The treatment of duplication thumbs in children. About a series of 32 patients.

29 children with 32 duplicated thumbs were followed up. Wassel's classification was used: type I (3 cases), type II (8 cases), type IV (16 cases), type V (3 cases), type VII (2 cases). There were no type III or VI cases. Seven cases were not operated on (minor abnormalities, refusal by the parents). Simple surgical ablation was performed in 12 cases, ablation with reconstruction in 10 cases, ablation with pollicisation in one case, ablation with longitudinal osteotomy in one case. Finally, Bilhaut's technique was performed in one case. 16 cases had a good result, 9 cases were disappointing with one case of stiffness, one step deformity, one protrusion of the metacarpal head and particularly 6 cases with joint instability. This latter complication is the most frequently encountered in various series and the authors emphasize the surgical precautions to avoid its occurrence.

[Intestinal perforation in abdominal contusions in children. 16 cases]. / Les perforations intestinales dans les contusions de l'abdomen chez l'enfant. 16 observations]

16 cases of intestinal perforation following blunt abdominal trauma in children (14 boys and 2 girls from 3, 5 to 15 years old) are recorded in a 18 years period. We found 12 injuries of the small bowel, 2 of the colon and 2 of the duodenum. Except in the cases with hypovolemia or traumatic coma, the diagnosis is often made on abdominal physical findings and clinical evolution. Laboratory and radiological data were often useless. Then, surgical management was often delayed, principally in the most recent period with the non operative management of most pediatric blunt trauma. Simple closure (7 cases), resection and anastomosis (7 cases) or resection and double ostomy (2 cases) were performed. The result summarize 2 death and one complication (fistula). Complications do not increase with delay.