[Van der Meulen urethroplasty. Some technical details, results and commentary (author's transl)]. / L'urétroplastie de Van der Meulen. Détails techniques, résultats et commentaires.

Nineteen cases of anterior hypospadias corrected by Van der Meulen's operation are reviewed. Principle of this procedure is presented, pointing out some important details for successful results. Rare complications were observed and in all cases the final aspects of the penis is good, and the meatus can be made as near the tip as possible. This technique is very easy, urinary diversion is not used, and hypospadias may be repaired in pre-school time. Chordee is unnecessary cured before urethroplasty. A post-operative rotation of the penis can occur, but generally disappears in some months.

[Lesions of the hip in congenital myxedema in children]. / Les lésions de la hanche au cours du myxoedème congénital chez l'enfant.

A series of 51 cases of congenital myxoedemia in children was analyzed to determine incidence of associated hip lesions. Mechanisms of epiphysial and articular cartilage growth are reviewed and events summarized that occur normally in the "growing hip": the upper femoral nucleus, and orientations of femoral neck and their physiologic variations. The role of thyroid hormones in bone growth is also discussed. Reviewed in greater detail are the myxedematous hips in children, or epiphysial dysgenesis, the causes of delay in bone maturation, the effect of substitutive therapy and mineralization disorders. In contrast to the richness of radiographic data, often very disturbing, restriction or even absence of functional signs is almost a constant feature, enabling a diagnosis of Legg-Perthes-Calvet's disease to be rejected, certain radiologic images being considered wrongly as comparable. Radiography provides images varying from delayed ossification of a sometimes very long upper femoral nucleus, termed "joint emptiness", to "pseudo-fragmentations" that are frequently encountered and are actually progressive ossifications. These sometimes progress towards deformity of femoral head in coxa plana but are usually well adapted to the acetabulum, reducing initial fears. Different parameters studied in the 51 patients are analyzed and an optimistic conclusion given, since neonatal screening for congenital myxedema and subsequent therapy should eliminate skeletal complications, particularly in the hip.

[Congenital pseudarthrosis of the clavicle. Apropos of 7 cases]. / Pseudarthrose congénitale de la clavicule. A propos de 7 observations.

The authors report 7 new cases of congenital pseudarthrosis of the clavicule. Clinical features are bearing out classical data of litterature. The disease is discovered during first months by the way of a clavicular swelling which settles mostly on the right side. But according to the authors the surgical treatment ought to be systematically purposed, restoring a normal morphology and avoiding any functional trouble. It consists in resecting the pseudarthrosis and grafting. This act is easy if done early, the ideal age being around 3 or 5.

[Congenital epulis of the newborn (granulous Abrikosov tumor). Remarks apropos of a personal case]. / Epulis congénitale du nouveau-né (tumeur granuleuse d'Abrikossoff). Commentaires à propos d'une observation personnelle.

The authors report a case of middle and superior gingival tumor in a newborn patient. Macroscopic and topographic aspects are a "congenital epulis". The surgical treatment is easy. Histologically finding shows a benign tumor with granulous cells called "Abrikossoff Tumor". The literature is reviewed to study histological aspect and pathogeny of this tumor. They try to distinguish the macroscopic aspect of the "congenital epulis" with the histologically finding. It is not systematically a granulous cells tumor.

[Urethroplasty technics. Apropos of 286 cases of hypospadia treated surgically. Indications, results and current therapeutic calendar]. / Techniques d'urétroplastie. A propos de 286 hypospadias opérés. Indications, résultats et calendrier thérapeutique actuel.

From 1957 to 1985, 286 urethroplasties for hypospadias repair were performed. Anterior hypospadias (235 cases) have been corrected with good result in 88% of cases (94.3% since 1974). Glandular or coronal hypospadias have been repaired by MAGPI procedure (65 cases, 1 fistula, 1 meatal stricture), and distal penile hypospadias by Mathieu's urethroplasty (32 cases, 1 fistula), since 1981. For subcoronal hypospadias, MAGPI procedure has been attempted and deserted to Mathieu's technique (19 cases, 4 fistulas). Posterior hypospadias (51 cases) were performed by two- or more-stage procedure before 1982. Then, 25 cases have been corrected by Duckett's procedure and 1 case with bladder mucosa graft. Immediate good result was obtained in 10 patients and 4 more after meatostomy for meatal stricture. 10 patients developed fistulas. A lower rate of fistula has been obtained by Duckett's operation personal modification. Most of hypospadias (80%) have been corrected from 2 to 4 years old, since 1981.

