B Ilharreborde

Publications (17)11.65 Total impact

• Article: Efficacy and late complications of percutaneous epiphysiodesis with transphyseal screws.

  B Ilharreborde, E Gaumetou, P Souchet, F Fitoussi, A Presedo, G F Penneçot, K Mazda
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  ABSTRACT: Percutaneous epiphysiodesis using transphyseal screws (PETS) has been developed for the treatment of lower limb discrepancies with the aim of replacing traditional open procedures. The goal of this study was to evaluate its efficacy and safety at skeletal maturity. A total of 45 consecutive patients with a mean skeletal age of 12.7 years (8.5 to 15) were included and followed until maturity. The mean efficacy of the femoral epiphysiodesis was 35% (14% to 87%) at six months and 66% (21% to 100%) at maturity. The mean efficacy of the tibial epiphysiodesis was 46% (18% to 73%) at six months and 66% (25% to 100%) at maturity. In both groups of patients the under-correction was significantly reduced between six months post-operatively and skeletal maturity. The overall rate of revision was 18% (eight patients), and seven of these revisions (87.5%) involved the tibia. This series showed that use of the PETS technique in the femur was safe, but that its use in the tibia was associated with a significant rate of complications, including a valgus deformity in nine patients (20%), leading us to abandon it in the tibia. The arrest of growth was delayed and the final loss of growth at maturity was only 66% of that predicted pre-operatively. This should be taken into account in the pre-operative planning.
  Journal of Bone and Joint Surgery - British Volume 02/2012; 94(2):270-5. · 2.83 Impact Factor
• Article: Hydatid disease drug therapy primarily to reconstruction of a multilevel thoracolumbar vertebral lesion.

  A Cogan, B Ilharreborde, T Lenoir, E Hoffmann, C Dauzac, P Guigui
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  ABSTRACT: We report, a very unusual case of multilevel vertebral hydatidosis adjacent to the thoracolumbar junction, without concomitant chord compression. Two months after initiating oral antiparasite treatment, the patient underwent resection of the lesion using a posterior approach, medullary decompression, and a T11-L3 instrumented arthrodesis. Arthrodesis via the anterior approach was performed at a later stage. In addition to its diagnostic value, this case raises renewed discussion about single-level lesions given their rarity: their indication for preoperative medullary angiography, their indication for circumferential surgery, the timing of medical treatment, and the strategy to implement for the residual lesions.
  Orthopaedics & Traumatology Surgery & Research 11/2011; 97(7):766-9. · 0.94 Impact Factor
• Article: Bone bridge resection for correction of distal radial deformities after partial growth plate arrest: two cases and surgical technique.

  G Lonjon, P Y Barthel, B Ilharreborde, P Journeau, P Lascombes, F Fitoussi
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  ABSTRACT: Partial closure of the growth plate is an uncommon complication in the distal radius even though distal radial fractures are among the most common injuries in children. We report two cases of resection of a bony bridge in the distal radial growth plate in boys aged 8 and 9 years with a description of the operative technique.
  The Journal of hand surgery, European volume. 06/2011; 37(2):170-5.
• Article: Benign febrile cervicalgia due to calcific retropharyngeal tendinitis: case study.

  S Queinnec, D Petrover, P Guigui, B Ilharreborde
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  ABSTRACT: Periarticular calcific tendinopathy has been well described, but no retropharyngeal locations have been reported in the surgical orthopedic literature. This pathology is a diagnostic pitfall, leading to fruitless invasive examinations and treatment. The clinical aspect is misleading, but pathognomic imaging can establish diagnosis. We report a case of febrile postoperative cervicalgia, initially suggestive of a septic complication, but in which imaging indicated retropharyngeal calcific tendinitis.
  Orthopaedics & Traumatology Surgery & Research 03/2011; 97(3):341-4. · 0.94 Impact Factor
• Article: Fixator-assisted medial tibial plateau elevation to treat severe Blount's disease: Outcomes at maturity.

