[Treatment results of fractures of the patella using pre-patellar tension wiring. Analysis of a series of 203 cases]. / Résultats du traitement des fractures de la rotule par haubanage pré-rotulien. Analyse d'une série de 203 cas.

Two hundred three fractures of the patella in 200 patients were treated by tension band wire fixation using one or several wire loops and 2 longitudinally directed Kirschner wires. They were reviewed with a mean follow-up of six years (range 1 to 10 years). There were 143 men and 57 women. Age at operation averaged 36 years (range 18 to 83 years). The most frequent etiology was a road traffic accident. The fractures were simple in 35.5%, slightly comminuted in 37%, and very comminuted in 27.5% of cases. Thirty-four fractures were open, and there were other associated fractures in 35 cases (17%); 12 fractures (6%) were seen in polytrauma patients. The operation was performed on the first day in 63 cases (31.5%), between 2 and 8 days following trauma in 112 cases (56%), and after the 8th day in 25 cases (12.5%). The authors used 2 Kirschner wires in 81 cases (40%), 3 in 73 cases (36%), and more than 3 in 49 cases (24%). A single wire loop was used in 99 cases and a modified tension band wiring in 104 cases; passive mobilisation of the knee was started on the second day after operation, and weight bearing was allowed after five days, except when there were associated lesions. The complications were sepsis in 11 cases (5%), loosening of material in 20 cases (10%), malunion in 9 cases (4.5%), nonunion in 8 cases (4%), femoropatellar osteoarthritis in 17 cases (8.5%). The results were excellent or good in 169 cases (83%), and fair or poor in 34 cases (17%). The authors recommend this operative technique which allows good anatomic reconstruction of the patella, early mobilisation of the knee and early weight-bearing with a high rate of consolidation.

[Coxitis in ankylosing spondylo-arthritis. Results of treatment with total arthroplasty. Apropos of 162 cases]. / Les coxites de la spondylarthrite ankylosante (SPA). Résultats du traitement par arthroplastie totale. A propos de 162 cas.

Excellent results were seen when 100 patients with ankylosing spondylitis who had undergone total replacement arthroplasty of the hip were reviewed 5 years after operation. One hundred and sixty hips had been replaced; 92.5% were painfree, 78% had flexion of greater than 90 degrees and 80% walked well without a stick. Using the scale of Merle d'Aubigné and Postel, 86% of the results were classed as satisfactory. The Muller and Charnley prostheses were very reliable. The outcome in hips with marked degenerative or hypertrophic changes were better than in those which were ankylosed. Operation is best carried out early before the joints are grossly damaged.