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.
This study compared 2 series: 24 patients with an Osgood Schlatter disease and 29 normal patients. The anteversion of the femoral neck in the Osgood Schlatter patients was low but there was no significant difference. The external rotation of the tibia was also low and there was a significant difference between the patients and the normal series. But the morphotype did not seem the most important aetiological factor, because all the types could be seen. The take-off leg was 3 times on 5 concerned. There was a patella alta in 36 per cent of the cases. The position of the tibial tuberosity in the patients was more medial than in the normal series. These constatations are in favour of an action of the quadriceps in the disease.
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.
A 22 years old Melanesian patient had a tumor in the anterior and external side of the left leg. Three times, this tumor had a surgical treatment, by resection, then an amputation of the leg. Always, its histological aspect was agreeing with a desmoid fibroma. After an evolution of 23 months time, metastases appeared in the lungs. Most of the authors don't agree the existence of metastases in these tumors. Four observations were reported in the literature, including one in 1989. They emphasize the difficulties of the histological diagnosis of these tumors. The metastases seems to be an argument in the evolution, which incites to modify the initial diagnosis as a fibrosarcoma in spite of the lack of obvious histological malignancy.
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.
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.
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.
