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Biomedical subjects

P Lecestre

Publications and source records attributed to P Lecestre.

At least 19 recordsLinked to original sources
PubMed1999

Biphasic synthetic bone substitute use in orthopaedic and trauma surgery: clinical, radiological and histological results.

Searching for an alternative to bone grafts in orthopedic and trauma surgery, two biphasic synthetic calcium phosphate ceramics BCP are made: the first, Eurocer 400, in granule form with a high interconnected porosity for void-filling, and the second, Eurocer 200, available in different shapes, with a good mechanical resistance in compression. Two hundred cases are reported with more than a six-month follow-up. The first 72 cases relating to hip arthroplasty revision surgery (29 involving acetabular and 43 femoral stem loosening) are exposed with some technical details. The next 71 cases concerning trauma and sequels are displayed with technical particulars. The remaining 57 other cold orthopedic indications are then enumerated. The very good biocompatibility of these ceramics is confirmed. Radiological incorporation is quickly seen in all the cases, faster with the filling substitute than with the second one, which, however, presents no mechanical failures when classical technical principles are respected. Finally, some histological studies are presented; the ceramics are progressively resorbed and bone reconstruction in and close to the substitutes is noticed. Therefore, the use of biophasic ceramics in almost all orthopedic and trauma surgery is recommended.

Journal Article↗
PubMed1993

[Osteosynthesis of fractures of the trochanteric region using the gamma nail, apropos of 76 reviewed cases].

The authors present 76 cases of trochanteric fractures, treated by a Gamma nail. The minimal follow-up was 6 months, with clinical and roentgenographical check-ups. The mean age was 74 years, with a female majority as classically; the most common cause was a simple fall. Unstable fractures represented 53% of the cases, with 39% subtrochanteric; nevertheless, full weight bearing was possible in 83% of the cases. The mechanical complications of this new technique have been studied in details and compared with other most common methods of osteosyntheses: the Ender rod and the sliding screw plate. The Gamma nail shows an uncontestable superiority compared to Ender's rods, but it has little advantage to D.H.S.-T.H.S., particularly because of the delay in full-weight bearing and deep infection rate. The Gamma nail moreover seems to be better adapted for the treatment of subtrochanteric fractures.

Adult↗
PubMed1990

[Synovial cyst of the hip. An unusual pathology for the orthopedic surgeon. Apropos of 2 cases].

A synovial cyst of the hip was identified by CT scan in two cases of iliac and/or femoral vein compression. In one of these cases, incomplete resection required radical treatment of the underlying condition, osteoarthritis of the hip. The authors discuss the clinical signs, aetiopathogenesis and treatment of this disease which, although rare, has been frequently reported in the literature over the last decade.

Biopsy↗
PubMed1979

[Compartment syndrome of the leg (author's transl)].

The authors have observed ten compartment syndromes of the leg. Nine occurred after tibial fractures, one after a contusive trauma. Early signs those of muscular and neural ischemia, with an acute pain when the toes are passively mobilised. The cast must be promptly removed. In 6 cases the two compartments were involved. In all cases the pulses were palpable. Arteriographs could occasionaly verify the integrity of the main arterial trunks. The treatment is based on early fasciotomies. It was realised in 5 cases, with good results when the fasciotomy was realised more than twelve hours after the trauma, the muscles were more or less necrotic. In one case all the muscles of the leg had to be excised.

Adult↗
PubMed1977

[Aseptic osteonecrosis in the renal transplant patient. Apropos of 27 surgically treated cases].

The authors have treated 27 cases of avascular necrosis of bone in patients following renal transplantation. They have noted some specific features--early onset after transplantation, multiple localization and rapid and severe progress of the lesion. The authors discuss the pathogenesis as it relates to cortico-steroids, bone dystrophy due to renal failure and the effects of dialysis. Surgical treatment requires special care because of the poor general condition of the patient. Operations have been done on 20 hips (12 forages, 1 cup arthroplasty, 2 Moore prostheses, 5 total prostheses) and 7 knees (1 forage, 6 removal of loose bodies). Two procedures were found to be valuable at the hip--forage at a very early stage and total prosthetic replacement. The indications for operation depend on the degree of functional disability. For the knee, necrosis affected both the femoral and tibial component resulting in effusion and locking. The only useful procedure seemed to be removal of loose bodies. In every case, surgical procedures must be conducted under careful and constant medical supervision.

Adolescent↗
PubMed1977

[Fatigue fractures: apropos of 8 cases].

Eight cases of fatigue fracture were observed by the authors. In two patients, they presented in metatarsal bones; others were in the lower end of the tibia, in the shaft of the fibula, in the patella, at the upper end of the fibula, in the shaft to the tibia and in the neck of the femur. The main features of these fractues, which occurred in previously intact bones, are reviewed. The role of previous muscle imbalance, or metabolic disturbance, (by age or in pregnancy) is discussed. Good results were obtained by simple immobilization. Surgery may be indicated in the two situations: 1. To eliminate the possibility of a bone tumour by biopsy and, 2. For internal fixation in special sites such as the femoral neck to avoid coxa vara or when healing is very slow, as occurs particularly in the femoral shaft.

Adult↗
PubMedDate not supplied

[Bimalleolar fractures and their equivalents].

The authors have reviewed 194 malleolar fractures. 164 cases were treated conservatively. Less of half of them led to satisfactory results. 44 cases were operated on either primitively or after failure of conservative treatment. 29 satisfactory results were noted on 33 cases reviewed after a one year (or more) follow-up. Both foci were systematically approached, including the cases where a ruptured fragment existed in place of the malleolar fracture. Important third posterior fragments were fixed by a postero-lateral approach in prone position. Usually the lateral malleoli were fixed by screwing or plating or wiring. Medial malleoli were fixed by screwing or wiring. In some cases, collapse of the tibial roof had to be treated by grafting. The authors emphasize the importance of a fair repair of such lesions which should be recognized by tomographs. Indications are detailed. In any case, treatment should be applied in emergency for avoiding early blisters.

Adult↗
PubMedDate not supplied

[Failures and limitations of the Papineau technic. A report of 54 cases].

The authors have treated 41 cases by Papineau's technique. There were 19 cases of osteitis, and 35 septic non-unions (9 in the femur, 16 in the tibia and 10 in other sites). Twenty-four cases healed, the average follow-up being one year. The causes of failure were analysed. Some are related to the technique itself - sepsis and fractures at the sites of graft removal, inadequate quantities of cancellous bon, long delay in bone union and skin problems particularly in the leg. The indications for this technique are compared with those of other techniques. It is concluded that it is a useful technique; only two patients required amputation.

Adult↗
PubMedDate not supplied

[Severe fractures of the lower end of the humerus in adults (author's transl)].

The authors have treated sixty six cases of severe comminuted fracture of the lower end of the humerus. Five main types have been distinguished: 1. Supracondylar fractures. 2. T-shaped fractures. 3. Trans-condylar fractures in which the fracture line is distal, detaching only the articular surfaces. 4. Diaphyso-epiphysial fractures. 5. Trans-columnar fractures similar to transcondylar fractures but with additional fractures detaching a fragment of lateral or medial epicondyle and a fracture through the trochlea separating the articular surface into two parts. Fifty-four patients were operated on to apply internal fixation. Analysis of the results based on critical criteria shows 53 p. 100 of satisfactory results. The authors emphasise the frequency and severity of damage to the ulnar nerve. They conclude that the results are better after surgical treatment than with conservative treatment which should be reserved for distal and comminuted fractures. A new type of plate has been designed to be applied and fixed to the lateral aspect of the bone.

Adolescent↗