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Traitement des luxations récentes du coude : à propos de 30 cas / O. LARNZAF in Journal de traumatologie du sport, Volume 31 numéro 1 (Mars 2014)
[article]
Titre : Traitement des luxations récentes du coude : à propos de 30 cas Titre original : Treatment of acute elbow dislocations: About 30 cases Type de document : texte imprimé Auteurs : O. LARNZAF, Auteur ; A. EL BARDOUNI, Auteur Année de publication : 2014 Article en page(s) : p.12-17 Langues : Français (fre) Mots-clés : Luxation récente Coude Traitement Acute dislocation Elbow Treatment Résumé : Résumé
Les luxations du coude se rencontrent dans les sports de contact et autres disciplines extrêmes. Cette étude rétrospective a porté sur 30 cas de luxations du coude, colligés entre 2007 et 2012. L’âge moyen de nos patients était de 36 ans, tous de sexe masculin et victimes de traumatismes violents au cours de compétitions équestres locales. La luxation était postérolatérale dans 23 cas et postérieure pure dans les sept autres. Cette atteinte était associée à une fracture de la tête radiale dans six cas et à un arrachement de l’épicondyle médial chez un patient. Tous les sujets ont bénéficié d’une réduction en urgence, sous sédation ou sous anesthésie générale. Les fractures de la tête radiale ont été traitées par un vissage dans quatre cas et une résection dans deux cas. Nous avons également réalisé un vissage pour la fracture de l’épicondyle. Le traitement a été complété par une immobilisation antalgique pendant une dizaine de jours suivie d’une mobilisation active pour 22 patients, chez qui le coude était jugé parfaitement stable. Pour les huit autres patients, une mobilisation dans le secteur de stabilité, protégée par une orthèse articulée, a été instaurée pendant une durée minimum de 45 jours. Après un recul moyen de 22 mois, un secteur de mobilité en flexion-extension supérieur à 100° a été obtenu chez plus de 80 % des patients et seuls deux cas ont gardé une raideur sévère. Les résultats globaux, évalués selon le Mayo Elbow Performance Score, ont été bons à très bons chez 25 patients, moyens chez trois patients et mauvais dans deux cas seulement. La reprise sportive s’est faite progressivement et le retour à la compétition n’a été autorisé qu’à partir du sixième mois.
Abstract
Elbow dislocations are encountered in contact sports and other extreme sports. This retrospective study included 30 cases of elbow dislocations, treated between 2007 and 2012. The average age of our patients was 36 years, all male and victims of violent trauma in local equestrian competitions. The dislocation was posterolateral in 23 cases and direct posterior in the other seven. This involvement was associated to a fracture of the radial head in six cases and a medial epicondyle tear in a patient. All subjects had a reduction under sedation or general anesthesia. Fractures of the radial head were treated by screwing in four cases and resection in two cases. We also made screwing for the epicondyle fracture. The treatment was completed by analgesic immobilization for about 10 days followed by active mobilization in 22 patients, in whom the elbow was considered perfectly stable. In eight patients, mobilization in the area of stability, protected by an articulated orthosis, was established for a minimum of 45 days. After a mean follow-up of 22 months, a range of motion for flexion-extension greater than 100° was achieved in 80% of patients and only two cases have kept a severe stiffness. The overall results, as assessed using the Mayo Elbow Performance Score, were good to very good in 25 patients, fair in three patients and poor in only two cases. The sport recovery was gradual and the return to competition was not allowed before the sixth month.Permalink : ./index.php?lvl=notice_display&id=34499
in Journal de traumatologie du sport > Volume 31 numéro 1 (Mars 2014) . - p.12-17[article] Traitement des luxations récentes du coude : à propos de 30 cas = Treatment of acute elbow dislocations: About 30 cases [texte imprimé] / O. LARNZAF, Auteur ; A. EL BARDOUNI, Auteur . - 2014 . - p.12-17.
