[Sequestration of the posterobasal segment of the right lower pulmonary lobe]. / Séquestration du segment postérobasal du lobe pulmonaire inférieur droit.

Pulmonary sequestration is a rare congenital malformation that receives its blood supply from a systemic artery. We report a case of pulmonary sequestration treated by ligature of the anomalous artery without pulmonary resection. Pulmonary sequestration must be treated surgically before the occurrence of severe complications.

[Angiosarcoma of the right atrium. Presentation of a surgically treated case and comparison with data of the literature]. / Angiosarcome de l'oreillette droite. Présentation d'un cas opéré et comparaison avec les données de la littérature.

The authors report the case of a 28-year-old woman referred to their department by a respiratory medicine department with an inferior mediastinal tumour arising from the right atrium, presenting in the form of dysponea, dry cough and chest pain associated with a general syndrome composed of fever, weight loss and physical asthenia. Physical examination revealed a superior vena cava syndrome, the electrocardiogram showed diffuse repolarization disorders and the chest x-ray showed an opacity of the anterior and inferior mediastinum. The diagnosis of tumour of the right atrium was based on echocardiography and thoracic CT scan. Subtotal surgical resection under cardiopulmonary bypass allowed examination of the histological type of the tumour. After routine chemotherapy, despite negative secondary staging and a favourable immediate course, the patient died 11 months after the operation in a context of local recurrence and hepatic and bone metastases.

[Surgical management of isolated fractures of the ulnar shaft]. / Le traitement chirurgical des fractures isolées de la diaphyse ulnaire.

Between 1997 and 2001, 40 isolated fractures of the shaft of the ulna were treated by internal fixation and were followed until healing. The mean age was 27 years. Twenty six were treated by open reduction and plate fixation (group I), and 14 by closed intramedullary pinning (group II). Most complications were secondary to technical defects and occurred in the first group, with nonunion in 7.7% of cases; complications in the second group were minimal. The authors used Oestern and Tscherne's criteria for their evaluation; good results were noted in 86% in the first group, and in 93% in the second. Surgical management of isolated ulnar shaft fracture using intramedullary pinning or AO plate fixation (1/2 tube or 1/3 tube), appear to provide comparable results, provided the technique was correct.

[Fractures of the trapezium]. / Les fractures du trapèze.

The authors report a retrospective study of eight cases of trapezium fractures. There were seven male and one female patient aged 21 to 48 years. The presumed mechanism of injury was established in only four cases. Clinical trapeziometacarpal abnormality was always present. The diagnosis was made on standard radiographs in seven cases, computed tomography was used in one case. The fracture was simple, vertical and lateral in five cases, complex in one case and consisted in a lateral avulsion in two cases. An associated Bennett's fracture was present in five cases. The treatment was conservative in two cases. Internal fixation was performed in four cases (3 using a lag screw, 1 using a Kirschner wire) and transosseous reinsertion in two cases. With an average follow-up of 3 years (1 year-6 years), open reduction and internal fixation appears to be simple and to give good or excellent results.

[Acute acalculous cholecystitis after digestive caustic burn]. / Cholécystite aiguë alithiasique après brûlure caustique digestive.

A case is reported of acute acalculous cholecystitis in a patient who suffered a digestive burn treated by total parenteral nutrition. Pain in the right upper abdominal quadrant and fever occurred 26 days after the start of parenteral nutrition and 24 h after abruptly resuming oral feeding. Ultrasonography showed a distended gall-bladder with a thickened wall and the formation of sludge. Cholecystectomy was followed by a complete recovery. The part played by each of the corrosive burn, the total parenteral nutrition and the abrupt resumption of oral feeding in the pathogenesis of this complication is reviewed.

[Bifocal schwannoma of the sciatic nerve: a case report]. / Schwannome bifocal de la bifurcation sciatique: à propos d'un cas.

Schwannoma is a benign tumor generally observed on peripheral nerves. A sciatic localization is rare, observed in 1% of the patients. Multiple localizations have been reported in exceptional cases. We report the case of a bifocal schwannoma observed at the bifurcation of the sciatic nerve in a high-level athlete. The misleading clinical presentation of this localization causes a delay in diagnosis.

[Neglected spontaneous bilateral rupture of the patellar tendon: a case report]. / Rupture bilatérale spontanée négligée des tendons rotuliens: à propos d'un cas.

A patient taking corticosteroids for rheumatoid arthritis experienced a spontaneous bilateral rupture of the patellar tendon. Initially neglected, the rupture was repaired surgically by tendinoplasty using the semitendinous tendon for the right knee and inversion of the quadriceps tendon for the left. Functional results were similar. On the right knee, the wire cerclage loosened leading to posterior sagittal displacement of the patella, pointing out the difficulties encountered when repairing neglected rupture of the patellar tendon. Due to the small number of cases and difficulties in assessing the techniques proposed, no large-scale series has been reported in the literature.

[Tuberculosis of the talus: a rare localization of Koch's bacillus]. / La tuberculose du talus: une localisation osseuse rare du bacille de Koch.

A 66-year-old woman complained of pain in the left rear foot and malleoli. Standard x-ray and magnetic resonance imaging as well as laboratory tests were non-contributive. Pathology study of a bone biopsy led to the diagnosis of talar tuberculosis. A 12-month regimen combining rifampicin, isoniazid and pyrazinamide was given. Clinical improvement was achieved although the patient developed significant reflex dystrophy. The risk of degeneration compromises the functional future of the ankle joint.

