[Proximal femoral epiphysis growth after closed reduction for congenital hip dislocation]. / Croissance de la tête fémorale après réduction de la luxation congénitale de la hanche.

PURPOSE OF THE STUDY: This cohort illustrates growth of the center of ossification of the femoral head during and after orthopedic reduction of congenital hip dislocation. MATERIAL AND METHODS: Thirty files of pediatric patients with congenital hip dysplasia were studied retrospectively. Mean age of the children was 24.5 Months. All had unilateral dysplasia, allowing a comparison of femoral head growth by calculating the centers of ossification on the AP views. RESULTS: Mean ratio between the radiological surface of the center of ossification of the femoral head on the dysplastic side and the normal side was about 1: 2. This ratio progressed rapidly during the first Months after reduction and became 1: 1 at a mean 43 Months after reduction. Beyond this time, growth of the femoral heads followed a similar pattern. DISCUSSION: Growth of the center of ossification of the femoral head is related to biomechanical stress forces. Reduction is the only event in the natural history of the disease, but renewed growth of the femoral head cannot provoke in itself normal acetabular growth. Complementary pelvic osteotomy was required for 13 hips. CONCLUSION: Accelerated growth of the femoral head ossification center continues to be a good indicator of femoral head vitality. Early and rapid growth observed after reduction, without osteochondritis, can lead to a normal femoral head at the end of growth.

[Extended melanocytic tumor of the cervical spine. Apropos of a case of melanotic schwannoma]. / Tumeur mélanique étendue du rachis cervical. A propos d'un cas de schwannome mélanotique.

A case of melanotic tumour was described localized close to the right cervical spine, destroying C6 and C7 vertebral bodies and pedicles, on a 27 years old woman. Histological and immunohistochemical findings, correlated with clinical and X-rays data, led up to the diagnosis of a melanotic schwannoma. Six years after the beginning of the illness, the outcome was preceded by a local vertebral involvement without metastasis and paradoxically with a good general state. The tumoral localization and the finding of nervous structures allowed to evoke a development from a cervical nerve root. On histological basis, we propose to classify this tumour along the new concept described by the Mayo Clinic pathologists team, under the name of psammomatous melanotic schwannoma. Some authors evoke a congenital outset in a context of endocrine disorders.