[Upper femoral epiphysiolysis in French Polynesia. Hip pain with serious consequences]. / L'épiphysiolyse fémorale supérieure en Polynésie Française. Une douleur de hanche aux conséquences lourdes.

High femoral epiphysiolysis is a frequent disability in French Polynesia, occurring more in obese young people that being a morphotype quite frequent in this geographical area. It is often at the stage of acute epiphysiolysis or fixed coxa vara these patients are examined. At such stage, sequellae are major and evolving to precocious coxarthrosis. It is at a stage of progressive coxarthrosis at the beginning that treatment and recovery are possible without sequellae. Any practitioner has to think about it when confronted to any pain in a hip of teenager, so a surgical treatment, in good conditions could be performed.

[Fractures of the capitellum humeri with late discovery]. / Les fractures du capitellum huméral de découverte tardive.

Four patients with an old fracture of the capitellum humeri were treated by simple excision of the fragment. The results were good in two patients and fair in the two others. The event of a painless period in two cases raised the problem of the limits with the osteochondritis dissecans.

[Surgical treatment of neglected elbow dislocations. Report of 81 cases]. / Traitement chirurgical des luxations négligées du coude. A propos de 81 observations.

The neglected dislocations of the elbow are rare in Europe. In Africa, amongst 81 operated cases, during 10 years, 52 were seen again, with a follow-up between 4 months and 7 years. From this group, the authors are trying to define the place of open reductions and resections of the lower end of humerus. The surgical indications were set up in accordance with functional discomfort. The results of open reductions and those of resections were satisfactory, respectively in 72 per cent and 74 per cent of the cases in flexion-extension movement, and 31 per cent and 41 per cent in the pronosupination. The open reduction remains often possible, even after significant delay. The resections are more mutilating, and they involve risks of laxity. They should be reserved to immediate and late failures. The place of the prosthetic surgery in this ailment is not yet defined.

[Resection of the distal part of the humerus in neglected elbow dislocations. Apropos of 23 case reports]. / La résection de la palette humérale dans les luxations négligées du coude. A propos de 23 observations.

The authors describe the results obtained in 23 resections of the lower extremity of the humerus in neglected elbow dislocation examined after periods of between 7 years to 4 months. Results on elbow mobility are satisfactory in more than 70% of the cases, taking into consideration initial disability. But the cost of such intervention to be paid is often a laxity of the elbow and diminished strength. Indications are inveterate disabling dislocation, in case of immediate or late failure of open reductions.

[Open reduction of the elbow. Apropos of 29 neglected dislocations]. / La réduction à foyer ouvert du coude. A propos de 29 luxations négligées.

The authors describe results and technical difficulties faced in a series of 29 elbow dislocations using the open technic, then observed over a period between 5 years and 4 months. Results obtained are satisfactory, taking into consideration the primary stiffness. Results on stability are better than those obtained by resection of the lower part of the humerus. Dislocations by the open technic have to be envisaged first in neglected luxations. Indications are limited to patients crippled and limited to non-functional position.

[Cutaneous malignant melanomas in New Caledonia. Study of the Cancer Registry (1977-1987)]. / Les mélanomes malins cutanés en Nouvelle-Calédonie. Etude du Registre des Cancers (1977-1987).

Investigation of cancer registration files in New Caledonia over a period of 11 years (1977-1987) draws the following conclusions: --The uncorrected incidence rate of cutaneous malignant melanoma is 3.63/100,000 inhabitants/year, for all ethnic groups together. --The incidence rate in the "non-European" population is 0.6/100,000 inhabitants/year. This low incidence and the anatomo-clinical manifestations observed (lentiginous melanoma of extremities) are common in coloured people. --The incidence rate in the "European" population is 8.75/100,000 inhabitants/year is noticeably higher than the incidence in the metropolitan population. Such conclusions are in accordance with the admitted data regarding epidemiology of cutaneous melanoma in high insolation countries. Cumulated incidence rate and topography of lesions are similar in this series whatever the sex.

[Blount's disease. Apropos of a case in a melanesian child]. / La maladie de Blount. A propos d'un cas chez un enfant mélanésien.

Reporting on a case of Blount's disease in a melanesian child in New Caledonia, the authors review the up-to-date knowledge on such an uncommon chondrodystrophy, striking black and Scandinavian children preferentially.

