[Experimental study of an axial vascularized pedicle flap induced in rats]. / Etude expérimentale d'un lambeau à pédicule vasculaire axial induit chez le rat.

The authors report an experimental study about induced flaps in rats. The aim of this study is to determine that neoangiogenesis can be formed from surgically introduced pedicle. Two main groups were studied: in the first one the arteriovenous pedicle was be anastomased at its distal end, in the other, an arteriovenous loop was created microsurgically. In both groups we obtained good results and the flaps stayed alive. Neoangiogenesis from the surgically introduced axial pedicle was observed. The prospects in human pathology are interesting to consider, for the surgeon might be liberated from the narrow anatomic limits imposed by vascular territories, by creating a suitable flap anywhere in the body.

[Fractures of the base of the first metacarpus]. / Fractures de la base du premier métacarpien.

The authors report a group of 73 cases of fractures of the base of the first metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%) and 20 non-articular fractures are described. Sixty-eight patients were treated surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5 rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen again after one year or more. We classify the results as follows: very good: 29 (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and the good results of the double diverging pin insertion lead the authors to apply this method in most fractures of the base of the first metacarpal, either articular or extra-articular.

[Bony metastases of the fingers. Apropos of 3 cases. Review of the literature]. / Les métastases osseuses des doigts. A propos de 3 observations. Revue de la littérature.

Bone metastases of fingers are rare, are of highest incidence in men 40 to 60 years, and may reveal the presence of a primary cancer. Radiologic imaging shows almost constant osteolytic lesions, the primary usually being located in the bronchi. Short-term prognosis is poor, with a mean survival of three and a half months. Bone biopsy should be conducted routinely to determine nature of lesion in fingers.

[Conservative treatment of esophagus ruptures and perforations. Esophageal diversion by minimal pharyngostomy]. / Traitement conservateur des ruptures ou des perforations de l'oesophage. Diversion oesophagienne par pharyngostomie a minima.

In ruptures or perforation of the oesophagus, the difficult choice between conservative methods (suture or drainage) and total exclusion of the organ can be avoided by minimal pharyngostomy. This procedure, which supersedes lateral oesophagostomy and makes use of an aspiration silicone-lined catheter to divert the oesophageal contents, is simple, rapid, effective and reversible. It is carried out in a region devoid of dangerous anatomical variants, in the avascular space below the greater cornu of the hyoid bone (a palpable landmark), the incision being made on the convexity of a curved clamp which pushes back the pharyngeal wall at the level of the sinus pyriformis. This technique has been used in 13 patients with satisfactory results.

[False aneurysm of the profunda femoris artery after fracture of the upper end of the femur. Apropos of a case]. / Faux anévrysme de l'artère fémorale profonde après fracture de l'extrémité supérieure du fémur. A propos d'un cas.

A case of false aneurysm arising at the origin of a branch of the profunda femoris artery following an intertrochanteric fracture of the femur is reported. The complication was due to the fracture itself by impalement by a bony fragment of the lesser trochanter. A review of the literature revealed 14 similar cases and confirmed the rarity of this complication.

[Achromic ungual melanoma. Apropos of a case]. / Mélanome unguéal achromique. A propos d'une observation.

A 55-year-old woman presented with suppurative paronychia that became chronic. In fact, this was an exceptional case of amelanotic subungual melanoma. This case is compared with a general review of subungual melanomas. Diagnosis is often delayed, due to the difficulty caused by the misleading clinical symptoms.

[Fracture of the base of the first metacarpus]. / Fractures de la base du premier métacarpien.

The authors report a group of 73 cases of fractures of the base of the first metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%) and 20 non-articular fractures are described. Sixty-eight patients were treated surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5 rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen again after one year or more. We classify the results as follows: very good: 29 (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and the good results of the double diverging pin insertion lead the authors to apply this method in most fractures of the base of the first metacarpal, either articular or extra-articular.

[Rehabilitation of the rheumatoid dorsal wrist by the Sauve-Kapandji operation combined with a realignment-stabilization synovectomy]. / Réhabilitation du poignet dorsal rhumatoïde par l'intervention de Sauvé-Kapandji associée à une synovectomie-réaxation-stabilisation.

The authors present a series of 25 cases of rheumatoid wrists, operated by tendon and intra-carpal synovectomy, accompanied by an arthrodesis of the lower ulnar articulation following a metaphyseal resection of the lower extremity of the ulnar according to Sauve and Kapandji. This series is "young", as the mean follow-up is 2 years. It involves 25 patients, including 4 operated on both wrists. This series has the advantage of being coherent as all the operations were performed by the same surgeon. The results concerning pain are good; 87% of the wrists were painless or only periodically painful, and 88% of the patients say they are well or very much better. This operation offers the satisfying aspect of prevention; an absence of pain in the wrist when inflamed and the absence of complications such as ruptured tendons. The study of the range of motion shows a global loss of 9% in the sagittal plane and a significant reduction in the score for motion in palmar flexion. The radiological signs of deterioration of carpitis are not stopped despite the operation but it does seem to be slowed down after intra-carpal synovectomy. Ulnar sliding has been carefully studied. We observe that a further sliding is more obvious in the Larsen 2 phase than in the Larsen 3 phase. This sliding is very slight. The comparison between the different series shows that operation protects the wrist from ulnar sliding more than ulnar head resections.

Prevalence of large-joint osteoarthritis in Asian and Caucasian skeletal populations.

OBJECTIVE: To determine ethnic variations of large-joint osteoarthritis (OA) in past populations. METHODS: One thousand two hundred and nine adult skeletons, excavated from archaeological sites in Japan, China and France were assessed for OA as defined by the presence of eburnation. RESULTS: Within Asian skeletal populations, elbow OA and patellofemoral joint OA were more common in hunter-gatherers than in agriculturalists. Compared with Caucasians, the Asian skeletal population had a higher prevalence of tibiofemoral joint OA. CONCLUSION: The relative frequencies of OA within and between ethnic groups at certain joint sites have changed over time from the past to the present.