La luxation congénitale de hanche, résultats coxométriques et évaluation des traitements, à propos d une série de 35 cas

La maladie luxante de hanche signe une anomalie des rapports fémoroacétabulaires, touche 2 à 20 enfants pour 1 000 et peut constituer une source de handicap. Nous avons évalué les traitements de 35 patients âgés de 7 ans en moyenne au dernier recul. Trente hanches ont été traitées orthopédiquement : 18 plâtrées d emblée et 12 plâtrées après traction continue. Onze ont été traitées chirurgicalement. Pour évaluer la dysplasie coxofémorale, les angles d Hilgenreiner (HTE), de Wiberg (VCE), cervicodiaphysaire (ACD), de Sharp, de direction conjugodiaphysaire (DIR) et conjugocotyloïdien (ACC) ont été mesurés à 2 ans, 4 ans et au plus grand recul. Les nécroses épiphysaires ont été évaluées par classification de Kalamchi-Mac Ewen. Le score de Severin et le score de Postel Merle d Aubigné (PMA) ont été évalués. Aucune différence n était retrouvée entre les 2 traitements orthopédiques pour VCE, ACC, DIR, Sharp, le score de Severin et le score PMA, très bon à excellent. 39 % de nécroses épiphysaires ont été observés dans le groupe plâtré contre 17 % dans le groupe tracté-plâtré. Les deux traitements ont permis un remodelage fémoroacétabulaire très satisfaisant et une diminution de la dysplasie. Le traitement par plâtre seul occasionne plus de nécroses épiphysaires. Parmi les hanches opérées, aucune nécrose épiphysaire n a été retrouvée. Le score PMA était de 16,9 et le score de Severin de 91 % des cas était bon à excellent. L analyse coxométrique montre une amélioration significative de VCE et ACD en post-opératoire. L analyse coxométrique pré-opératoire caractérise la dysplasie et constitue un élément important pour le choix du geste chirurgical, type d ostéotomie pelvienne ou fémorale.Congenital hip dislocation is characterized by abnormal femoroacetabular contact. It affects 2-20 per 1 000 children and can result in disability. We investigated the treatment of 35 patients aged 7 years at the time of most recent evaluation. 30 hips were orthopedically treated: 18 hips were plastered immediately and 12 hips were plastered after continuous traction. Eleven hips were treated surgically. To assess the hip joint dysplasia, we measure the acetabular index (HTE), the Wiberg s angle (VCE), the femoral shaft-neck angle (ACD), the Sharp s angle, the orientation of the epiphyseal angle (DIR) and the acetabular or femoral origin of the dysplasia (ACC) at 2 years, 4 years and at the time of most recent evaluation. Epiphyseal necroses were assessed by classification of Kalamchi-Mac Ewen. The score of Severin and the score of Postel Merle d Aubigné (PMA) were evaluated. No difference was found between the 2 orthopedic therapies for the angles VCE, ACC, DIR and Sharp. The scores of Severin and PMA were very good to excellent. We observed 39% of epiphyseal necroses in the plastered group against 17% in the pulled-plastered group. Both treatments lead to a very satisfactory femoroacetabular remodeling and a decrease of dysplasia. The plaster therapy is more likely to involve ephiphyseal necrosis than a therapy combining plastering and continuous traction. No epiphyseal necroses were found in the surgically treated hips. The PMA score was 16.9 and for 91% of the patients, the Severin s score was good to excellent. Coxometric evaluation highlighted a significant improvement of the angles VCE and ACD after surgery. The characterization of the dysplasia by coxometry is thus an important element in the choice of the surgery (pelvic or femoral osteotomy).GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Growth tethering devices for idiopathic scoliosis

International audienceAdolescent idiopathic scoliosis is a 3D spine deformity that worsens during the whole growth. The treatments available are bracing during the whole growth to avoid progression of the deformity and surgical fusion of the spine at skeletal maturity for the most severe curves. Recent advances in flexible spinal implants have given rise to new expectations in the management of progressive scoliosis with growth modulation without fusion. For the first time, treatment allows us to expect a correction of progressive curves without fusion. This review discusses the recent developments in the field of spinal growth modulation techniques and discusses the pros and cons of the medical devices used in this indication

A thoracic spinal bone giant cell tumor in a skeletally immature girl. A case report and literature review

International audienceGiant cell tumors (GCT) are benign primary bone tumors, locally aggressive, affecting in long bones in young adults during the third decade. It is rare to experience this lesion in skeletally immature patients. GCT are related to a risk of local recurrence and malignant transformation