[A makeshift miniature fracture-fixation device: the "domino" apparatus]. / Un minifixateur "de fortune": le montage "domino".

The fixation of an external synthetic apparatus on fingers or metacarpals is often relevant to an emergency. In such a condition, particularly overseas, the surgeon does not get all the time and adequate apparatus. So, several expedient measures may be utilized. The authors describe a makeshift apparatus, simple and cheap, giving satisfactory stability when more sophisticated apparatus is not available.

[A case of ureteral bilharziasis followed for 22 years]. / A propos d'une bilharziose uretérale suivie pendant 22 ans.

The authors report on one case of urinary schistosomiasis monitored for 22 years. It illustrated the problems posed by the "bilharzial uretero-hydronephrosis". They analyse the different therapy problems which have to have been successively solved: Low double ureteral stenosis. The difficulty to be certain of such a stenosis is recalled. The possibility of a reflux or an ureteral atony must be eliminated. True stenosis must be operated without delay; Kidney cancer revealed 20 years later through chronic renal failure by vesico-ureteric reflux caused by the first surgical intervention (latero-lateral vesico-ureteric anastomosis); Iatrogenic vesico-ureteral reflux, treated by uretero-vesical implantation on "psoic" bladder with anti-reflux submucous path. The future of such a chronic renal failure is linked to the capability of the remaining ureter to ensure an acceptable passage of urine, and to the rehabilitation possibility of the kidney. Finally, the authors recalled the difficult therapeutic indications in case of ureteral attack due to bilharziosis.

[An alternative to cesarean section: symphysiotomy (Zarate's operation)]. / Une alternative à la césarienne: la symphyséotomie (opération de Zarate).

The authors explain the technique and the indications of the Zarate's operation. This non-total subcutaneous symphysiotomy eases delivery through natural canals of a cephalic presentation blocked at either the interspinous or at the inferior strait of the pelvis. Such an intervention, almost ignored in France, is really useful in the developing countries. Rather easily performed, it makes possible to limit the necessity of a cesarean section, to prevent both mother and child from serious trauma when instrumental extraction has become necessary in a dystocic pelvis, and finally to reduce the occurrence of vesico-vaginal fistula and hysterorrhexis. On the credit of this method, a special notice must be given to its practicability and to the fact that the uterus remains undamaged. On the other hand, the post-operative recovery is somewhat longer and with more disabling conditions than with the cesarean section; some painful and motor side effects which may last for a rather long time may be imputable to it.

[Epiperineural nerve sutures and neurilemmatic sutures. Comparative clinical results about 109 cases (author's transl)]. / Résultats cliniques comparés des sutures nerveuses "mixtes" épipérineurales et des sutures névrilemmatiques. A propos d'une série de 109 cas de plaies de nerfs de la main.

During the last ten years, 109 medical cases of traumatic hand nerve lesions have been observed, implicating 78 big nerves (median 35, cubital 42, radial 1) and 37 little nerves (median 35, cubital 42, radial 1) and 37 little nerves (interosseous, collateral, digital). 81 "mixte" epiperineural sutures have been realized (according to a technical proceeding purposed by one of the authors since 1970, and practised with the only aid of a simple optical increase by dissection's magnifying-glasses) : In the same time, 38 neurilemmatic sutures have been seen at second hand and their clinical results noted. 64+ of the global results are very good or "good" concerning the "mixte" epiperineural sutures against 34% for the neurilemmatic sutures. To note : the best quality of the results for the median nerve as well for the primitive sutures, and unfavourable influence of the associated lesions.

[Cystic lymphangioma of the spleen (author's transl)]. / Lymphangiome kystique de la rate.

A rare form of true non-parasitic cysts of the spleen, cystic lymphangiomas are seen as round calcified images in the left hypochondrium. Bidimensional ultrasonography has considerably simplified the diagnosis of splenic cysts, but modern investigations, which can usually eliminate the presence of hydatid cysts in the spleen, cannot differentiate the various types of non-parasitic cysts. Diagnosis of cystic lymphangiomas, currently made after pathological examinations, can be assisted by needle-puncture aspiration guided by ultrasonography, and the role of this investigatory method in diagnosis and therapy is discussed. The only radical treatment for splenic cysts is splenectomy, which should be conducted routinely because of the difficulty of pre-operative diagnosis and the high risk of severe complications.