Langues : Français (fre)
in Journal de traumatologie du sport > Volume 31 numéro 1 (Mars 2014) . - p.12-17
Mots-clés : Luxation récente Coude Traitement Acute dislocation Elbow Treatment Résumé : Résumé
Les luxations du coude se rencontrent dans les sports de contact et autres disciplines extrêmes. Cette étude rétrospective a porté sur 30 cas de luxations du coude, colligés entre 2007 et 2012. L’âge moyen de nos patients était de 36 ans, tous de sexe masculin et victimes de traumatismes violents au cours de compétitions équestres locales. La luxation était postérolatérale dans 23 cas et postérieure pure dans les sept autres. Cette atteinte était associée à une fracture de la tête radiale dans six cas et à un arrachement de l’épicondyle médial chez un patient. Tous les sujets ont bénéficié d’une réduction en urgence, sous sédation ou sous anesthésie générale. Les fractures de la tête radiale ont été traitées par un vissage dans quatre cas et une résection dans deux cas. Nous avons également réalisé un vissage pour la fracture de l’épicondyle. Le traitement a été complété par une immobilisation antalgique pendant une dizaine de jours suivie d’une mobilisation active pour 22 patients, chez qui le coude était jugé parfaitement stable. Pour les huit autres patients, une mobilisation dans le secteur de stabilité, protégée par une orthèse articulée, a été instaurée pendant une durée minimum de 45 jours. Après un recul moyen de 22 mois, un secteur de mobilité en flexion-extension supérieur à 100° a été obtenu chez plus de 80 % des patients et seuls deux cas ont gardé une raideur sévère. Les résultats globaux, évalués selon le Mayo Elbow Performance Score, ont été bons à très bons chez 25 patients, moyens chez trois patients et mauvais dans deux cas seulement. La reprise sportive s’est faite progressivement et le retour à la compétition n’a été autorisé qu’à partir du sixième mois.
Abstract
Elbow dislocations are encountered in contact sports and other extreme sports. This retrospective study included 30 cases of elbow dislocations, treated between 2007 and 2012. The average age of our patients was 36 years, all male and victims of violent trauma in local equestrian competitions. The dislocation was posterolateral in 23 cases and direct posterior in the other seven. This involvement was associated to a fracture of the radial head in six cases and a medial epicondyle tear in a patient. All subjects had a reduction under sedation or general anesthesia. Fractures of the radial head were treated by screwing in four cases and resection in two cases. We also made screwing for the epicondyle fracture. The treatment was completed by analgesic immobilization for about 10 days followed by active mobilization in 22 patients, in whom the elbow was considered perfectly stable. In eight patients, mobilization in the area of stability, protected by an articulated orthosis, was established for a minimum of 45 days. After a mean follow-up of 22 months, a range of motion for flexion-extension greater than 100° was achieved in 80% of patients and only two cases have kept a severe stiffness. The overall results, as assessed using the Mayo Elbow Performance Score, were good to very good in 25 patients, fair in three patients and poor in only two cases. The sport recovery was gradual and the return to competition was not allowed before the sixth month.Permalink : ./index.php?lvl=notice_display&id=34499 Exemplaires (1)
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Exclu du prêtOutcomes Of Bilateral Sacroiliac Joint Fusions And The Importance Of Understanding Potential Coexisting Lumbosacral Pathology That Might Also Require Surgical Treatment / Bruce E. DALL in Acta Orthopaedica Belgica, Vol 81/2 (Juin 2015)
[article]
Titre : Outcomes Of Bilateral Sacroiliac Joint Fusions And The Importance Of Understanding Potential Coexisting Lumbosacral Pathology That Might Also Require Surgical Treatment Type de document : texte imprimé Auteurs : Bruce E. DALL, Auteur ; Sonia V. EDEN, Auteur Année de publication : 2015 Article en page(s) : p.233-239 Langues : Anglais (eng) Mots-clés : Sacroiliac joint fusion surgery, outcomes bilateral lumbosacral algorithm treatment Résumé : Only one study in the literature describes performing a bilateral sacroiliac joint fusion, and the results were poor. Many patients needing a bilateral sacroiliac joint fusion frequently have had previous lumbosacral surgeries and present with lumbosacral pain as well. This study reviews our results in consecutive patients having had a bilateral sacroiliac joint fusion over a five-year period. Fifteen patients