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R Parot

Publications and source records attributed to R Parot.

5 recordsLinked to original sources
PubMed2006

[Transverse sacral fracture in children: a case report presenting with neurological injury and review of the literature].

Transverse fractures of the sacrum are exceptional in children. We report a case in a 10-year-old girl. The patient presented an isolated flexion fracture of the sacrum in Denis zone III (transverse "U" fracture) of S1-S2 with neurological signs at the initial examination: sensorial deficit in the perineum and sphincter dysfunction. Treatment consisted in laminectomy and bone resection to relieve compression causing the neurological injury. Orthopedic treatment led to correct bone healing. Outcome was favorable with complete resolution of the neurological deficit and stability at three years. Eight cases of transverse sacral fracture before the age of 18 years have been reported in the literature. The diagnostic elements are similar to those in adults, but can be missed in children who rarely present sacral fracture. The therapeutic approach has varied, both for children and adults. We advocate surgical treatment in the event of neurological complications and orthopedic treatment of stable bone lesions.

Child↗
PubMed2002

[Initial management of congenital varus equinus clubfoot by Ponseti's method].

The choice of first-line treatment for congenital varus equine clubfoot remains a controversial issue largely dependent on experience. In France, functional treatment predominates. In 1948, Ponseti proposed reducing the deformity with successive casts. Although cast treatment is a very old method, Ponseti's method is original because it is based on strict rules established from anatomic evidence. The goal is not to correct the apparent deformation, but on the contrary to impose a simultaneous supination and abduction of the foot. Once the calcaneopedal block has been derotated, percutaneous tenotomy of the Achilles tendon is performed. We relate our experience with this method and recall the precise technique used to make the casts. After the cast, derotation braces are worn at night but rehabilitation exercises are not required. We emphasize the quality of the clinical reduction achieved as well as the smaller number of patients who require surgery at walking age.

Achilles Tendon↗
PubMed2002

[Scoliosis and congenital diaphragmatic agenesis].

PURPOSE OF THE STUDY: Diaphragmatic agenesis is the most extreme anatomic form of congenital diaphragmatic defects. Clinically this pathology is not different from posterolateral diaphragmatic hernia described by Bochdalek. We describe our observations of scoliosis in 16 neonates with diaphragmatic agenesis. MATERIAL AND METHODS: Between 1987 and 1996, 69 neonates underwent surgery for a congenital diaphragmatic hernia (CDH) at our institution. Sixteen of these patients had the most extreme form of CDH. Ten of these 16 patients survived. Spinal and/or chest wall deformities were observed in nine patients, including isolated scoliosis in two patients, scoliosis associated with a chest wall deformity in three, and isolated chest wall deformity (pectus excavatum or pectus carnium) in four. These deformities developed between 13 months and three and a half years of age (mean: two years). RESULTS: For two patients the deformity was mild (Cobb angle<15 degrees ) and required only observation. A Milwaukee brace was used in three patients that had severe kyphoscoliosis. Isolated chest wall deformities were treated with observation. No patient required operative treatment for these skeletal deformities. DISCUSSION: The preliminary results of this study indicate that chest wall deformities and scoliosis frequently occur during surgery for diaphragmatic agenesis. Nonoperative treatment is usually sufficient, however, follow-up of these patients until adulthood is recommended.

Abnormalities, Multiple↗
PubMed1999

[Prognostic factors of secondary complications in pediatric traumatology: a prospective study of 700 patients].

BACKGROUND: The objective of the study was to estimate prevalence of therapeutic complications in a department of orthopedics pediatric surgery, and to determine predictors of minor and serious complications. METHODS: Between November 1996 and 1997, children less than or equal to 17 years of age, admitted for bone fracture (head and face excepted) were selected in a prospective study. In all, 700 children were treated until bone consolidation. Individual, socio-economic, anatomical, environmental and therapeutic factors were progressively registered. All complications were noted. RESULTS: The mean age of the children was 9.2 years; 25 patients could not be traced. Prevalence rate of therapeutic complications was 10.3%. In multivariate analysis using logistic regression, six factors increased the risk of adverse event: kind of fracture (diaphysial), comminuted aspect, compounded fracture and bone displacement, season (spring and autumn), and use of medical transport between accident place and hospital. The same factors, season and compounded fracture excepted, were predictors of serious complications. CONCLUSION: The results show that therapeutic complications depend on anatomical and environmental factors above all, and that medical procedure is not a prognosis factor. So if prevention of fractures is possible before injury, a better knowledge of initial risk can improve prevention of complications.

Adolescent↗