{"title":"Scoliose idiopathique en période de croissance. Indications et programmes thérapeutiques","authors":"N Khouri , R Vialle , P Mary , B Biot","doi":"10.1016/j.emcrho.2003.11.004","DOIUrl":"10.1016/j.emcrho.2003.11.004","url":null,"abstract":"<div><p>Progressive scoliosis requires effective treatment. Physical therapy is useful but not sufficient. Bracing slows the progression of the deformity. When bracing fails or the patient does not comply with the treatment, the deformity may progress rapidly, becoming unacceptable in adolescence or adulthood. This situation requires surgery for instrumentation to correct the curvature and bone grafting to stabilize the spine. Surgical treatment for idiopathic scoliosis follows stringent rules and produces satisfactory outcomes, allowing the patient to lead a normal life if the residual motion range at the lumbar spine is sufficient.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"1 1","pages":"Pages 45-63"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2003.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78360466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Luxation sous-talienne : à propos d’un cas","authors":"P Djian , P Thelen","doi":"10.1016/j.emcrho.2003.12.003","DOIUrl":"10.1016/j.emcrho.2003.12.003","url":null,"abstract":"<div><p>Nous rapportons le cas d’une luxation sous-talienne chez un basketteur de 20 ans traitée orthopédiquement avec un bon résultat clinique et radiologique à 6 mois de recul.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"1 1","pages":"Pages 94-95"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2003.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74228685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Meyrueis (Ancien professeur du Service de Santé des Armées, chirurgien des Hôpitaux) , A. Cazenave (Ancien chirurgien des Hôpitaux des Armées) , R. Zimmermann (Ancien chirurgien des Hôpitaux des Armées)
{"title":"Biomécanique de l’os. Application au traitement des fractures","authors":"P. Meyrueis (Ancien professeur du Service de Santé des Armées, chirurgien des Hôpitaux) , A. Cazenave (Ancien chirurgien des Hôpitaux des Armées) , R. Zimmermann (Ancien chirurgien des Hôpitaux des Armées)","doi":"10.1016/j.emcrho.2003.11.005","DOIUrl":"10.1016/j.emcrho.2003.11.005","url":null,"abstract":"<div><p>Bone is a living anisotropic and viscoelastic material. Bone remodels in response to the mechanical demands placed upon it (Wolff’s law). Bone strength varies according to the direction in which the load is imposed. Bone is weaker in tension than in compression. Muscle activity alters the in vivo stress pattern in bone. Bone healing is influenced by mechanical factors. The most extensive question is the choice between stable or unstable fixation: the osteosynthesis is static if the stiffness never changes during the fracture healing. In an open fracture site a static osteosynthesis must be stable. The osteosynthesis is dynamic when its stiffness vary during the fracture repair in order to improve the callus formation or to reduce the risk of refracture (nail and external fixator). The dynamic osteosynthesis can be slightly unstable during 5 or 6 weeks in order to enhance the periosteal callus and after that stable until the end of the fracture healing. The amount of instability which improves the healing is still unknown. The experience suggests that it must be moderate.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"1 1","pages":"Pages 64-93"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2003.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"108086637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Damiano (Ancien interne), T Bardin (Professeur des Universités, chef de service)
{"title":"Liquide synovial normal et pathologique","authors":"J Damiano (Ancien interne), T Bardin (Professeur des Universités, chef de service)","doi":"10.1016/j.emcrho.2003.11.002","DOIUrl":"https://doi.org/10.1016/j.emcrho.2003.11.002","url":null,"abstract":"<div><p>Synovial fluid analysis is a very important diagnosis step in rheumatology. Cell count allows to differenciate inflammatory arthritis, in which cell count exceeds 2000 cells/mm<sup>3</sup>, from non inflammatory arthropathy, in which cell count is less than 1000 cells/mm<sup>3</sup>. Bacteriological studies must be performed on an emergency basis before antibiotic administration, and must include direct examination and culture, which allow the diagnosis of septic arthritis to be made and the choice of antibacterials. Demonstration of crystals in synovial fluid is a rapid and unexpensive way to diagnose microcrystalline arthritis. Synovial fluid must be examined under normal and polarized light. Equipment of the polarizing light microscope with a compensator and a rotating stage increases its diagnosis performances. Monosodium urate crystals are negatively birefringent, whereas calcium pyrophosphate dihydrate crystals are positively birefringent. Other crystals (cholesterol, oxalate, corticosteroids….) can also be identified in synovial fluid. Various artefacts must be avoided including anticoagulant crystals and synovial fluid must be anticoagulated with sodium heparin or citrate.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"1 1","pages":"Pages 2-16"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2003.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137421491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N Khouri (Médecin adjoint) , R Vialle (Interne des hôpitaux de Paris) , P Mary (Praticien Hospitalier) , C Marty (Praticien Hospitalier)
{"title":"Scoliose idiopathique. Stratégie diagnostique, physiopathologie et analyse de la déformation","authors":"N Khouri (Médecin adjoint) , R Vialle (Interne des hôpitaux de Paris) , P Mary (Praticien Hospitalier) , C Marty (Praticien Hospitalier)","doi":"10.1016/j.emcrho.2003.11.001","DOIUrl":"10.1016/j.emcrho.2003.11.001","url":null,"abstract":"<div><p>Idiopathic scoliosis has no detectable cause and occurs in previously healthy children. The spinal curvature produces a deformity in the three planes resulting in vertebral rotation with a rib-hump and alteration of the sagittal balance of the trunk. The diagnosis of scoliosis is readily made by asking the patient to bend forward: presence of thoracic asymmetry in this position indicates scoliosis and rules out less worrisome causes of spinal curvature. The scoliotic curvature may worsen, the risk being greatest during the growth period. The pubertal growth spurt may be accompanied with rapid development of a severe deformity. This is often the case in patients with scoliosis since early childhood. Every patient with scoliosis should receive careful follow-up at 6-month intervals until growth completion.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"1 1","pages":"Pages 17-44"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2003.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80952426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}