[Recto-sigmoid cancer and polyps in children. Comments apropos of 2 cases of atypical juvenile polyps]. / Cancers recto-sigmoïdiens et polypes chez l'enfant. Commentaires à propos de 2 cas de polypes juvéniles atypiques.

The writers present a report of 2 observations of colo-rectal carcinoma, on a 19 month old infant with a mixed juvenile and adenomatous polyp situated at the recto-sigmoid junction and treated successfully by segmental colectomy, and on a 10 years old girl presenting a large colloid rectal carcinoma which occurred 6 years after resection of an atypical rectal juvenile polyp. After recalling the rarity and the gravity of colo-rectal carcinoma in childhood, the authors underline the importance of histological investigations in the juvenile polyposis which is usually benign; the possibility of histological aspects on separate polyps and sometimes on the same polyp explains the degeneration of some multiple juvenile polyps (several cases in the literature), or isolated polyp (first case described).

[Internal male pseudo-hermaphrodism (male with a uterus). Apropos of 6 cases]. / Pseudo-hermaphrodisme mâle interne (homme à utérus). A propos de 6 observations.

Internal male pseudo-hermaphrosdism (man with a uterus) constitutes an uncommon range of sexual ambiguity. Regard to 6 personal case histories covering 3 families of 2 brothers, and gazing on the different cases picking out the literature, some problems are looking on successively: concerning the etiopathogenesis, the genetical transferring way, the aspect of the mullerian duct structures and of the male internal genital canals, the prognosis and the chirurgical therapy of this disease which is founded by chance, most of the times during the chirurgical therapy of a cryptorchidy or during a laparotomy.

[Meconial peritonitis. Recordings about six observations. Diagnostic and prognostic value of calcifications. Therapeutic given off (author's transl)]. / Les péritonites méconiales. Commentaires à propos de 6 observations. Valeur diagnostique et pronostique des calcifications. Conséquences thérapeutiques.

The authors report six cases of meconium peritonitis with intra-abdominal calcifications; surgical intervention was successful in four. In five patients, fibrocystic desease of pancreas was eliminated. Presenting this report, it is their intention to underline the good prognosis of calcifications which generally eliminate the meconium ileus.

[Congenital pyloric atresia. Report of three cases (author's transl)]. / Atrésies pyloriques congénitales. A propos de trois observations.

Congenital pyloric atresia is a relatively unusual condition. From three cases the authors point out the diagnosis basis. The main clinical findings are hydramnios, early non bilious vomiting and epigastric distension. Diagnosis is based upon abdominal plain films. They demonstrate an air dilated stomach, and no air distal to the pylorus. When films can be taken in the upright position, they demonstrate a single intragastric air-fluid level. Radiologic findings are essential, because surgical inspection alone fails to demonstrate membranous atresia and cordonal atresia which are more frequent than total atresia. In the two former conditions, radiologic findings lead the surgeon to look for the obstruction by the mean of a catheter introduced by a juxta-pyloric antrotomy.

[Towards reasoned early surgical treatment for hiatal hernia in the infant (author's transl)]. / Pour un traitement chirurgical précoce raisonné des hernies hiatiales du nourrisson.

The authors report 2 cases of HH and MCT in newborn of 1 1/2 and 5 months old who quickly develop a peptic stenosis despite a good medical treatment. Reviewing 51 cases of early surgical treatment (29 cases operated on before 2 months of age), they estimate legitimal an early surgical treatment for HH and MCT in newborn. They insist on the necessity to begin with a rigourous medical treatment, which cannot exceed one month if an oesophagitis persist (documented by a good and acurate endoscopic examination). This examination is the guide line for the surgical indication and is more acurate than the clinical and radiological informations. They point out the absence of mortality and the improvement of the results if the patients are operated on before 2 months old. In the literature ones can observe that the incidence of recurrence and peptic stenosis is decreased when the patients are operated on early.

