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Biomedical subjects

P Trouilloud

Publications and source records attributed to P Trouilloud.

8 recordsLinked to original sources
PubMed1992

[A nail for progressive lengthening. An animal experiment with a 2-year follow-up].

The elongation nail was experimented on 10 pure-breed Romanov ewes aged 9 to 12 month-old. It was implanted in a randomly chosen femur, the other femur being used as a control. After a superior and lateral approach to the femur, drilling and initial distraction averaging 26 mm, the nail was inserted and locked at both ends. Lengthening began at D1 by alternate inward and outward rotation maneuvers exerted on the pelvic limb. One ewe presented an intraoperative hip dislocation, another one unlocked the upper lock, with secondary shortening. The other 8 ewes underwent successful lengthening without apparently suffering (63-mm gain, i.e. 37% at the end of lengthening). Two ewes died at 9 months and their femura presented with a space remaining to fill smaller than 3 mm. Five of the other 6 ewes were followed up for an average of 10 months after bone healing and nail removal, over a total follow-up of 2 years. The femur is modified all over its diaphysis and widened at the level of the regenerated tissue, where cortical bone is thinner but has a normal lamellar appearance. Bone marrow is replaced by trabecular bone filled with fatty marrow. The pathology study of the last of the 6 ewes followed up for 2 years showed a bridge between both sites of incipient regeneration, indicating bone healing. The final gain as compared to the non-operated side is 27%. Progressive lengthening can be performed with an internal fixator in animals. The clinical trial in progress with allow evaluating this technique and establishing its field of application.

Animals↗
PubMed1991

Lower limb-length discrepancy. An epidemiologic study.

Two retrospective epidemiologic studies have examined the incidence and prevalence of significant lower limb-length discrepancy and the number of surgical corrections by lengthening in 1987 in France. The incidence of apparatus prescriptions for asymmetry correction filled was 2.16 per 100,000 population. The prevalence of people using a corrective apparatus was one per 1000 population. The male-to-female ratio was 1.95:1. Because of biases in the study population, the actual incidence and prevalence of significant limb-length discrepancies is likely to be considerably higher. A questionnaire administered to surgeons of the French Orthopedic Society revealed that the majority of surgical lengthenings were performed by large orthopedic teams. In the 418 procedures reported, the tibia was lengthened more often than the femur (ratio 1.1:1). Gradual distraction techniques were used in 89.4% of cases, with the Ilizarov apparatus used in 57.4%, the Wagner apparatus in 20.6%, and the Orthofix fixator in 11.2%. Immediate distraction techniques were used in 7.9% of cases, 85% of which were done on the femur. Average total lengthening was 51 mm for tibia and femur. Average lengthening was greater for methods of gradual distraction (53.5 mm) than for immediate distraction (31.4 mm).

Adolescent↗
PubMed1988

[Variations in the calcaneo-fibular ligament (lig. calcaneofibulare). Application to the kinematics of the ankle].

The authors observe variations in the calcaneo-fibular ligament because this ligament controls two articulations, the talo-crural and the subtalar. This study is based on the dissection of the ankle of 20 specimens. The calcaneo-fibular ligament is reinforced by the ventral and lateral talo-calcaneus ligaments with variations. 3 types of disposition have been described. Type A: A lateral talo-calcaneal ligament reinforces the calcaneo-fibular ligament. These two ligaments are divergent on the proximal, medial, or distal part. Type B: There is an independent lateral talo-calcaneal ligament forward of the calcaneo-fibular ligament. Type C: A ventral talo-calcaneal ligament is observed, parallel to the interosseous ligament. The authors consider the consequences of variation in the lateral ligaments of the ankle for the functioning of the tibio-tarsal articulation, the subtalar articulation and the astragalo-scaphoid articulation in order to propose specific radiographic examination of the kinematics of the ankle.

Ankle Joint↗
PubMed1987

Anatomic basis of a superior approach to the acetabulum with osteotomy of the ala of the ilium.

This study demonstrates the importance of a superior approach to acetabulum with intrapelvic osteotomy of the iliac ala in certain fractures of the acetabulum. This study is based on the dissection of 15 formolized and 5 frozen subjects, the surgical treatment of 17 acetabular fractures, and the performances of 2 Chiari-type osteotomies and 2 Salter-type osteotomies. We investigated the gluteus medius muscle and its pedicle in relation to the iliac ala. Landmarks for the osteotomy lines and the gluteal pedicles are defined in terms of the requirements of different surgical approaches. The superior approach for acetabular fractures was made using a skin incision of Smith-Petersen type. The underlying principle is the performance of an intrapelvic osteotomy of the iliac ala, the anterosuperior part of the ala being tilted outward and backward and pedicled on the gluteal muscles. This provides intra- and extrapelvic exposure of the acetabular walls. The advantages and drawbacks of this route of approach in surgery of the pelvic girdle are discussed in terms of the types of fracture treated and tumoral locations. The anatomic findings are illustrated from traumatology and tumoralpathology. This approach seems particularly suitable for acetabular fractures interrupting the pelvic ring.

Acetabulum↗
PubMed1985

Extensor tendon injuries. Presentation of a series of ninety-nine cases.

A series of 99 cases of injuries of the extensor system, followed in the 3 Traumatology and Orthopedics Ward (Dijon, France) is presented. Results were analyzed according to Verdan's classification. In most cases, a Jenning "barb-wire" type repair, introduced in France by Y. Allieu, was made. Early mobilization and skin tension problems are emphasized; two cases of degloving on the dorsum of the hand are presented with details. As well, a special place concerning the results of repair in the proximal interphalangeal joint must be reserved, because of the very frequent association of articular destruction and the very difficult problem s of surgical management which arise in these cases.

Early Ambulation↗