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R Seringe

Publications and source records attributed to R Seringe.

At least 19 recordsLinked to original sources
PubMed1992

[Congenital asymmetrical pelvis. Clinical, radiological study and outcome].

In congenital pelvic obliquity, there is a restricted abduction in one hip and an abduction contracture in the other. This association has been considered as a cause of acetabular dysplasia with progressive subluxation of the hip opposite to the abduction contracture. The clinical and radiological study of 120 children with an average follow-up of 3 years and 3 months permitted to demonstrate that two different types exist: the simple types (93 cases) without dysplasia, which never developed progressive subluxation and must not be treated, and the pelvic obliquities with dysplasia-subluxation-dislocation (27 cases) which have to be treated if the decentration of the hip opposite to the abduction contracture is marked. Distinguishing between these two types may be difficult because the X-ray is nearly never strictly correct because of the pelvic obliquity. This work leads to a better comprehension of the acetabular dysplasias who are subdivided into pseudodysplasias, secondary dysplasias and primary dysplasias. In the screening for the detection of congenital dislocation of the hip, it is essential that a pelvic obliquity be recognised because it constitutes a sign of hip at risk. Then, the clinical research of instability could be completed by echographic study in the two or three months or by radiographic study after 3 months in order to have a very precise diagnosis and apply the best treatment.

Acetabulum↗
PubMed1992

[Coxa vara in children. Apropos of 28 cases].

Infantile coxa-vara is an infrequent lesion and two etiologic factors have been recognised: mechanical and genetic. As in Blount's disease, the same populations (black and scandinavian people) are usually affected. Twenty eight patients with 42 infantile coxa vara were reviewed. The diagnosis was often late. The radiographs showed the decrease of the neck-shaft angle and the signs of cervical dystrophy. The aggravation of the coxa vara is usual and pseudarthrosis or osteo-arthritis can be observed. Thirty six femoral valgus sub-trochanteric osteotomies were done. The results were best when the surgery was done before the age of 9 years. When the surgery was done later, an epiphysiodesis of the greater trochanter was associated to the femoral osteotomy if the epiphyseal cartilage was fused. Langenskiold's osteotomy was used only when the neck-shaft angle was lower than 80 degrees. The results were evaluated according to the neck shaft angle and the morphology of the femoral head: 22 very good and good, 11 fair and 3 bad results were noted.

Adolescent↗
PubMed1991

[Screening and diagnosis of hip instability in newborn infants].

Instability is the clinical sign that characterizes congenital dislocation of the hip. The methods used to detect hip instability do not all have the same value, and snapping is only an accessory and inconstant sign. In case of doubt, ultrasonography with dynamic test may be a useful complement to clinical examination. The natural course of the disease being unpredictable, treating all dislocated hips seems to be justified. The author discusses the risks and reliability of clinical examination and the criteria of hips at risk of dislocation to conclude in favour of clinical detection.

Hip Dislocation, Congenital↗
PubMed1991

Minor tibial duplication: a new cause of congenital bowing of the tibia.

Five infants presented with a congenital anterolateral, unilateral bowing of the tibia. The fibula was normal but a bifid homolateral great toe was seen, associated with hand malformations. Plain films and CT disclosed a short tibial duplication, with distinct corticals. We do think that this abnormality represents a new entity, and may be related to a genetic anomaly. The long term follow up of our patients shows a spontaneously favourable prognosis without any association with pseudarthrosis. The only therapeutic problem is a limb length discrepancy.

Abnormalities, Multiple↗
PubMed1991

[Salter's single-stage bilateral pelvic osteotomy].

45 children (3 years 9 months old in average), suffering from congenital dislocation of the hip or acetabular dysplasia have sustained a bilateral innominate osteotomy in a single stage. Two different operative procedures have been used: "simultaneous osteotomy" (15 children) and "successive osteotomy" (30 children). The post-operative follow-up lasted 4 years 3 months. On both sides, the correction of acetabular deformity was obtained, the average value of the acetabular angle which was 36.6 in a pre-operative state, being 17.1 post-operative and 11.5 at the last follow-up. Complications were rare (3 superficial infections, 1 Kirschner wires migration and 2 hip instabilities which called for a capsulorraphy). The results were excellent for 83 hips, fair for 3 hips in 3 children (asymmetrical shift of the osteotomy) and poor for 4 hips in 3 children (who were contraindications of the Salter's osteotomy). The authors conclude that one-step bilateral innominate osteotomy is viable and simple. It makes a second operation unnecessary and results in a better angular gain compared to that obtained after unilateral osteotomy.

Blood Loss, Surgical↗
PubMed1990

[Congenital convexity of the feet. Anatomical study and practical conclusions].

