H Carlioz

Hôpital Armand-Trousseau (Hôpitaux Universitaires Est Parisien), Lutetia Parisorum, Île-de-France, France

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Publications (45)28.15 Total impact

  • I Ghanem, J P Damsin, H Carlioz
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    ABSTRACT: This study analyzes the risks and benefits of Ilizarov's technique in congenital pseudarthrosis of the tibia (CPT). This was a retrospective review of 14 patients treated between 1985 and 1993 for CPT, by using Ilizarov's technique. In 12 cases, this technique was used after failure of previous surgical treatment. Realignment, end-to-end compression, and leg lengthening were undertaken in all the cases, without excision of the pseudarthrosis site. The mean fixation duration was 7.8 months. Union was achieved with the initial treatment in seven cases. Bone grafting was used in six of the seven remaining cases and achieved bone healing in three of them. Refracture occurred in one case, and ended with nonunion. At 3.5-year average follow-up, the tibia was united in nine cases. We found that the best indications for Ilizarov's technique in CPT were the normotrophic and hypertrophic types of pseudarthrosis (Apoil II), after the age of 5 years. Secondary massive bone grafting is to be considered in some cases. The major disadvantage of this method is the lack of excision of the pseudarthrosis site. Even after healing is achieved, the bone remains dystrophic and fragile and necessitates a permanent protective orthosis, until the end of bone growth.
    Journal of Pediatric Orthopaedics 01/2007; 17(5):685-90. DOI:10.1590/S0043-31442007000300022 · 1.43 Impact Factor
  • J P Damsin, Cyrille Cazeau, Henri Carlioz
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    ABSTRACT: This case report illustrates a scoliotic patient with congenital fusion of several ribs associated with a thoracic curvature. To report the procedure used to correct scoliosis in association with congenitally fused ribs. All cases of congenitally fused ribs reported in the literature are associated with malformed vertebrae. For this reason, the only proposed treatment for patients with progressive scoliosis is a spinal fusion. This report presents the first case of progressive scoliosis associated with fused ribs, but without vertebral malformation, that was managed by resection of these ribs. When worsening of the thoracic scoliosis was observed from 30 degrees at 13 months to 44 degrees at 4 years, the three fused ribs were resected en bloc. No spinal fusion was performed. The spine was held in correction by a localizer cast for 3 months. Fourteen years after treatment, the spine is almost normal; thoracic and lumbar curves are 10 degrees. When malformed fused ribs are on the concave side of a progressive scoliosis with no vertebral malformation at the same level, resection of these ribs is probably an efficient and sufficient method of treatment.
    Spine 06/1997; 22(9):1030-2. DOI:10.1097/00007632-199705010-00018 · 2.45 Impact Factor
  • F Boillot, A Blamoutier, H Carlioz
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    ABSTRACT: Rare congenital dislocation of hip (CDH) (0.03 for 1,000 births) are irreducible at birth; they are named teratologic in literature. However some of them are isolated without any pathological context, having a postural origin or due to an underlying disease. Seventeen dislocated hips, irreducible at birth, were seen in 12 infants and included in this study. Clinical examination of these neonates was normal with the exception of signs of CDH. Postural abnormalities such as pes calcaneus, genu recurvatum, torticolis were seen in ten infants but none of the 12 had any manifestation of neurologic, dystrophic or malformative disease. However, manifestations of a disease able to explain the CDH such as congenital myopathy, cutis laxa, cortical atrophy, Klinefelter syndrome, appeared within the following months in four infants. Treatment of these CDH started in every case by an attempt of reduction by continuous traction and was efficient in eight cases. A redislocation occurred for four hips and this treatment was uneffective for five hips. Finally seven hips had to be treated by open reduction. Reduction was maintained for nine hips after closed treatment (one of them after a redislocation and a second time of orthopaedic treatment). One hip is still dislocated after failure of closed treatment. Stabilisation of the reduction was necessary by pelvic and/or femoral osteotomy in majority of cases. Morphological modifications of hip established from X-rays and during the surgical procedure are rather related to the age of the dislocation making inappropriate the term "teratologic". The irreducible and isolated CDH can be postural in origin but as well due to a disease whom manifestations will appear lately. Their treatment, orthopaedic or surgical, is difficult and the results often disappointing.
