20 research outputs found
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 ùgés de 7 ans en moyenne au dernier recul. Trente hanches ont été traitées orthopédiquement : 18 plùtrées d emblée et 12 plùtrées aprÚs 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, trÚs bon à excellent. 39 % de nécroses épiphysaires ont été observés dans le groupe plùtré contre 17 % dans le groupe tracté-plùtré. Les deux traitements ont permis un remodelage fémoroacétabulaire trÚs satisfaisant et une diminution de la dysplasie. Le traitement par plùtre 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
Lâavenir de la chirurgie pĂ©diatrique en France : la dĂ©mographie des chirurgiens pĂ©diatres en formation
Objectifs : Faire le recensement des internes et chefs de
clinique des universités-assistants des hÎpitaux (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 lâinternat ou des Ă©preuves classantes nationales, orientation
choisie en chirurgie pédiatrique, le centre hospitalier universitaire (CHU) de formation
durant lâinternat, lieu dâexercice. RĂ©sultats : Cinquante-trois internes sont
inscrits en diplĂŽme dâĂ©tudes spĂ©cialisĂ©es complĂ©mentaires (DESC) de chirurgie infantile
avec une orientation urologique, viscérale, thoracique ou plastique et vingt-et-un en
orthopĂ©die pĂ©diatrique. Par ailleurs treize internes en DESC dâorthopĂ©die adulte vont
sâorienter vers lâorthopĂ©die pĂ©diatrique. La rĂ©partition 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
rĂ©flexions engagĂ©es par la Commission nationale de lâinternat et du post-internat. Le
nombre important dâinternes formĂ©s chaque annĂ©e montre lâattractivitĂ© de la chirurgie
pĂ©diatrique pour les chirurgiens en formation. Il nous alerte sur la nĂ©cessitĂ© dâadapter
la formation des chirurgiens pédiatres aux capacités de formation de notre systÚme 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