  F Fitoussi, B Ilharreborde, Y Lefevre, P Souchet, A Presedo, K Mazda, G F Penneçot
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  ABSTRACT: Severe forms of Blount's disease may be associated with medial tibial plateau (MTP) depression. Management should then take account of joint congruence, laxity, limb axis, torsional abnomality, leg length discrepancy (LLD) and eventual recurrence history. Eight knees (six patients) were managed in a single step comprising MTP elevation osteotomy, lateral epiphysiodesis and proximal tibia osteotomy to correct varus and rotational deformity. Fixation was achieved using an Ilizarov external fixator. Mean age was 10.5 years. Mean hip-knee-ankle (HKA) angle was 151°; distal femoral varus, 94°; metaphyseal-diaphyseal angle (MDA), 27°; and angle of depression of the medial tibial plateau (ADMTP), 42°. Predicted residual proximal tibial growth was 2.6cm. At a mean 48 months' follow-up, results were good in six cases, medium in one and poor (due to incomplete lateral epiphysiodesis) in one. Mean lateral tibial torsion was 9° and final LLD 11mm. Weight-bearing was resumed at 2 months, and the fixator was removed at 5.5 months postoperatively. At end of follow-up, mean HKA angle was 179.6°, MDA 7.3° and ADMTP 5.4°. This technically demanding procedure gave satisfactory results in terms of axes and congruence; longer term assessment remains needed. Level IV. Retrospective study.
  Orthopaedics & Traumatology Surgery & Research 02/2011; 97(2):172-8. · 0.94 Impact Factor
• Article: Thoracolumbar junction lateral spine dislocation.

  E Morel, B Ilharreborde, F Zadegan, C Dauzac, L Rillardon, P Guigui
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  ABSTRACT: The authors describe a case of traumatic lateral spine dislocation at the thoracolumbar junction level, without fracture, in a healthy young adult, complicated by a complete neurological deficit. The main aspects of surgical management are discussed based on a review of the literature. Control of the spinal cord is a mandatory first step, before reduction, independently of neurological deficits considerations. Instrumented stabilization and fusion are achieved thereafter; levels selection for instrumentation and fusion depends on the injury location.
  Orthopaedics & Traumatology Surgery & Research 06/2010; 96(4):476-9. · 0.94 Impact Factor
• Article: A dynamic method for in vitro multisegment spine testing.

  B Ilharreborde, K Zhao, E Boumediene, R Gay, L Berglund, K N An
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  ABSTRACT: Robotics recently spread to spine biomechanical research. The aim of the present work is to describe and validate a new method for in vitro studying of a multisegmental spinal specimen under dynamic conditions. This method relies on the use of a simulator with six degrees of freedom (to impose movements in all directions), an optoelectric apparatus (for collecting kinematics data) and an original system for attaching kinematic markers, allowing their precise removal and replacement under different examination conditions. The accuracy of measurements as well as their reproducibility under static and dynamic conditions is reported here in the study of a human lumbar spinal specimen (L1-sacrum). The method appears to be reliable and reproducible, and should therefore enable future studies of variations in mobility between healthy and pathological spines, to better understand the influence of different implants on spinal kinematics.
  Orthopaedics & Traumatology Surgery & Research 05/2010; 96(4):456-61. · 0.94 Impact Factor
• Article: [In Process Citation]

  B Ilharreborde, W Delblond, M Ould-Slimane, G F Penneçot, P Guigui, K Mazda
  Revue de Chirurgie Orthopédique et Traumatologique 04/2010; 96(2):236-41.
• Article: Odontoid process pathologic fracture in spinal tuberculosis.

  M Ould-Slimane, T Lenoir, C Dauzac, D Breitel, E Hoffmann, P Guigui, B Ilharreborde
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  ABSTRACT: Craniovertebral junction tuberculosis is a rare lesion in which treatment remains controversial. Options range from conservative treatment to surgery, independently of any associated neurological threat. We here report the first case of pathologic odontoid fracture in a context of spinal tuberculosis, complicated by unusual neurological evolution. The patient presented with non-contiguous multifocal tuberculosis, of which there have previously been only 6 reported cases.
  Orthopaedics & Traumatology Surgery & Research 02/2010; 96(1):80-4. · 0.94 Impact Factor
• Article: [Pelvic ring fractures internal fixation: Iliosacral screws versus sacroiliac hinge fixation.]

  B Ilharreborde, D Breitel, T Lenoir, T Mosnier, W Skalli, P Guigui, E Hoffmann
  Revue de Chirurgie Orthopédique et Traumatologique 12/2009; 95(8):693-698.
• Article: Upper extremity kinematics analysis in obstetrical brachial plexus palsy.