    Archives de Pédiatrie 03/1996; 3(2):117-21. · 0.41 Impact Factor
  • J P Damsin, I Ghanem, H Carlioz
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    ABSTRACT: Risks and benefits of using Ilizarov apparatus in the treatment of congenital tibial or fibular pseudarthrosis (CTFP) are presented in this retrospective study. We reviewed with an average follow-up of 3 years and 4 months, the outcome of twenty consecutive patients treated between 1985 and 1993, for a CTFP using the Ilizarov apparatus. Sixteen patients were treated for non union of both tibia and fibula, 1 patient for an isolated non union of the fibula, and 3 patients for correction of a previously treated, malunited pseudarthrosis. The apparatus was used in four different ways: Realignement, end to end compression, and leg lengthening in 14 cases, Simple external fixation in association with another method of treatment in 2 cases, Progressive correction of malunion in 3 cases, Progressive diaphyseal reconstruction in 1 case (fibula). The mean fixation duration was 7.3 months. Union was achieved with the initial treatment in 11 out of 20 cases (including the 3 cases of malunion correction). Bone grafting was used in 7 out of the 9 remaining cases, and led to bone healing in 3 of them. Five complications were encountered: deep infection in 1 case, repeated stress fracture in 1 case, repeated fracture of the pins in 1 case, malunion in 6 cases, and less than 3 cm leg length discrepancy in 4 cases. Ilizarov external fixator is an efficient solution for many cases of CTFP, in which healing did not occur with other methods of treatment. The best indication for its use are the normotrophic and the hypertrophic types of non union (Apoil II), after the age of 4 or 5. Secondary massive bone grafting is to be considered in some cases, since it can either achieve bone union or strengthen it. The major disadvantage of this method is the lack of excision of the dystrophic tissue at the non union site. So, even after the non union is healed, the bone remains dystrophic and fragile, and necessitates a permanente protective orthosis, until the end of bone growth.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1996; 82(1):34-41. · 0.55 Impact Factor
  • I Ghanem, J P Damsin, H Carlioz
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    ABSTRACT: The incidence of bilaterality in slipped capital femoral epiphysis (SCFE) ranges, in the literature, from 19 per cent to 80 per cent. The role of contralateral pinning is to prevent late slipping of the femoral epiphysis and its complications. The purpose of this study is to assess the usefulness of routine preventive contralateral pinning in SCFE, and to evaluate its complications. We reviewed retrospectively 74 consecutive patients treated for unilateral SCFE by associated routine preventive contralateral pinning. The age at surgery ranged from 10 years and 6 months to 16 years and 10 months. The osteosynthesis was achieved by a single cannulated holothreaded screw with a cross grooved head, with or without the use of washers. An accidental pin penetration was noted in 4 cases. The epiphyseal position of the screw was satisfactory in 56 cases. The patient was allowed to walk the second or third day after surgery with the use of crutches. All our patients were reviewed after the end of squeletal growth. The follow-up ranged from 2 to 12 years and 8 months. The age at which the patient was last seen ranged from 15 years and 7 months to 27 years. Two major complications were noted: a femoral fracture at the level of the screw penetration in one case, and secondary slipping of the epiphysis after premature removal of the screw in two cases. The removal of the screw was considered to be very difficult in 10 cases. A relative overgrowth of the greater trochanter was noted in 8 cases, and was of no clinical significance. No infection was noted. At last follow-up, the shape of the femoral head and the function of the hip were normal in all cases except for one hip where severe coxa vara developed because of a secondary slip after premature removal of the screw. There is a lot of controversy about the real necessity of routine preventive contralateral osteosynthesis in SCFE. In our experience this surgery succeeded in reducing the incidence of secondary contralateral slipping. The two cases in our series could have been prevented by an accurate timing of screw removal. The complications of this procedure are rare, and it could be done during the same operative time as the SCFE side's. The only case of femoral fracture was secondary to a violent car accident. The routine prophylactic controlateral osteosyntheis in SCFE, using a single screw is a safe procedure and allows to reduce the incidence of bilaterality.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1996; 82(2):130-6. · 0.55 Impact Factor
