Posteromedial elastic stable intra-medullary nailing (ESIN) in volarly displaced metaphyso-diaphyseal distal radius fractures in child

SummaryIntroductionThe distal metaphyso-diaphyseal fractures of the radius with volar angulation are generally considered unstable. Too distal to be treated with classic elastic stable intramedullary nailing (ESIN) via a laterodistal approach and too proximal to be stabilized with simple conservative treatment, they are sometimes treated by plating.Patients and methodsTo avoid the disadvantages of the open exposure necessary for this latter fixation and to prevent volar angulation while respecting the curvature of the radius, radial elastic nailing with posteromedial distal entry was used in 16 patients. These patients were reviewed with an average follow-up of 4.5months.ResultsSix patients presented a mean volar angulation of 7°, eight a mean posterior angulation of 5.5°, and two were aligned at 0°. On the AP view, seven patients presented a mean residual varus of 6.5°, four a mean residual valgus of 5°, and five were at 0°. The pronating curvature of the radius and the radioulnar index remained intact in all cases. One case of extensor digitorum tenosynovitis was observed and disappeared after wire removal.DiscussionFor the unstable fractures of the distal third of the radius, certain authors propose systematic classic ESIN, but the lateral point of entry inevitably entails a varus misalignment, which is no longer the case if the entry is medial.Level of evidenceLevel 4. Retrospective Study

L'Institut de Recherches sur les Fruits et Agrumes 1942-1984 : de l'IFAC à l'IRFA

Ce rapport fournit quelques éléments pour un bilan et ravive la mémoire par un rappel historique et géographique de la naissance de l'IFAC, de sa croissance, puis de l'ultime phase de dépendance croissante à son intégration dans un organisme de plus grande dimension. Tout au long de ses 40 années d'existence, l'activité de l'IRFA a été répartie en quatre programmes consacré aux agrumes, à l'ananas, aux bananiers et aux plantains et aux autres fruitier

57Fe HYPERFINE INTERACTION MEASUREMENTS IN AN IRON CONCENTRATED OXIDE GLASS Fe203(30)BaO(45)B2O3(25)

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Propriétés magnétiques d'un oxyde amorphe riche en fer : Fe2 O3 (30) BaO (45) B2O3 (25)

La transition magnétique d'un oxyde amorphe riche en fer a été caractérisée par des mesures d'aimantation et susceptibilité magnétique et par spectroscopie Môssbauer de 57Fe. On note de fortes interactions antiferromagnétiques dans le verre et un comportement mictomagnétique à basse température. L'ordre magnétique au-dessous de la transition est de nature spéromagnétique

Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Globally, the number of patients undergoing maintenance dialysis is increasing, yet throughout the world there is significant variability in the practice of initiating dialysis. Factors such as availability of resources, reasons for starting dialysis, timing of dialysis initiation, patient education and preparedness, dialysis modality and access, as well as varied \u201ccountry-specific\u201d factors significantly affect patient experiences and outcomes. As the burden of end-stage kidney disease (ESKD) has increased globally, there has also been a growing recognition of the importance of patient involvement in determining the goals of care and decisions regarding treatment. In January 2018, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference focused on dialysis initiation, including modality choice, access, and prescription. Here we present a summary of the conference discussions, including identified knowledge gaps, areas of controversy, and priorities for research. A major novel theme represented during the conference was the need to move away from a \u201cone-size-fits-all\u201d approach to dialysis and provide more individualized care that incorporates patient goals and preferences while still maintaining best practices for quality and safety. Identifying and including patient-centered goals that can be validated as quality indicators in the context of diverse health care systems to achieve equity of outcomes will require alignment of goals and incentives between patients, providers, regulators, and payers that will vary across health care jurisdictions

Paralytic congenital talipes equinovarus of unknown origin: A new entity. Multicenter study of 42 cases

SummaryBackgroundParalysis of the lateral and/or anterior leg muscles can lead to relapse of treated talipes equinovarus.HypothesisThe muscle function impairment is due to isolated permanent paralysis, and early palliative tendon transfer may prevent recurrence of the deformity.Material and methodsForty-two cases of congenital talipes equinovarus that recurred after conservative therapy were reviewed after a mean follow-up of 10 years. In 39 cases, second-line surgery was performed (posteromedial release, n=33; and muscle transfer, n=26). Outcomes were evaluated clinically.ResultsSeparating the cases into two groups, based on whether muscle transfer was performed, showed a statistically significant difference: muscle transfer intended to restore eversion and/or dorsal flexion of the foot was associated with significantly better functional outcomes.DiscussionIn addition to providing etiological insights, the identification of paralysis in patients with talipes equinovarus can influence treatment decisions, depending on the nature of the muscle deficiencies, with the goal of preventing recurrences. Early muscle transfer to restore eversion and/or dorsal flexion of the foot may provide the best functional outcomes by minimizing the need for soft-tissue release.Level of evidenceIV, retrospective multicentre study