[Tumoral calcinosis of the plantar forefoot: a case report and review of the literature]. / Calcinose pseudo-tumorale plantaire: à propos d'un cas et revue de la littérature.

Tumoral calcinosis of the plantar forefoot is an uncommon benign condition resulting from deposits of hydroxyapatite crystals in periarticular soft tissue. The pathogenic mechanism remains to be clarified. This condition is generally observed in young subjects and a hereditary pattern is often discovered. We report the clinical, radiological, and biological findings in a case of right forefoot tumoral calcinosis observed in a sixteen-year-old girl and describe the surgical treatment and pathology results. Based on this case and a review of the literature, we discuss the different pathogenic hypotheses as well as the appropriate diagnostic and therapeutic approach.

[New varieties of lateral metatarsophalangeal dislocations of the great toe]. / Nouvelles variétés de luxations métatarso-phalangiennes du gros orteil: les luxations latérales.

PURPOSE OF THE STUDY: We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. MATERIAL AND METHODS: Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). DISCUSSION: Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament rupture. CONCLUSION: We propose another additional classification with pure lateral dislocation (type III) and dorso-lateral dislocation (type IL or IIL+), which are related to the formerly described variants.

[Role of celioscopy in the assessment and treatment of non-palpable testis in adults. Report of 2 cases]. / Place de la coelioscopie dans l'exploration et le traitement des testicules impalpables chez l'adulte. A propos de deux observations.

The authors reported two cases of impalpable testis in young mens. Laparoscopy is useful in both the diagnosis and the management of impalpable testes. Intraabdominal testicles can be removed laparoscopically if atrophic or can be partly devascularized by spermatic vessel clipping if apparently normal. A second-stage vasal-based orchidopexy can then be performed once adequate testicular reperfusion via the the defferential pedicle is believed to have occurred.

[Thrombosis of the superior vena cava in Behcet's disease. Apropos of a case associated with chylothorax]. / Les thromboses de la veine cave supérieure au cours de la maladie de Behcet. A propos d'un cas associé à un chylothorax.

The authors report a case of superior vena cava thrombosis associated to a chylothorax during Behcet's disease. This thrombosis was revealed during an evolutive phase by dyspnea and a superior vena cava syndrome. Its course was favourable under a medical treatment associating: pleural drainage, parenteral feeding, corticotherapy and heparin therapy. Then the authors review the bibliography and recall the frequency, pathogenesis, clinic and treatment of this unusual complication of the Touraine's aphthosis. Such a complication appears paradoxically to present a favourable course.

[Fractures of the coronoid process]. / Les fractures de l'apophyse coronoïde.

INTRODUCTION: A retrospective study has been made of a series of 22 cases, and the classification and treatment of fractures of the coronoid process of the ulna have been discussed. MATERIAL, METHODS AND RESULTS: A report has been made of 22 cases of coronoid process fracture (18 males and four females). The mean age was 26 years (range: 19-47 years). According to the Reagan and Morrey Classification, there were 11 type I (avulsion of the tip of the bone), seven type II (a fragment of less than 50% that was detatched from the coronoid process), and four type III cases (a fragment of more than 50% that was detatched from the coronoid process). Elbow dislocation was present in 16 cases, and a radial head fracture was associated in four cases. All type I fractures were treated by immobilization of the elbow in a plaster cast for ten to 15 days, with eight excellent and three good results. In type II fractures, open reduction, internal fixation with antero-posterior lag-screw and early post-operative movement in three patients gave better results than immobilization for three weeks, which was the procedure used in four cases (after transosseous reinsertion in one case). In type III fractures, good results were obtained following open reduction and internal fixation with antero-posterior lag-screw in three patients. The result was average in the fourth case, with immobilization for four weeks. CONCLUSION: The Reagan and Morrey classification is most useful for the classification of coronoid process fractures. If there is no comminution of the detatched fragment, open reduction and internal fixation with antero-posterior lag-screw is the treatment of choice in type I and II fractures. In type I fractures, immobilization for about two weeks gives good results.

[Metacarpophalangeal dislocation of the index finger. Apropos of 7 operated cases]. / Les luxations métacarpo-phalangiennes de l'index. A propos de sept cas opérés.

Complex dislocation of the metacarpophalangeal joint of the index finger is an uncommon injury. The authors report seven cases, including three neglected dislocations, two with associated osteochondral fractures and one with sesamoid entrapment. Open reduction was necessary in each of the seven cases. In recent dislocations (four cases), both approaches were successful in obtaining reduction and normal finger movements were obtained. The dorsal approach was simple and safe, while the palmar approach was difficult and had many disadvantages. In the case with sesamoid entrapment, the sesamoid had to be removed to achieve reduction. In neglected dislocations (three cases), the dorsal approach was successful in one case (three weeks), two incisions were necessary in one case (seven months), and one case was treated by Swanson prothesis (two years). None of these patients regained normal mobility postoperatively.

[Isolated retroperitoneal hydatid cyst. Apropos of 2 new cases]. / Le kyste hydatique rétropéritonéal isolé. A propos de deux nouveaux cas.

Hydatid disease in endemic countries is common but an isolated retroperitoneal localisation is rare. After a review of the aetiopathogenesis and clinical aspects, the authors express the opinion that safe, rapid and reliable technique of echotomography is the key investigation in obtaining a positive diagnosis. In terms of its course, the histopathological appearances are those of a locally malignant tumour which as a preferential and severe effect on renal function. Surgery is the only valid method for eradication of the parasite and freeing the urinary tract.