  F Fitoussi, N Maurel, A Diop, E M Laassel, B Ilharreborde, A Presedo, K Mazda, G-F Penneçot
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  ABSTRACT: Several recent studies demonstrate that upper extremities kinematics analysis is in increasing use to assist clinical practice. We describe an upper limb kinematics analysis protocol that was first applied to a group of healthy children (to obtain normative data), and subsequently, to a child presenting with obstetrical brachial plexus palsy (OBPP) before and after surgical treatment. The protocol is based on two very simple tasks. Reflective markers are placed on the studied segments, and optoelectronic cameras three-dimensionally record the position of the markers during the course of movement. The data, collected by a Vicon system (Oxford Metrics Ltd., Oxford, UK), are analyzed by a dedicated software; this software provides coefficient of multiple correlation (CMC) for the comparison of different kinematics curves and motion amplitudes. A CMC above 0.95 was considered to be excellent, between 0.85 and 0.95 was good, and below 0.85 was poor. Twelve healthy children, average age 9.7 years (from 7 to 14 years), were analyzed. A 7-year-old patient presenting left OBPP was similarly analyzed, pre- and postoperatively, after a lateral rotation osteotomy of the humerus. The analysis of the 12 healthy children established a kinematics corridor for each task and each angle considered. Analysis of the pathological patient revealed kinematics anomalies during movement which went undetected at simple clinical examination. CMC analysis after treatment showed improvement of all movements around the shoulder, going from "poor" preoperatively to "excellent" postoperatively. Amplitudes analysis similarly demonstrated postoperative improvement, which increased from 28 to 67% according to the rotations considered, around the shoulder and elbow. The interest in these results should be confirmed by studies in a larger number of patients. Upper extremity kinematics analysis is increasingly utilized in current clinical practice. Although many problems occur because of the non-cyclical and non-automatic nature of movement, review of the literature and our preliminary results show that reproducibility is satisfactory. Interest in our work arises from helping develop a preoperative evaluation tool (providing a more global view of abnormalities) as well as a postoperative assessment one (for the quantification of movement gains obtained by surgery after humeral osteotomy). Level IV. Diagnostic retrospective study.
  Orthopaedics & Traumatology Surgery & Research 07/2009; 95(5):336-42. · 0.94 Impact Factor
• Article: An unusual Hangman's fracture: description and surgical management.

  E Morel, B Ilharreborde, F Zadegan, L Rillardon, P Guigui
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  ABSTRACT: C2 pedicles, or "Hangman's" fracture and "Tear-Drop" fracture, have until now been described as two distinct entities, the former caused by extension-distraction and the latter by compression-flexion mechanisms. The present clinical case combined these two fracture types of the second cervical vertebra (C2), without neurologic complication. Surgical management reduced and stabilized the lesions of the bone and of the mobile segment between C2 and C3. A right-side subhyoid presternocleidomastoid approach was selected, the main deformity lying between the body of the second and third cervical vertebrae.
  Orthopaedics & Traumatology Surgery & Research 06/2009; 95(3):229-33. · 0.94 Impact Factor
• Article: [Macrodactyly].

  F Fitoussi, B Ilharreborde, P Jehanno, J-M Frajman, P Souchet, K Mazda, G-F Penneçot
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  ABSTRACT: There are two types of congenital enlargement of the finger. In one type, the finger is enlarged as part of a syndrome or because of a tumor or a malformation. In the other, the finger is enlarged as an isolated anomaly called "true macrodactyly", with an abundance of fat mainly on the palmar side of the finger. This condition is a rare congenital malformation and the etiology is unknow. The enlarged portion of the finger or the hand can be in a distribution of a major peripheral nerve, most often the median nerve. This condition is called nerve territory-oriented macrodactyly. Macrodactyly can be static, present at birth and does not increase disproportionately with growth, or progressive with a disproportionate growth of the digit. Treatments are difficult and challenging. The goals of operative treatments are: to control the growth in children, mainly with epiphysiodesis; to reduce the size of the finger with resection of skin and subcutaneous tissue with occasionally recession osteotomy, angulation osteotomy and arthrodesis; amputation in severe progressive macrodactyly. Parents should be informed of the potentiel number of operations necessary and of the limitation of function.
  Chirurgie de la Main 06/2009; 28(3):129-37. · 0.53 Impact Factor
• Article: [How to determine the upper level of instrumentation in thoracic adolescent idiopathic scoliosis: a prospective study of 103 patients].

  B Ilharreborde, E Morel, F Fitoussi, A Presedo, P Souchet, G-F Penneçot, K Mazda
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  ABSTRACT: Determining the level of fusion remains a highly debated topic in adolescent isiopathic scoliosis. The King and Lenke classifications are used, but have their limitations, particularly the weak interobserver reproducibility. We describe the method we use which is independent of the anatomic classification, based on the predictable reduction of the different curvatures. The goal is to achieve good balance of T1 and the shoulders and reestablish spinal balance in the frontal and sagittal planes. The purpose of this work was to assess the midterm results of this strategy for determining the upper level of instrumentation. The series included 103 adolescents who underwent surgery for idiopathic thoracic scoliosis using a posterior segmental instrumentation. The upper level of fusion was determined by analyzing the rigidity of the proximal curvature and the inclination of T1 and the shoulder. X-rays (preop, postop, last follow-up) were digitalized for computer processing. Comparisons were made with the t test for paired series. Mean age at surgery was 15.2+/-1.7 years (range 10.8-19.3). Mean follow-up was 30.2 months. The clavicular angle and T1 inclination were improved significantly, both for the unique thoracic curvatures and for double thoracic curvatures. No correlation could be found between T1 inclination and shoulder balance. At last follow-up, 86.5% of the patients satisfied all balance criteria. The results of our method, which was carried out fully in 97% of patients, are encouraging and show that systematic instrumentation of the entire proximal curvature is not warranted for double thoracic curvatures. The long-term consequences for the residual T1 inclination remain to be assessed.
  Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 10/2008; 94(5):481-9. · 0.37 Impact Factor
• Article: [Sagittal balance of the spine and degenerative spondylolisthesis].

