Prise en charge de la synovite transitoire de la hanche chez l'enfant

La synovite transitoire de la hanche (STH) est la cause la plus fréquente de boiterie aiguë chez l'enfant. Sa présentation clinique est peu spécifique et peut faire évoquer d'autres pathologies plus graves telles que l'arthrite septique de hanche. Au sein de notre institution, un enfant se présentant avec une douleur aiguë de hanche d'allure non traumatique bénéficiait d'un bilan complet visant à exclure la plupart des pathologies entrant dans le diagnostic différentiel de la STH. Notre travail a consisté à évaluer la nécessité d'effectuer un tel bilan et définir la pertinence de certains examens faits en routine. Nous avons également cherché à proposer un protocole de prise en charge des boiteries aiguës non traumatique de l'enfant. Nos résultats montrent que le bilan doit se limiter à exclure la présence d 'un phénomène infectieux aigu et que des examens plus spécifiques ne sont pas nécessaires de routine

Bénéfice de la chirurgie assistée par ordinateur en orthopédie : application au domaine du pied et de la cheville

In foot and ankle surgery accurate fracture reduction and implant placement may be challenging. Fracture malreduction or implant malposition may remain undetected with use of conventional fluoroscopy and are often only recognized on postoperative computed tomography (CT) scans. The development of a three-dimensional (3D) mobile imaging system has provided intraoperative control of fracture reduction and implant position. Three-dimensional computer assisted surgery (3D-CAS) has demonstrated improved accuracy in spine and pelvic surgery. Recently, the application of 3D-CAS in the field of foot and ankle surgery has shown very promising preliminary results. It appears that the intraoperative use of 3D imaging will become a standard of care

kyste synovial de l'hallux lié à la pratique de l'escalade

Rôle de surcharges mécaniques dans la pathogenèse des kystes synoviaux au niveau du pied chez les grimpeurs : étude de 3 ca

La prothèse totale de cheville : mise au point

La prothèse totale de cheville est de plus en plus reconnue dans la prise en charge de l’arthrose et s’est imposée comme une alternative à l’arthrodèse. Cependant, cette chirurgie reste délicate, les indications doivent être ciblées et la technique chirurgicale exige une expertise du chirurgien. Au cours des dernières années, la prothétique de cheville a connu un essor important et les nouvelles technologies ont fait leur apparition offrant des possibilités de planification et d’instrumentation sur mesure. L’influence de ces techniques sur les résultats au long terme reste à démontrer mais les avantages, comme la diminution du temps opératoire et l’amélioration de la précision chirurgicale, sont intéressants. Le but de cet article est de faire une mise au point sur la prothèse de cheville dans le traitement de l’arthrose de cheville

Gesture-Controlled Image Management for Operating Room: A Randomized Crossover Study to Compare Interaction Using Gestures, Mouse, and Third Person Relaying

In this work, we aim at comparing formally three different interaction modes for image manipulation that are usable in a surgery setting: 1) A gesture-controlled approach using Kinect ®; 2) oral instructions to a third part dedicated to manipulate the images; and 3) direct manipulation using a mouse

Factors affecting bone mineral mass loss after lower-limb fractures in a pediatric population

The purpose of this study was to assess the effects of the durations of cast immobilization and non-weight-bearing periods, and decreases in vigorous physical activity (VPA) on bone mineral parameters in a pediatric population treated for a lower-limb fracture

Diabetic foot infections: recent literature and cornerstones of management

PURPOSE OF REVIEW: Diabetes mellitus has reached pandemic levels and will continue to increase worldwide. Physicians and surgeons should know to manage one of its most prevalent complications, the diabetic foot infection (DFI), in a scientifically based and resource-sparing way. We performed a nonsystematic review of recent scientific literature to provide guidance on management of DFIs. RECENT FINDINGS: Studies in the past couple of years provide data on which recommendations for diagnosing and treating DFI are based, especially with validated guidelines and reviews of the microbiology and selected aspects of the complex DFI problem. Recent literature provides approaches to prevention and studies support more conservative surgical treatment. Unfortunately, there have been virtually no new therapeutic molecules, antibiotic regimens, randomized trials, or surgical techniques introduced in the recent past; we briefly discuss how this may change in the future

Ultrasonography of the sural nerve: normal and pathologic appearances

Ultrasonography (US) of peripheral nerves has gained wide popularity because of the increased definition of modern high-frequency electronic transducers, as well as the well-known advantages of US, which include easy availability, low cost, and the possibility of realizing a dynamic examination. Traditionally, US has been deployed to assess the major nerves of the limbs. More recently, US has also been used to assess the normal appearance and pathologic changes of smaller subcutaneous nerves. The sural nerve is a small sensory nerve in the subcutaneous tissues of the calf that can be affected by a variety of disorders. This pictorial essay illustrates the normal anatomy of the sural nerve, the technique for its examination by US, as well as the US appearance of its main pathologic changes