[Pyogenic sacroiliac arthritis in children. Analysis and commentary apropos of 7 cases]. / Les arthrites sacro-iliaques à pyogènes chez l'enfant. Analyse et commentaires à propos de 7 observations.

Seven cases of pyogenic arthritis of the sacro-iliac joint in children were observed between 1968 and 1981. Their analysis is discussed with the conclusions of the too much rare publications in the recent literature. Taking in to account the anatomic particularities the necessity of very precise roentgenographic technics in order to assess the sacro-iliac joint, especially in children because of incomplete ossification, the authors replace this pathology into the osteomyelitis in children. From the clinical aspects of the disease, with its typically localized pain, and its acute clinical and biological septicemic syndrome, the authors attempt to demonstrate that the classical idea of a delayed diagnosis, is not absolute. Even in this particular localization, an early "up to date" diagnosis is possible allowing rapid treatment with efficient antibiotherapy directed towards the responsible germ after their isolation (especially staphylococcus aureus). Indubitable progress has been gained with systematic radio-nuclide bone scanning in emergency.

[About of 82 obstetrical astro-articular injuries of the new-born (excepting brachial plexus palsies). Limits of initial therapeutic aggression and follow-up of evolution, particulary concerning traumatic separation of upper femoral epiphysis (author's transl)]. / A propos de 82 traumatismes obstétricaux ostéo-articulaires du nouveau-né (paralysies du plexus brachial exceptées). Limites de l'agression thérapeutique initiale et surveillance de l'évolution, en particulier dans les décollements épiphysaires de l'extrémité supérieure fémorale.

Obstetrical fracture has not a bad character, because of quick healing and, above all, because of extraordinary modelling by growth. The authors record 33 fractures of long bones which confirm this good prognosis. 20 birth fractures of the clavicule associated with brachial plexus palsies are recorded on account of their pathogenic, diagnostic and therapeutic intricacies. Prognosis of obstetrical traumatic separation of the epiphysis (epiphysiolysis) would be more preoccupying. This feeling is not given off the series of 28 observations recorded which conern 13 upper humeral, 6 lower humeral epiphysis, 1 of 6 upper femoral and 1 lower femoral epiphysis, of upper and lower of tibia. Diagnosis is not so easy, helped, if necessary, by arthrography. The clinical aspect of "pseudo-dislocation" associated with periostal callus, early appearing (about on the 10th day) rectifies diagnosis. Early treatment, as little aggressive as possible, (essentially orthopedic management by tractions along the axis of limb, giving up an anatomy as close as possible to normality) avoids sequellae, not existing at shoulder nor elbow and, if they exist, extremely decreased at hip, and the surgical management of which is always delayed. Initially good result of one birth dislocation of cervical spine, precedently recorded is considerably impaired.

[A new orthopedic apparatus for the treatment of congenital equinovarus clubfoot. The active-passive articulated splint. Critical study propos of 72 cases treated in our department]. / Un nouvel appareillage orthopédique de traitement du pied bot varus équin congénital. L'attelle articulée activo-passive. Etude critique à propos de 72 cas traités dans le service.

The authors present a new equipment for orthopaedic assesment of club-foot. This "dynamic splint" aims to produce a self-correction of the deformity by the infant at time of each movement of his lower limb. With regard to 72 such deformities, concerning 47 children, they record the results after an average follow-up of more than 2 years. Criterions of results, clinical and chiefly radiological, more objectives, are classified into 3 parts : correction of varus of the foot, correction of adduction of the hind-foot, correction of equinus.

[Bone scanning in children: technic and indications. Apropos of 50 cases]. / La scintigraphie osseuse chez l'enfant: technique et indications. A propos de 50 observations.

In children, radionuclide skeletal imaging with 99m Tc M. D.P. has been performed in 50 cases. Scans are done immediately, 20 minutes and three hours after injection. Osteomyelitis has been studied in 24 cases, Legg Perthes disease and benign bone tumors in the others. The scintigraphic patterns are very sensitive but not characteristic. However this exam seems to be essential in some orthopedic disorders of children.