had bilateral sacroiliac joint fusions with 13 having concurrent lumbosacral fusions. The modified posterior midline fascial splitting approach, first described by Belanger was utilized. Patients were followed for an average of 30.3 months. There were no infections, neurovascular injuries, lasting morbidity or deaths. One non-union of a sacroiliac joint (7%) occurred, which after revision was satisfactory. There was a statistically significant drop in pain (p = 0.01488) using the VAS, and patient satisfaction rates were 86%. With all those patients saying they would have the surgery again for the same result. There was no significant increase in functionality. Patients needing bilateral sacroiliac joint fusions frequently fall into the “failed back” category, and it is important to evaluate both the sacroiliac joints and the lumbosacral spine for potential pain generators. This study shows that by treating all the pain generators in both areas there were significant decreases in pain, low complications, low re-operation rates, and high patient satisfaction scores. Overall functionality, however, was not positively affected. Permalink : ./index.php?lvl=notice_display&id=40565
in Acta Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.233-239[article] Outcomes Of Bilateral Sacroiliac Joint Fusions And The Importance Of Understanding Potential Coexisting Lumbosacral Pathology That Might Also Require Surgical Treatment [texte imprimé] / Bruce E. DALL, Auteur ; Sonia V. EDEN, Auteur . - 2015 . - p.233-239.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.233-239
Mots-clés : Sacroiliac joint fusion surgery, outcomes bilateral lumbosacral algorithm treatment Résumé : Only one study in the literature describes performing a bilateral sacroiliac joint fusion, and the results were poor. Many patients needing a bilateral sacroiliac joint fusion frequently have had previous lumbosacral surgeries and present with lumbosacral pain as well. This study reviews our results in consecutive patients having had a bilateral sacroiliac joint fusion over a five-year period. Fifteen patients had bilateral sacroiliac joint fusions with 13 having concurrent lumbosacral fusions. The modified posterior midline fascial splitting approach, first described by Belanger was utilized. Patients were followed for an average of 30.3 months. There were no infections, neurovascular injuries, lasting morbidity or deaths. One non-union of a sacroiliac joint (7%) occurred, which after revision was satisfactory. There was a statistically significant drop in pain (p = 0.01488) using the VAS, and patient satisfaction rates were 86%. With all those patients saying they would have the surgery again for the same result. There was no significant increase in functionality. Patients needing bilateral sacroiliac joint fusions frequently fall into the “failed back” category, and it is important to evaluate both the sacroiliac joints and the lumbosacral spine for potential pain generators. This study shows that by treating all the pain generators in both areas there were significant decreases in pain, low complications, low re-operation rates, and high patient satisfaction scores. Overall functionality, however, was not positively affected. Permalink : ./index.php?lvl=notice_display&id=40565 Exemplaires (1)
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Exclu du prêtSignificance Of Spinal Canal And Dural Sac Dimensions In Predicting Treatment Of Lumbar Disc Herniation / Shuai YUAN in Acta Orthopaedica Belgica, Vol 80/4 (Décembre 2014)
[article]
Titre : Significance Of Spinal Canal And Dural Sac Dimensions In Predicting Treatment Of Lumbar Disc Herniation Type de document : texte imprimé Auteurs : Shuai YUAN, Auteur Année de publication : 2014 Article en page(s) : p.575-581 Langues : Anglais (eng) Mots-clés : lumbar disc herniation spinal canal dural sac MRI parmeter treatment Résumé : This retrospective study was performed to investigate the significance of quantitative MRI measurements of spinal canal and dural sac dimensions for treatment decisions and clinical outcome of lumbar disc herniation. 182 patients (111 nonsurgical patients and 71 surgical patients) were included, while 78 nonsurgical patients and 50 surgical patients were enrolled in the final follow-up. The initial JOA score in nonsurgical patients was significantly superior to surgical patients (t-test : p < 0.001), whereas the final JOA score and the rate of improvement were not significantly different between the two groups of patients (t-test : p > 0.05). 