Anatomy of the Lisfranc joint complex.

The authors studied the Lisfranc joint complex using gross dissection and examination of anatomical sections of frozen samples in the frontal and sagittal planes. They distinguished a medial compartment, a central compartment, a lateral compartment, the secondary joint line, and the connections with the cuneoscaphoid articulation. The ligaments were divided on the basis of topography (dorsal, interosseous, and plantar) and course (longitudinal, oblique, and transverse). The dorsal and plantar ligaments reinforce the articular capsules. The interosseous ligaments are the strongest. A common characteristic of these ligaments is that they vary considerably in course, number, and insertions.

Fracture callus in osteopetrosis.

The histologic features of bone callus after a traumatic fracture in a patient with osteopetrosis are presented. The fracture callus develops in stages that are apparently normal. The tissue is initially rich in bone-forming cells and vessels. One year later, however, unlike mature osteopetrotic bone, the tissue shows no Haversian organization.

[Heyman's operation for the treatment of congenital metatarsus varus]. / L'opération de Heyman pour le traitement du metatarsus varus congénital.

The authors report their experience with the operation of Heyman, i.e. complete release of the tarsometatarsal and intermetatarsal joint for the treatment of congenital metatarsus varus. This operation of Heyman is capable of meeting the requirements of correction if the indications are precise and if the surgical technique is perfect. The operation is indicated in cases of varus over 15 degrees, passively reducible, with good axes of the hindfoot and without bony alterations of the Lisfranc joint, in children between 3 and 8 years old. There should be a dorsal and medial capsulotomy, with section of the medial 2/3 of the plantar aspects of tarsometatarsal and intermetatarsal capsules; the lateral portion, the lateral 1/3 of the capsule and the insertions of the fibularis brevis and tibialis anticus should be spared. A complete capsulotomy is not indicated owing to the risk of dislocation of the tarsometatarsal joint. The correction should be stabilized during the operation by Kirschner wires to avoid a loss of correction when putting the foot in plaster.

Histological study of the phalangeal articular side following Keller procedure for hallux valgus.

Through a histological study, the authors have examined the coating tissue at the base of the proximal phalanx of the hallux. This study concerns five females who have undergone an operation according to Keller technique, and necessitated a reoperation for unsatisfactory results at the first operation. The study proves that resection of the phalanx leads, in time, to the formation of a coating fibrous cartilage. Such layer tends to reproduce a structure that is similar to an articulation, even though missing a hyaline cartilage. This microscopical structure supports well the load that is directed along the perpendicular axis of the phalanx, preserving, in time, a sufficient gliding capacity between the two surfaces, with optimal limitation of the natural wear-out process.