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P Lascombes

Publications and source records attributed to P Lascombes.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Labor trauma-induced epiphysiolysis of the proximal femur. 4 cases].

The authors report on 4 cases of obstetrical traumatic slipping of the upper femoral epiphysis. Firstly, they emphasise the difficulties of diagnosis because trauma is often missed. In two cases the delivery was a cesarean section (in the same clinic!). Wrong diagnoses are: --neonatal septic arthritis with swelling and inflammation of the hip, lateral deviation of the metaphysis on the x-ray. Nevertheless, there are no signs of an infectious disease and symptoms begin at birth. --congenital dislocation of the hip but clinical testing of stability is painful and doubtful. Secondly, when diagnosis is uncertain, a joint aspiration confirms haemarthrosis, and arthrography shows the displacement of the epiphysis on the metaphysis. Finally, the authors explain their therapeutic procedure: three times orthopaedic treatment with traction and spica cast for 2 months, a pin osteosynthesis in one case. Prognosis was favourable in two cases, but the two other cases present a lateral rotation of the leg in relation to a retroversion of the femoral head.

Adolescent↗
PubMed1989

[Surgical treatment of spinal deformity due to cerebral motor disorders using a Luque type appliance].

The authors report a series of 20 cerebral palsy patients with spine deformities who need a surgical treatment. The procedure is a posterior approach and a segmental spine instrumentation: Luque-Galvestone or Cotrel-Dubousset-Luque type. Vertebral bone-graft is always performed and sacral bone is fused 16 times. Sitting position is authorized 4 to 7 days after the operation. Improvement of frontal and sagital curves as well as pelvic obliquity is of 50% and remains unchanged with a two years follow-up. Among the complications, most of them are pulmonary infections with 2 severe cases on 9 patients. Even functional status is also improved, post-operative pains and social difficulties are frequent during almost 6 months.

Activities of Daily Living↗
PubMed1989

[Tillaux's fracture].

Tillaux fracture or fracture of the antero-lateral portion of the distal tibia has a vertical fracture line either at the middle of the epiphysis or close to the external malleolus. It is seen around 13-14 years. Distance from the fracture line to the external malleolus depends of the degree of closure of the epiphyseal plate. When the medial aspect of the physis is open, the fracture line is more medial. The location of the fracture line in the epiphysis therefore depends on the maturity of the physis as shown by closure of its medial portion. Tomography is frequently necessary to see the fracture line and mainly to appreciate the fracture gap. If the gap is less than two millimeters non operative treatment with plaster cast is sufficient.

Adolescent↗
PubMed1989

[Congenital pseudarthrosis of the legs and the Ilizarov method. Apropos of 4 cases].

Four cases of congenital pseudarthrosis were treated by the Ilizarov method and consolidation obtained by 3.5 months in three patients who had all undergone several previous surgical procedures. Although the length of follow up is short (maximum 3.5 years) consolidation occurred quicker than by traditional methods. This technique also permitted both simultaneous correction of axial malalignment and leg lengthening. We think that this method has a place as a salvage procedure except where the distal fragment is very thin or dystrophic.

Adolescent↗
PubMed1988

Anatomic basis for the orthopedic treatment of bladder exstrophy: anatomic study of the sacrosciatic ligaments in the newborn.

Anatomic study of the pelvis of 30 fetuses and newborn children, yielded a precise relationship between the sacrotuberous ligaments and size of the gluteal region. At birth, the distance between the posterior superior iliac spine and the ischium is 40 mm. Closure of the anterior defect in bladder exstrophy sometimes requires an orthopedic surgical procedure. Bilateral posterior iliac osteotomy and section of these ligaments can be easily done by a single medial posterior approach herein described.

Bladder Exstrophy↗
PubMed1988

[Continuous inflation of a leaking cuff of an intubation tube].

Perforation of the cuff of the endotracheal tube peroperatively is a very serious problem, especially when it occurs in a patient prone on an orthopaedic table. This is even more dramatic when the patient is not breathing spontaneously and he cannot be turned over to be reintubated. Given the unusual character of this situation, an apparatus has been designed to keep the cuff inflated permanently. It was a circuit consisting of a manual pressure valve, flexible tubing, a peripheral catheter and the cuff supply tube. The gas used was medical air at 3 bar pressure. This method proved perfectly safe and efficient, the operation having continued without reintubation.

Adolescent↗
PubMed1988

Computerised tomography in non-treated congenital hip dislocation.

Computerised tomography, carried out in 5 non-treated cases of congenital dislocation of the hip, shows that the femoral head can move in a large anteroposterior cavity. When the hip is extended the common position of dislocation is lateral superior and slightly anterior to the acetabulum. When the hip is flexed (at a right angle), the femoral head is located posterior and slightly superior to the acetabulum. Dislocation reduction has always been possible. When the hip is flexed a large "click" takes place; whereas if the hip is extended, the "click" is less noticeable, or even absent.