The authors have studied the pathological anatomy of two congenital pes convex, (C.P.C) coming from an 8 days boy suffering of arthrogryposis. One of the feet has been dissected by stage whilst the other one has been operated on according to a procedure of correction of the deformities. The two feet combined an irreducible dislocation of the os naviculare on the neck of the talus, a calcaneo cuboïdeum subluxation, a moderate equinus of the hind foot, an important contracture of the extensor tendons and an elongation of the structural soft tissues of the sole. The main abnormalities of the talus and of the calcaneus involved the upper direction of the anterior articular facet, in relation to the dorsal dislocation of the os naviculare and the dorsal subluxation of the cuboïdeum. The subtalaris joint was little altered. The study of dissections and the clinical reports published connected with the observations of the authors confirm the pre-eminence of the transversal dislocation of the tarsus and of its irreducibility. On the other hand the abnormalities of the subtalar joint have been, probably over estimated. The sometimes important increase of talo calcaneal angle on A.P. radiographies may be explained by the incidence itself. The verticality of the talus is not a reliable feature of C.P.C. and the deformities of the fore foot are variable (pronation, supination). This study leads to a new definition of the C.P.C.: Congenital deformity of the foot with tarsi-transversa dislocation or subluxation involving mainly the talo-navicular joint. The criterious of diagnosis are debated and a logical surgical procedure of correction is suggested.

Ankle Joint↗
PubMed1990

[Pathogeny and natural history of congenital dislocation of the hip].

Based on a review of the literature, the authors have made a critical study of several etiological factors. Endogenous factors such as acetabular dysplasia, increased anteversion of the femoral neck, capsular laxity support the genetic theory but they are neither constant nor necessary and are only facilitating factors. The major factor seems to be a mechanical one linked to the position in uterus: hyperflexion with adduction and external rotation causing an abnormal pressure on the greater trochanter leading to an expulsion of the head upward and backward. This theory can explain the natural history of C D H which is first, at birth a hip unstability followed by to possible evolutions: either a persistent luxation becoming irreducible or a spontaneous stabilisation leading sometimes to complete healing or to residual abnormalities (subluxation or dysplasia). This concept suggests practical conclusions: the importance of an early diagnosis, the selection of the signs of the hip at risk the pattern of prevention, the importance of non clinical investigations, the principles of the treatment based on postures, the indications for the different types of treatment.

Animals↗
PubMed1990

[Idiopathic congenital club foot: results of functional treatment (269 feet)].

The manipulative treatment consisted of manipulations, muscular stimulations and fixation of the foot on a sole with non elastic strapping. This "functional" method used since the neonatal period was studied in 183 infants (269 clubfeet) with an average follow-up of 6 years and 2 months. A surgical release completed the correction in 139 feet. The initial examination permitted to distinguish 3 different grades of clubfeet, according to the clinical stiffness. The physiotherapist who treated the patients were separated in "specialized" and "unspecialized". During the evolution, 5 different categories were defined according to the clinical and radiological aspects. The criteria adopted for evaluating the results were scored with a screen of 100 points. The results obtained from 157 feet with a minimal follow-up of 4 years, were excellent and good in 86.6 per cent cases, fair in 10.2 per cent and poor in 3.2 per cent. The global results of the "functional" method, taking the insufficient follow-up into account, are for the whole series: success in 38.7 per cent, intermediary results in 15.6 per cent and failure in 45.7 per cent. The main factors which have a pejorative influence on the results are the irreducibility (according to the initial classification), the "unspecialized" physiotherapists, the socio-familial problems.

Clubfoot↗
PubMed1990

[Clinical examination of the hips in newborn infants].

The author describes the criteria for screening a hip at risk in the newborn. The following criteria are important: evaluation of abduction, fetal position of the lower limbs and instability. After examination, the hips are classified as normal, irreducible and questionable. A good clinical examination can clarify most of these diagnoses.

Fetus↗
PubMed1988

[Diagnostic difficulties of isolated symptomatic unilamellar periosteal appositions. Uncommon form of fatigue fracture in children].

We describe five cases of painful periosteal reaction occurring in children. The initial radiographic appearance of stress fracture may be troublesome since the new bone formation may be confused with malignant bone lesion. Because of the importance of making a correct diagnosis multiple imaging techniques will often be employed. We discuss the radiographic signs and their usefulness in the differential diagnostic of periosteal reaction.

Adolescent↗
PubMed1985

[Failure of Dwyer's procedure in internal pes cavus in children. Physiopathological considerations and therapeutic deductions].

The authors have performed 34 Dwyer's calcaneal osteotomies in children with pes cavus confined to the medial arch in non-paralytic lesions (poliomyelitis and spina bifida were excluded). In 12 cases it was associated with osteotomy of the 1st metatarsal or with plantar release. No arthrodeses were performed in these 34 cases. After an average follow-up of five years the results were doubtful: in 24 instances the deformity was the same or worse. In 21 cases a secondary operation was necessary. The authors considered that the Dwyer's procedure corrects only the varus of the heel which is a secondary deformity. They believe that, in pes cavus, there is a dynamic clawing of the toes in the swing phase of gait. This produces secondary deformities. In the sagittal plane there is a synergic or paralytic imbalance at the metatarso-phalangeal level leading to vertical displacement of the 1st metatarsal and deepening of the medial arch. In the frontal plane, this vertical displacement leads to an irreducible pronation of the forefoot with secondary varus of the heel. In the horizontal plane a lateral rotation of the talus results in varus of the calcaneum.

Adolescent↗