  E Morel, B Ilharreborde, T Lenoir, E Hoffmann, R Vialle, L Rillardon, P Guigui
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  ABSTRACT: Several reports have examined the pathophysiology of degenerative spondylolisthesis. Very little work has however been devoted to the influence of spinal balance in the sagittal plane in its pathogenesis. The purpose of this work was to present a descriptive analysis of pelvic and spinal sagittal balance in a cohort of seventy patients treated for degenerative spondylolisthesis and to compare findings with those established in a population of 250 volunteers. The goal was to deduct pathophysiological hypotheses and identify therapeutic implications. Seventy patients were included in this study. The following variables were noted: pelvic incidence and version, sacral slope, lumbar lordosis, thoracic kyphosis, T9 sagittal tilt and S1-S2 angle. These variables were measured on digitalized lateral views of the spine using a dedicated software (SpineView). Univariate analysis of the values obtained was performed to identify the variable distributions. Multivariate analysis was applied to study the relationships between these variables and to better define perturbations of spinal balance in the anteroposterior plane. The findings were compared with those obtained in a control population. One of the essential characteristics of the cohort of patients with degenerative spondylolisthesis was the presence of an exaggerated pelvic incidence (62.6 degrees versus 54.7 degrees in the control population). The most significant determinants of T9 sagittal tilt (which reflects sagittal balance) were: pelvic version, pelvic incidence, lumbar lordosis, and L4-S1 local lordosis. One-third of our patients presented posterior tilt due to exaggerated thoracic kyphosis. The high pelvic incidence, via hyperlordosis and increased pelvic version, could be one of the factors favoring degenerative disease of the spinal unit. This work enabled us to better describe sagittal balance in patients with degenerative spondylolisthesis and to propose hypotheses concerning the underlying mechanism of progressive degeneration. We emphasize the diversity of spinal balance in these patients and the different therapeutic implications.
  Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 12/2005; 91(7):615-26. · 0.37 Impact Factor
• Article: Fixator-assisted medial tibial plateau elevation to treat severe Blount's disease: Outcomes at maturity

  F. Fitoussi, B. Ilharreborde, Y. Lefevre, P. Souchet, A. Presedo, K. Mazda, G.F. Penneçot
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  ABSTRACT: IntroductionSevere forms of Blount's disease may be associated with medial tibial plateau (MTP) depression. Management should then take account of joint congruence, laxity, limb axis, torsional abnomality, leg length discrepancy (LLD) and eventual recurrence history.Patients and methodsEight knees (six patients) were managed in a single step comprising MTP elevation osteotomy, lateral epiphysiodesis and proximal tibia osteotomy to correct varus and rotational deformity. Fixation was achieved using an Ilizarov external fixator. Mean age was 10.5 years. Mean hip-knee-ankle (HKA) angle was 151°; distal femoral varus, 94°; metaphyseal-diaphyseal angle (MDA), 27°; and angle of depression of the medial tibial plateau (ADMTP), 42°. Predicted residual proximal tibial growth was 2.6 cm.ResultsAt a mean 48 months’ follow-up, results were good in six cases, medium in one and poor (due to incomplete lateral epiphysiodesis) in one. Mean lateral tibial torsion was 9° and final LLD 11 mm. Weight-bearing was resumed at 2 months, and the fixator was removed at 5.5 months postoperatively. At end of follow-up, mean HKA angle was 179.6°, MDA 7.3° and ADMTP 5.4°.DiscussionThis technically demanding procedure gave satisfactory results in terms of axes and congruence; longer term assessment remains needed.Level of evidenceLevel IV. Retrospective study.
  Orthopaedics & Traumatology: Surgery & Research.
• Article: Une fracture des pédicules de C2 inhabituelle : description et prise en charge

  E. Morel, B. Ilharreborde, F. Zadegan, L. Rillardon, P. Guigui
  Revue de Chirurgie Orthopédique et Traumatologique 95(3):275-280.