Acetabulum↗
PubMed1988

Elastic stable intramedullary nailing of femoral shaft fractures in children.

We report the use of elastic stable intramedullary nailing (ESIN) in 123 fractures of the femoral shaft in children. Flexible rods are introduced through the distal metaphyseal area, and the aim is to develop bridging callus. Early weight-bearing is possible and is recommended. There was one case of bone infection and no delayed union. Complications were minimal, the most common being minor skin ulceration caused by the ends of the rods. A surprising feature was the low incidence of growth changes, with a mean lengthening of only 1.2 mm after an average follow-up of 22 months. Compared with conservative treatment, ESIN obviates the need for prolonged bed rest and is thus particularly advantageous for treating children.

Adolescent↗
PubMed1988

[Fractures of the pelvis and associated bladder-urethral rupture].

We report 82 cases of pelvic fractures associated with vesico-urethral ruptures. Pelvic fractures were 23 simple fractures, 5 bilateral obturator foramen's margin fractures, 30 pubic dislocations sometimes associated with other fractures and 24 complex fractures. Urological injuries were 64 urethral ruptures, 13 bladder ruptures and 5 vesicourethral injuries. These well documented cases allow us to study relations between bone and visceral injuries as well as result's quality in relation to treatment. From this study a treatment schedule has been deduced insisting upon the fact these bone and visceral injuries must be treated immediately and if possible in a one time procedure. The repairs time schedule depends upon the fracture's type from which benefit can be taken out for the urethral access.

Adolescent↗
PubMed1988

[Prognosis of fractures of the lower end of the femur in children and adolescents. Apropos of 96 cases].

A multicentre study undertaken in a number of orthopaedic and traumatology departments of hospitals in the East of France have made it possible to bring together, over 10 consecutive years, 96 fractures of the lower end of the femur in children and adolescents. The analysis of this retrospective series agrees with the findings in the literature both in its clinical features and the methods of treatment. The results were very good in 84 per cent of cases. The authors feel that the standard scoring systems are too optimistic and they prefer an analytic description of the complications which presented in 54 per cent of cases with 13 per cent of malunions, 16 per cent of epiphysiodeses and 7 per cent of inequalities of limb length greater than 10 mm. The etiology and pathology of these diverse complications is reviewed. Vascular lesions seem to play an unimportant role. The prognosis, as defined, seems to be realistic since this work has taken account of a large proportion of the fractures occurring during the same period in the same region.

Adolescent↗
PubMed1988

[Anatomic characteristics of the pelvis in children].

Growth characterizes the pelvic modifications until adult maturity is reached. Recollection of pelvic ossification is done insisting upon the primary ossification points, the triradiate cotyloid cartilage and the secondary ossification points. The socket's neonatal particular morphology with it's cartilaginous roof and it's fibrocartilaginous acetabular labrum finds it's application in ultrasonography. Bone modifications which occur permanently during growth result in increase of pelvic volume and in modifications of the physical mechanical resistance characteristics so that there are differences between children and adult fractures. Ligamental hyperlaxity and numerous cartilaginous structures are also accountable for these differences. About visceral concern, the main characteristic apart from genital modifications is the apparent migration of the bladder from the neonatal abdominal position down to the adult backward pubic position. Bladder capacity variations have been studied. The male urethra anatomy is recalled from which the different surgical procedures are deduced. The main vasculo nervous axes orientations are described allowing the comprehension of CT scan images. In fact the horizontal plan given by the modern imagery is sometimes difficult to study. An apprentice ship schedule is given following the bone, vasculo-nervous and visceral identification.

Adolescent↗
PubMed1988

[Study of distraction osteogenesis in an animal body submitted to anticancer chemotherapy].

The authors studied distraction osteogenesis in an animal subjected to prolonged anti-mitotic chemotherapy (Methotrexate and Doxorubicin). This chemotherapy decreased osteogenesis (essentially at the expense of external regeneration) though without inhibiting it totally. Distraction bone consolidation is thus possible in the animal, permitting reconstruction of limb segments by mobilization of an axial fragment in accordance with the Ilizarov technique.

Animals↗
PubMed1988

[Role of the pathologist in the treatment of osteosarcoma].

We describe the pathological method for the study of osteosarcoma surgical specimens treated by chemotherapy according to Rosen and Huvos. The aims of this method are to assess the extent and the histological viability of each tumor after chemotherapy. The borderline between good and bad response is about 5% viable tumor cells. This histological response determines postoperative chemotherapy.

Antineoplastic Agents↗