A New Paradigm for the Management of Thoracolumbar Pediatric Spine Traumas

International audienceThe transient breath holding sign (TBHS) is a clinical sign often associated with magnetic resonance imaging (MRI) spine traumatic lesions. The aims of this study were to prospectively evaluate the TBHS in the detection of thoracolumbar lesions in a large cohort of children and to establish a comprehensive strategy on the use of MRI in spine traumas in children

L’avenir de la chirurgie pédiatrique en France : la démographie des chirurgiens pédiatres en formation

Objectifs : Faire le recensement des internes et chefs de clinique des universités-assistants des hôpitaux (CCA) en formation en chirurgie pédiatrique et analyser les résultats en fonction des besoins de la spécialité. Matériel et méthodes : Les données concernant la démographie des chirurgiens pédiatres en formation ont été recueillies par un questionnaire adressé aux internes, CCA et coordonnateurs interrégionaux de la spécialité, de septembre 2009 à mars 2010. Les informations suivantes ont été recueillies : nom et prénom, sexe, année de validation du concours de l’internat ou des épreuves classantes nationales, orientation choisie en chirurgie pédiatrique, le centre hospitalier universitaire (CHU) de formation durant l’internat, lieu d’exercice. Résultats : Cinquante-trois internes sont inscrits en diplôme d’études spécialisées complémentaires (DESC) de chirurgie infantile avec une orientation urologique, viscérale, thoracique ou plastique et vingt-et-un en orthopédie pédiatrique. Par ailleurs treize internes en DESC d’orthopédie adulte vont s’orienter vers l’orthopédie pédiatrique. La répartition des internes sur le territoire montre des différences importantes entre les inter-régions. Il existe 55 postes de CCA en chirurgie pédiatrique. Conclusion : Cette étude devra servir de socle aux réflexions engagées par la Commission nationale de l’internat et du post-internat. Le nombre important d’internes formés chaque année montre l’attractivité de la chirurgie pédiatrique pour les chirurgiens en formation. Il nous alerte sur la nécessité d’adapter la formation des chirurgiens pédiatres aux capacités de formation de notre système de santé et aux besoins de santé de la population française

A novel locus on chromosome 1 underlies the evolution of a melanic plumage polymorphism in a wild songbird

Understanding the mechanisms responsible for phenotypic diversification within and among species ultimately rests with linking naturally occurring mutations to functionally and ecologically significant traits. Colour polymorphisms are of great interest in this context because discrete colour patterns within a population are often controlled by just a few genes in a common environment. We investigated how and why phenotypic diversity arose and persists in the Zosterops borbonicus white-eye of Reunion (Mascarene archipelago), a colour polymorphic songbird in which all highland populations contain individuals belonging to either a brown or a grey plumage morph. Using extensive phenotypic and genomic data, we demonstrate that this melanin-based colour polymorphism is controlled by a single locus on chromosome 1 with two large-effect alleles, which was not previously described as affecting hair or feather colour. Differences between colour morphs appear to rely upon complex cis-regulatory variation that either prevents the synthesis of pheomelanin in grey feathers, or increases its production in brown ones. We used coalescent analyses to show that, from a 'brown' ancestral population, the dominant 'grey' allele spread quickly once it arose from a new mutation. Since colourmorphs are always found inmixture, this implies that the selected allele does not go to fixation, but instead reaches an intermediate frequency, as would be expected under balancing selection

Data for microsatellites, spectrophotometry and melanins dosage

This file contains 1) microsatellites data in GENPOP format, 2) morphometric data for birds included in the pedigree analysis, 3) Spectrophotometry measurements and 4) Results from the dosage of melanins for 12 individuals. Localities coordinates are also provided

Unfiltered VCF file for 42 individuals

SNPs calls for individual GBS data from the same three localities as in Pooled RAD-seq. Colors and localities for each individuals are provided in a separate excel file

SNPs validated with different MAC (2 or 3) and a sequencing depth of 10 or 20X

This archive contains three types of files with extensions '.n', '.y' and '.alleles'. '.n' files list for each library the number of reads associated at each SNP position. '.y' files list the number of times a SNP is detected. '.alleles' files give the name of the contig displaying a given SNP, then the position of the SNP from the restriction site, the total number of reads for the whole dataset, the count of the minor allele, the count of the major allele, and the two possible nucleotides encountered at this positio