Post-HTA reinjury rates are higher than post-PTA rates but the difference is not statistically significant. For sportspeople at a regional or higher level, the time interval before the return to competition has an influence on the risk of reinjury.

Anterior hip snapping is a rare clinical observation. The physiopathological hypothesis currently held is a sudden slip of the iliopsoas tendon over the iliopectineal eminence. For symptomatic cases, a surgical technique is proposed. The aim of this work is to describe the anatomy of the femoral portion of the iliopsoas, which is the target of surgery. We have studied, through dissection of embalmed cadavers, the different components of the musculotendinous complex forming the femoral portion of the muscle and the gliding apparatus associated with it. The psoas major tendon exhibited a characteristic rotation. The iliacus tendon, more lateral, received the most medial iliacus muscular fibers, then fused with the main tendon. The most lateral fibers, starting in particular from the ventral portion of the iliac crest, ended up without any tendon on the anterior surface of the lesser trochanter and in the infratrochanteric region. The most inferior muscular fibers of the iliacus, starting from the arcuate line, joined the principal tendon of the psoas major passing around it by its ventromedial surface. An ilio-infratrochanteric muscular bundle was observed, in a deeper position, under the iliopsoas tendon; it arose from the interspinous incisure and on the anterior inferior iliac spine, ran along the anterolateral edge of the iliacus and inserted without any tendon onto the anterior surface of the lesser trochanter of the femur and in the infratrochanteric area. The iliopectineal bursa was studied on horizontal cross sections of a frozen pelvis and on 5 of the non-frozen preparations after dividing the iliopsoas tendon. The iliopectineal bursa had the shape of a 5 to 6-cm high and 3-cm wide cavity; in its upper part, it was divided into 2 compartments: a medial compartment for the main tendon and a lateral compartment for the accessory tendon.

The proposed evaluation score may facilitate PMS diagnosis and treatment standardisation. Rehabilitation has a major role associated in half of the cases with botulinum toxin injections.

No abstract

Hypertonia of the upper limb due to spasticity causes pronation of the forearm and flexion of wrist and fingers. Nowadays this spasticity is often treated with injections of botulinum toxin and sometimes with selective fascicular neurotomy. To correctly perform this microsurgical technique, it is necessary to get precise knowledge of the extramuscular nerve branching in order to be better able to select the motor branches which supply the muscles involved in spasticity. The same knowledge is required for botulinum toxin injections which must be made as near as possible to the zones where intramuscular nerve endings are the densest, which is also where neuromuscular junctions are the most numerous. Thus, it is necessary to better know these zones, but their knowledge remains today imprecise. The muscles of the anterior compartment of 30 forearms were dissected, first macroscopically, then microscopically, to study the extra- and intramuscular nerve supply and the distribution of terminal nerve ramifications. The results were then linked to surface topographical landmarks to indicate the precise location of motor branches for each muscle with the aim of proposing appropriate surgical approaches for selective neurotomies. Then for each muscle, the zones with the highest density of nerve endings were divided into segments, thus determining the optimal zones for botulinim toxin injections.