Biomedical subjects
P Colombet
Publications and source records attributed to P Colombet.
[Anterior cruciate ligament reconstruction: biomechanical comparison on cadaver specimens using a single or double hamstring technique].
PURPOSE OF THE STUDY: We worked with cadaver specimens to evaluate control of anterior knee laxity after reconstruction of the anterior cruciate ligament (ACL) comparing double two-strand anterolateral and posteromedial reconstruction with the classical four-strand technique. We hypothesized that the double reconstruction would provide better control of anterior laxity in both flexion and extension. MATERIAL AND METHODS: Sixteen cadaver knees were randomly assigned to reconstruction technique. Anterior tibial translation was measured with an arthrometer (Rolimeter) at maximal manual tension at 20 degrees, 60 degrees and 90 degrees flexion on the intact knee, after section of the ACL and after arthroscopic reconstruction using either the classical four-strand hamstring technique or a double two-strand anteromedial and posterolateral technique. An EndoButtonCL was used for the femoral fixation and a interference screw with staples for the tibial fixation. Variation in the length of each construct was measured between 0 degrees and 90 degrees flexion. RESULTS: In the single reconstruction group, the length of the graft varied by 0.5 +/- 0.7 mm between 0 degrees and 90 degrees flexion. In the double reconstruction group, the length varied by 0.5 +/- 0.9 mm for the anteromedial construct and 3.4 +/- 0.5 mm for the posterolateral construct. When studied with an intact ACL, anterior laxity of the 16 knees was 3.2 +/- 1.1, 3.5 +/- 1.5 and 2.6 +/- 1.1 mm at 20 degrees, 60 degrees, and 90 degrees respectively. After section of the ACL, laxity increased significantly at all angles: 9.4 +/- 3.3, 6.1 +/- 2.5 and 6.8 +/- 2.9 at 20 degrees, 60 degrees, and 90 degrees respectively. After classical four-strand single graft reconstruction, the residual anterior laxity was 3.7 +/- 0.9, 3.1 +/- 1.1, and 2.3 +/- 1.6 mm at 20 degrees, 60 degrees, and 90 degrees flexion. Statistical analysis using parametric or non-parametric tests as appropriate showed a significant difference in laxity at 20 degrees, 60 degrees, and 90 degrees of flexion between knees with a cut ACL and knees with reconstructed ACL. At 20 degrees flexion, residual laxity was greater after single-construct reconstruction. At 60 degrees and 90 degrees there was no significant difference in anterior translation of the tibia in knees with intact or reconstructed ACL. After reconstruction with the dual-construct technique, laxity was 3.4 +/- 1.3, 2.6 +/- 1.5, and 2.4 +/- 1.2 mm at 20 degrees, 60 degrees and 90 degrees flexion respectively. Laxity was significantly greater with a cut ACL than after reconstruction at 20 degrees, 60 degrees, and 90 degrees flexion, but there was no significant difference in anterior translation of the tibia at 20 degrees, 60 degrees, and 90 degrees flexion between knees with an intact and a reconstructed ACL. DISCUSSION: These results based on a clinical evaluation measuring anterior translation of the tibia with an arthrometer are in agreement with results in the literature using robots. Compared with the classical technique, reconstruction of the ACL with a dual-construct technique provides a statistically significant improvement in control of anterior tibial translation at 20 degrees of flexion. The advantage of the dual anteromedial and posteriolateral construct technique is thus not found in the control of anterior laxity but rather in control of rotation laxity. CONCLUSION: Reconstruction of the ACL with a two-bundle graft technique provides control of anterior laxity at 20 degrees, 60 degrees, and 90 degrees flexion similar to that observed in knees with an intact ACL while the single construct technique re-establishes physiological laxity at 60 degrees and 90 degrees only. This improved control of anterior laxity with the two-bundle reconstruction is a small improvement regarding anterior laxity, the more potential advantage concerning rotational stability.
[Computer-assisted surgery of the anterior cruciate ligament].
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[Treatment of chronic ankle instability with the Chrisman-Snook's technique].
PURPOSE OF THE STUDY: We report our experience on lateral ankle instability treated by the Chrisman Snook procedure. We studied the objective and subjective results as well as the effect on peroneus brevis tendon function. MATERIAL AND METHODS: Among 110 patients treated for chronic lateral ankle instability between 1991 and 1997, 32 cases were treated with this technique. The average age was 25 years (16-37) and the average time to surgery from the initial trauma was 30 months. This was a retrospective study using the Karlson Peterson form while the laxity was measured with Telos device (120 N). Cybex testing was performed on 10 patients. Twenty-seven patients participated in sport. RESULTS: The follow-up ranged from 6 to 65 months (average 25 months). The average Karlson's score was 82.6 with 78 per cent excellent and good results. Lateral ligament laxity was reduced from 17 mm to 4 mm on Telos measurements and no osteoarthritis was noticed radiographically. The joint mobility consistently returned to the preoperative level. Twenty four patients returned to sport although half of the patients had some pain during sport activities or with fast walking. DISCUSSION: Males and patients participating in sporting activities had the best results and none of the patients had recurrent instability despite new sport injuries. The persistence of some pain may be associated with the long period of instability prior to reconstruction in this group of patients. CONCLUSION: The Chrisman Snook lateral ligament reconstruction is a technically easy and solid technique and we recommend it in patients with significant chronic lateral ligament instability.
Needs, demands and manpower balance. Dentists/populations. FDI Commission, 1996.
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Dynamic structure factor
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Erratum: Support for the Haldane conjecture: Gap for magnetic excitations in the quasi-one-dimensional S=1 Heisenberg antiferromagnet AgVP2S6
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[F.D.I./W.H.O. mixed working group].
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Support for the Haldane conjecture: Gap for magnetic excitations in the quasi-one-dimensional S=1 Heisenberg antiferromagnet AgVP2S6.
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[Information for patients].
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[Why a hepatitis B - AIDS file?].
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[What conclusions (provisional) can be drawn for our daily practice?].
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Anatomic basis of the sural fascio-cutaneous flap: surgical applications.
Studies of the fascio-cutaneous vascularization and innervation of the leg seem incomplete. After reviewing the classical findings, the authors report on their anatomic study 15 dissections. Perforating pedicles, originating from the peroneal artery (3 to 5) and posterior tibial artery (4 to 5) destined for the skin and fascia of the posterior aspect of the leg were constantly found. This study suggests the possibility of a distally based sural fascio-cutaneous flap, a flap which has been successfully constructed clinically.
[Value of sural fascio-cutaneous flaps with distal pedicle for covering tissue loss of the lower third of the leg].
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[The distally based sural fascio-cutaneous flap. A new technic for the coverage of loss of substance of the lower leg].
Prognosis of compound open fractures has been transformed by the use of plastic surgery to cover wounds. However, loss of substance of lower third of leg remains a delicate problem frequently requiring the use of microsurgical techniques by experienced teams. The sural cutaneo-aponeurotic distal base flap, the subject of a detailed anatomical study by the authors, can resolve the problem without affecting muscle capital and at the price of minor esthetic sequelae. Results in two clinical cases confirm reliability of this flap.
Thermopower and low-dc-field magnetization study of the layered FexZrSe2 compounds: Anderson-type localization and anisotropic spin-glass behavior.
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