88.46% of nonsurgical patients and 90.00% of surgical patients had a good or excellent outcome (chi-square test : p > 0.05). However, if the 16 recurrent cases were included, the proportions dropped to 75.82% and 84.90% for nonsurgical and surgical patients, respectively. Compared with nonsurgical patients, quantitative parameters, such as midsagittal diameter and available diameter of spinal canal, lateral recess width and cross-sectional areas of spinal canal and dural sac, were significantly smaller in surgical patients (t-test : p < 0.001), and was reflected in the initial JOA score (128 cases ; Spearman rank correlation coefficient : r 0.01 = 0.486, 0.499, 0.493, 0.507, 0.484 ; p < 0.001). The spinal canal and dural sac dimensions were important predictive factors for treatment selection of lumbar disc herniation. Permalink : ./index.php?lvl=notice_display&id=34680
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.575-581[article] Significance Of Spinal Canal And Dural Sac Dimensions In Predicting Treatment Of Lumbar Disc Herniation [texte imprimé] / Shuai YUAN, Auteur . - 2014 . - p.575-581.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.575-581
Mots-clés : lumbar disc herniation spinal canal dural sac MRI parmeter treatment Résumé : This retrospective study was performed to investigate the significance of quantitative MRI measurements of spinal canal and dural sac dimensions for treatment decisions and clinical outcome of lumbar disc herniation. 182 patients (111 nonsurgical patients and 71 surgical patients) were included, while 78 nonsurgical patients and 50 surgical patients were enrolled in the final follow-up. The initial JOA score in nonsurgical patients was significantly superior to surgical patients (t-test : p < 0.001), whereas the final JOA score and the rate of improvement were not significantly different between the two groups of patients (t-test : p > 0.05). 88.46% of nonsurgical patients and 90.00% of surgical patients had a good or excellent outcome (chi-square test : p > 0.05). However, if the 16 recurrent cases were included, the proportions dropped to 75.82% and 84.90% for nonsurgical and surgical patients, respectively. Compared with nonsurgical patients, quantitative parameters, such as midsagittal diameter and available diameter of spinal canal, lateral recess width and cross-sectional areas of spinal canal and dural sac, were significantly smaller in surgical patients (t-test : p < 0.001), and was reflected in the initial JOA score (128 cases ; Spearman rank correlation coefficient : r 0.01 = 0.486, 0.499, 0.493, 0.507, 0.484 ; p < 0.001). The spinal canal and dural sac dimensions were important predictive factors for treatment selection of lumbar disc herniation. Permalink : ./index.php?lvl=notice_display&id=34680 Exemplaires (1)
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Exclu du prêtFate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively / Aditya AGGARWAL in Acta Orthopaedica Belgica, Vol 80/4 (Décembre 2014)
[article]
Titre : Fate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively Type de document : texte imprimé Auteurs : Aditya AGGARWAL, Auteur Année de publication : 2014 Article en page(s) : p.451-456 Langues : Anglais (eng) Mots-clés : cervical spine tuberculosis kyphotic deformity non operative treatment Résumé : Study design : Retrospective study Objective : Observation of post treatment kyphotic angle in patient of cervical spine tuberculosis managed non operatively Background : The incidence of tuberculosis of cervical spine is about 6-9%. The most dreaded complications of spinal tuberculosis are neural involvement and spinal deformity. Due to destruction of the vertebra tuberculosis of spine usually leads to variable amount of kyphotic deformity. Methods : We retrospectively reviewed 13 patients with clinico-radiological diagnosis of cervical spine tuberculosis managed in our centre between 2004 to 2011. The patients were started on antitubercular therapy. Crutchfield tongs traction was applied 8 to 12 weeks followed by mobilization with four post collar. The kyphotic angles were measured by radiograph at presentation and last available follow up radiograph. Observations : The mean age of the patients was 20 years. C3-C4 vertebra was the most commonly involved area. One patient had single vertebra involvement, five patients had two vertebrae involvement, five patients had three vertebrae involvement and two patients had four vertebrae involvement. The average number of vertebrae involved was 2.6 vertebrae. 9 out of 13 patients had neural deficit at the time of initial presentation. The mean follow up was 21.23 months (12 to 42 months). All patients responded favorably and had neural recovery. At final follow up, 10 out of 13 patients had improvement in kyphotic angle, two patients had deterioration of kyphotic angle and one patient had no change in kyphotic angle. Only one patient had significant deterioration in kyphotic angle. Conclusion : Non operative treatment of cervical spine tuberculosis by initial traction and antitubercular therapy improves the pretreatment deformity irrespective of the number of vertebra involved. Permalink : ./index.php?lvl=notice_display&id=34663
