Les luxations de Ia rotule en dehors des luxations trauniatiques r#{233}centes. Revue d'Orthop#{233}die, 36, 181. MARZIANI, R. (1930): Sulla lussazione della rotula e sul suo trattamento operativo.
SUMMARY The thickness of left patellar articular cartilages after formalin fixation was studied in a series of autopsies on 82 subjects aged 25-96 years. For each specimen the minimal uncalcified cartilage thickness in a transverse patellar slab was determined separately for a 'lateral' segment and a 'central and medial' segment. In the women the cartilage from subjects more than 50 years old showed progressive thinning with increasing age. This was due to lesions causing disintegration of the tissue and not to matrix shrinkage. It had a strong potential to progress to full-thickness cartilage loss in the older women, and to give an appearance indistinguishable from osteoarthrosis as seen in surgical excision specimens. This progression towards patellofemoral osteoarthrosis in the elderly affects the female population generally, and not just a special subgroup; however, the incidence of clinical symptoms from this cause is not known. In men progressive thinning with age of patellar cartilage in subjects more than 50 years old was less severe, especially so in the case of the 'lateral' segment; a site of full-thickness uncalcified cartilage loss on the left patella at autopsy was seen only occasionally in the older men.Breaks in surface continuity are a normal feature of adult human articular cartilage. Often the lesions are mild, and may then require indian ink staining en face or histology of vertical sections for their detection (Meachim, 1972); more severe lesions are macroscopically apparent on unstained surfaces.A previous quantitative study has shown that during adult life there is an age-related increase in the percentage of the patellar articular surface area affected by 'histologically overt' fibrillation (Meachim and Emery, 1974). In terms of the functional effectiveness of cartilage as a covering material over bone, this tangential spread of the lesions is however less crucial than their vertical progression downwards into the tissue. Such vertical spread can cause matrix disintegration and lead to destructive cartilage thinning from tissue loss. This study of the patella was a quantitative investigation of this phenomenon in relation to age and sex.The thickness of the uncalcified cartilage after formalin fixation was measured on left patellae from a series of adult autopsies. Minimal thickness was recorded as that at the thinnest site found on each of two topographically different cartilage Accepted for publication May 3, 1977 Correspondence to Dr. G. Meachim, Department of Pathology, University of Liverpool, New Medical School, Ashton Street, PO Box 147, Liverpool L69 3BX segments considered separately. The results indicate that there are differences between the evolution of degenerative changes in the patellofemoral joint and those described in the hip (Byers et al., 1970); they also indicate that the severity of patellofemoral degeneration in older subjects differs between the two sexes. Material and methodsPatellae from the left knee joint of 82 adult white European subjects (40 men, 42 women)...
SUMMARY Lordosis and lordoscoliosis are disabling deformities that may develop in children with spina bifida, sometimes to a severe degree in late childhood and adolescence in patients previously without serious spinal deformity. Correction and fusion of the affected spine by a posterior approach is difficult, unrewarding and liable to complications. A preliminary report on 11 patients treated by anterior approach, multiple vertebral osteotomy, and Dwyer staple and cable fixation has shown adequate correction of severe deformity in 10 patients, with recovery of lost function due to the development of the spinal deformity, sound fusion in all cases, and improved appearance and stability. There has been no increase in paralysis as the result of the operation, even in two patients in whom there was only slight lower‐limb involvement and no bladder paralysis. The operation is one of considerable magnitude, requiring a high level of medical, surgical and anaesthetic expertise, but recovery of the patients after operation has been rapid and uneventful and there have been no significant complications. RÉSUMÉ Correction de la lordo‐scoliose dans le spina bifida par ostéotomie vertébrale multiple et arthrodèse avec fixation de Dwyer Lordose et lordoscoliose sont des déformations handicapantes qui peuvent se développer parfois à un degré grave chez des enfants âgés ou des adolescents avec spina bifida, antérieurement sans déformation vertébrale grave. La correction et l'arthrodèse de la colonne altérée par une approche postérieure est difficile, décevante et sujette à complications. Des résultats initiaux suggèrent que lorsque l'approche antérieure est utilisée, l'ostéotomie vertébrale multiple avec cable de Dwyer et fixation par agrafe peut procurer un bénéfice considérable. Chez 10 des 11 malades opeérés, l'intervention a permis une correction adéquate de la déformation vertébrale avec récupération de toute perte de fonction, progrès dans l'apparence et la stabilité. Dans tous les cas, une fusion solide est survenue. Il n'y a pas eu d'aggravation dans les paralysies à la suite de l'intervention même chez deux malades qui présentaient seulement une atteinte légère des membres inférieurs et aucune paralysie vésicale. L'intervention nécessite une compétence élevée médicale, chirurgicale et anesthésique mais la récupération des malades après intervention a été rapide et sans histoire et il n'y a pas eu de complications notables. ZUSAMMENFASSUNG Die Korrektur einer Lordoskoliose bei Spina bifida durch mehrfache spinale Osteotomie und Verschmelzung mit Dwyer Fixation Lordose und Lordoskoliose sind behindernde Derformierungen, die sich bei älteren Kindern und Heranwachsenden mit Spina bifida, die zuvor keine wesentlichen spinalen Deformierungen hatten, manchmal sogar bis zu einem ausgeprägten Maße entwickeln können. Korrektur und Verschmelzung der betroffenen Wirbel durch rückwärtige Annäherung ist schwierig, undankbar und neigt zu Komplikationen. Erste Resultate lassen vermuten, daß, wenn eine vordere Annäherung verwandt wird,...
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