treatment.

Two patients with inflammatory monoarthritis of the knee due to joint penetration by plant thorns are reported. Histopathology demonstrated granulomatous synovitis in both and visualized fragments of black thorn. Synovectomy was partly effective. Awareness of this cause of chronic monoarthritis will avoid delay in diagnosis and treatment.

Adult

Iliopsoas bursitis.

Explore the source record for details and available documents.

Arthritis, Rheumatoid

Fracture of the anterior arch of the atlas associated with a congenital cleft of the posterior arch. Demonstration by CT.

A case of a vertical fracture of the anterior arch of the atlas associated with a congenital cleft of the posterior arch of the same vertebra is reported. Such an association has not previously been described in the literature. X-Ray computed tomography is an excellent exam for visualizing this region and for easily distinguishing between fractures and congenital clefts.

Adult

[Chronic anterior laxity of the knee treated by extra-articular ligamentoplasty. 226 cases reviewed after more than 2 years].

Two-hundred and twenty-six patients with chronic anterior laxity of the knee treated by Lemaire extra-articular ligamentoplasty were assessed after a follow-up of 2 to 9 years, with a mean of 4.5 years. Fifty-five knees had only an anterior laxity and 166 anterior laxity combined with medial laxity, in 100 of which tensioning or reinforcement of the medial ligament was needed. Forty-two per cent of sporting patients were able to return to sport at the same level, though half of them had some discomfort. Fifty-one per cent of patients did not experience any instability in daily and working life but half of them had occasional pain. Sixty-one per cent of knees did not, at review, show a positive MacIntosh pivot shift test and the absence of pivot shift correlated statistically with the quality of the functional result. In seventy-three per cent of knees there was a positive Lachmantest indicating definite laxity at the review. Thirty per cent of knees developed a lateral laxity, which questions the innocuousness of removal of the iliotibial tract. Twenty-seven per cent showed radiological deterioration of the medial joint space. A comparison of these results with the published results of intra-articular ligamentoplasty suggests that extra-articular ligamentoplasty with fascia lata should be limited to the treatment of isolated chronic anterior ligament laxity in middle-aged patients who do not participate in strenuous sporting activities.

Adolescent

[Weight-bearing early after osteosynthesis of the femoral neck by nail-plate (100 cases)].

One hundred trochanteric or transcervical fractures, 64 of which were in patients more than 75 years old, were treated by internal fixation with a THS nail-plate. This device is characterised by a better bending strength than a one-piece nail-plate and a design which limits the risk of displacement of the screw in the head so that immediate weight-bearing can be allowed. Weight was borne on the limb in 81 cases at the tenth post-operative day. It did not improve the mortality, there being 17 deaths by the third month but it greatly helped post-operative care and rehabilitation without producing any additional complications. As a result, 43 per cent of patients could return home by the 45th post-operative day and 74 per cent had recovered their previous level of autonomy within three months of operation. There were only four mechanical complications, all in transcervical fractures: one crack fracture in the femoral head and three displacements following inadequate reduction, treated by prosthetic replacement. The follow-up of 80 patients at three months showed that consolidation always developed between the 45th and 90th day with full weight-bearing and a stable radiological picture. There was no intra-articular penetration or bending of the screw and no break-out of the implant. Whilst it is a definite advance in the treatment of trochanteric fractures, a longer follow-up is needed to determine its place compared with prostheses in transcervical fractures.

Aged

[Surgery in a plastic air-filled chamber. Current possibilities].

The authors have made an assessment of the use of an isolating operation chamber in 137 operations, primarily for the insertion of prostheses the the hip or knee, but also for the shoulder. The isolating chamber can be used equally well for hip, knee, shoulder or other surgery. The unit is made in the form of a plastic balloon, the air inside is sterile. Inflation is maintained by air passed through filters said to give complete sterility. The chamber is fitted with gloves to allow work to be done inside it. It is adherent to the skin of the patient and its wall is incised at the same time as the skin. The result is a very satisfactory isolation of the wound, eliminating faults in aseptic technique but requiring fresh sterilisation for each new procedure. Their assessment has shown that this enclosure can be used without any major problem of adaptation.

Antisepsis