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.451-456[article] Fate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively [texte imprimé] / Aditya AGGARWAL, Auteur . - 2014 . - p.451-456.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.451-456
Mots-clés : cervical spine tuberculosis kyphotic deformity non operative treatment Résumé : Study design : Retrospective study Objective : Observation of post treatment kyphotic angle in patient of cervical spine tuberculosis managed non operatively Background : The incidence of tuberculosis of cervical spine is about 6-9%. The most dreaded complications of spinal tuberculosis are neural involvement and spinal deformity. Due to destruction of the vertebra tuberculosis of spine usually leads to variable amount of kyphotic deformity. Methods : We retrospectively reviewed 13 patients with clinico-radiological diagnosis of cervical spine tuberculosis managed in our centre between 2004 to 2011. The patients were started on antitubercular therapy. Crutchfield tongs traction was applied 8 to 12 weeks followed by mobilization with four post collar. The kyphotic angles were measured by radiograph at presentation and last available follow up radiograph. Observations : The mean age of the patients was 20 years. C3-C4 vertebra was the most commonly involved area. One patient had single vertebra involvement, five patients had two vertebrae involvement, five patients had three vertebrae involvement and two patients had four vertebrae involvement. The average number of vertebrae involved was 2.6 vertebrae. 9 out of 13 patients had neural deficit at the time of initial presentation. The mean follow up was 21.23 months (12 to 42 months). All patients responded favorably and had neural recovery. At final follow up, 10 out of 13 patients had improvement in kyphotic angle, two patients had deterioration of kyphotic angle and one patient had no change in kyphotic angle. Only one patient had significant deterioration in kyphotic angle. Conclusion : Non operative treatment of cervical spine tuberculosis by initial traction and antitubercular therapy improves the pretreatment deformity irrespective of the number of vertebra involved. Permalink : ./index.php?lvl=notice_display&id=34663 Exemplaires (1)
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Exclu du prêtLuxations carpo-métacarpiennes irréductibles des doigts longs. Présentation et revue générale de la littérature. (À propos d’un cas) / H. BOUSSAKRI in Journal de traumatologie du sport, Volume 31 numéro 4 (Décembre 2014)
[article]
Titre : Luxations carpo-métacarpiennes irréductibles des doigts longs. Présentation et revue générale de la littérature. (À propos d’un cas) Titre original : Carpo-metacarpal irreducible dislocations of the long fingers. Case report with literature review Type de document : texte imprimé Auteurs : H. BOUSSAKRI, Auteur ; F. DUSSERRE, Auteur Année de publication : 2014 Article en page(s) : p.219-223 Langues : Français (fre) Mots-clés : Articulations carpo-métacarpiennes Luxations irréductibles Traitement Carpo-metacarpal joints Irreducible dislocations Treatment Résumé : Nous rapportons un cas de luxations multiples des articulations carpo-métacarpiennes des doigts longs survenues après un traumatisme fermé de la main droite lors d’un match de volley-ball. Il s’agit de luxations dorsales carpo-métacarpiennes des doigts longs (pouce exclu), sans aucune fracture associée. Nous les avons traitées par une réduction à foyer ouvert, après échec du traitement orthopédique puis stabilisation par embrochage suivie d’une immobilisation de 4 semaines. La rééducation a été débutée précocement et poursuivie plusieurs semaines après ablation des broches. Au dernier recul de 8 mois, le résultat fonctionnel était satisfaisant, avec une bonne force musculaire et une récupération complète de la mobilité du poignet, des doigts en flexion-extension. Le patient a pu reprendre ses activités quotidiennes et sportives. La difficulté du diagnostic, le mécanisme de survenue ainsi que le traitement sont discutés.
We report a case of traumatic multiple dislocations of the carpo-metacarpal joints without dislocation of the first metacarpal base joint during a volleyball game. This injury is uncommon and has been reported rarely. We performed open reduction and wire fixation after failure of the orthopedic treatment. At 8 months follow-up, the functional outcome was satisfactory with good muscle strength and good range of motion was preserved. The patient has been able to return to all his daily and sports activities. The difficulty of diagnosis, mechanism of the injury and treatment are discussed.Permalink : ./index.php?lvl=notice_display&id=34529
in Journal de traumatologie du sport > Volume 31 numéro 4 (Décembre 2014) . - p.219-223[article] Luxations carpo-métacarpiennes irréductibles des doigts longs. Présentation et revue générale de la littérature. (À propos d’un cas) = Carpo-metacarpal irreducible dislocations of the long fingers. Case report with literature review [texte imprimé] / H. BOUSSAKRI, Auteur ; F. DUSSERRE, Auteur . - 2014 . - p.219-223.
Langues : Français (fre)
in Journal de traumatologie du sport > Volume 31 numéro 4 (Décembre 2014) . - p.219-223
Mots-clés : Articulations carpo-métacarpiennes Luxations irréductibles Traitement Carpo-metacarpal joints Irreducible dislocations Treatment Résumé : Nous rapportons un cas de luxations multiples des articulations carpo-métacarpiennes des doigts longs survenues après un traumatisme fermé de la main droite lors d’un match de volley-ball. Il s’agit de luxations dorsales carpo-métacarpiennes des doigts longs (pouce exclu), sans aucune fracture associée. Nous les avons traitées par une réduction à foyer ouvert, après échec du traitement orthopédique puis stabilisation par embrochage suivie d’une immobilisation de 4 semaines. La rééducation a été débutée précocement et poursuivie plusieurs semaines après ablation des broches. Au dernier recul de 8 mois, le résultat fonctionnel était satisfaisant, avec une bonne force musculaire et une récupération complète de la mobilité du poignet, des doigts en flexion-extension. Le patient a pu reprendre ses activités quotidiennes et sportives. La difficulté du diagnostic, le mécanisme de survenue ainsi que le traitement sont discutés.
We report a case of traumatic multiple dislocations of the carpo-metacarpal joints without dislocation of the first metacarpal base joint during a volleyball game. This injury is uncommon and has been reported rarely. We performed open reduction and wire fixation after failure of the orthopedic treatment. At 8 months follow-up, the functional outcome was satisfactory with good muscle strength and good range of motion was preserved. The patient has been able to return to all his daily and sports activities. The difficulty of diagnosis, mechanism of the injury and treatment are discussed.Permalink : ./index.php?lvl=notice_display&id=34529 Exemplaires (1)
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Exclu du prêtMorel-Lavallée lesion associated with atypical skin damage / Matteo Luisetto in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
PermalinkIntérêt de l’injection de plasma riche en plaquettes lors d’arthrose du coude chez le chien / Alexandre Thibault in Le Point vétérinaire Expert Canin, 407-408 (Juillet-Août 2020)
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