  • F Boillot, A Blamoutier, H Carlioz
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    ABSTRACT: Background.- Rare congenital dislocation of hip (CDH) (0.03 for 1,000 births) are irreducible at birth; they are named teratologic in literature. However some of them are isolated without any pathological context, having a postural origin or due to an underlying disease. Patients.- Seventeen dislocated hips, irreducible at birth, were seen in 12 infants and included in this study. Clinical examination of these neonates was normal with the exception of signs of CDH. Postural abnormalities such as pes culcaneus, genu recurvatum, torticolis were seen in ten infants but none of the 12 had any manifestation of neurologic, dystrophic or malformative disease. However, manifestations of a disease able to explain the CDH such as congenital myopathy, cutis laxa, cortical atrophy. Klinefelter syndrome, appeared within the following months in four infants. Treatment of these CDH started in every case by an attempt of reduction by continuous traction and was efficient in eight cases. A redislocation occurred for four hips and this treatment was uneffective for five hips. Finally seven hips had to be treated by open reduction. Reduction was maintained for nine hips after closed treatment (one of them after a redislocation and a second time of orthopuedic treatment). One hip is still dislocated after failure of closed treatment. Stabilisation of the reduction was necessary by pelvic and/or femoral osterotomy in majority of cases. Conclusions.— Morphological modifications of hip established front X-rays and during the surgical procedure are rather related to the age of the dislocation making inappropriate the term “teralogic”. The irreducible and isolated CDH can be postural in origin but as well due to a disease whom manifestations will appear lately. Their treatment, orthopaedic or surgical, is difficult and the results often disappointing.
    Archives de Pédiatrie 02/1996; 3(2):117-121. DOI:10.1016/0929-693X(96)85061-5 · 0.41 Impact Factor
  • F. Boillot, A. Blamoutier, H. Carlioz
    Archives de Pédiatrie 01/1996; 3(2). · 0.41 Impact Factor
  • L Daumas, G Filipe, H Carlioz
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    ABSTRACT: The aim of this study was to emphasize the anatomical particularities of congenital vertical talus. We propose a one stage operative procedure adapted to the deformities. A retrospective study of 24 children with congenital vertical talus was conducted. An etiology was observed in 58 per cent of cases and 42 per cent were considered as idiopathic. From a radiological analysis of 39 feet, we precise the anatomical particularities. We used anteroposterior and lateral X-ray and lateral stress views with maximal plantar and dorsal flexion. Most of the lesions were localized in the midtarsal joint. The irreducibility of the talonavicular dislocation is the predominant lesion. It is usually associated with a disorientation of the cubocalcaneal joint. The articular surfaces are disorganized with a dorsal orientation. There is a variable amount of equinus deformity in the hindfoot. However the talocalcaneal divergence angle is nearly normal. The forefoot is most of the times in eversion but sometimes in inversion. All children were treated initially by physiotherapy. We recommend operative treatment for them between one to two years old. After a soft tissue release, the talonavicular dislocation and the hind foot equinus deformity is reduced simultaneously. The subtalar joint is respected and not opened. Retracted tendons may be an obstacle to the reduction. They must be lengthened if necessary especially the Achilles tendon, the peronei, the extensors and the tibialis anterior. Reduction is maintained by a K wire transfixing the midtarsal joint. Clinical results were difficult to evaluate. Out of 24 operated feet, a satisfactory outcome had been achieved in 15 feet. All were plantigrad and 18 had a good cosmetically aspect. The only bad result concerned an old case which was not operated by this technique. Conservative treatment is usually unsuccessful in congenital vertical talus. Numerous procedures have been advocated for the surgical correction of this deformity. Some authors advised excision of the navicular, full open peritalar release or extraarticular talocalcaneal arthrodesis. These are often extensive procedures and most are performed in two stages. Recently, one stage operative procedure was proposed. It allows a good correction with the respect of the subtalar joint and a lower risk of talus avascular necrosis. Furthermore it is more adapted to the deformity with a less extensive scar and a better respect of the anatomy.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1995; 81(6):527-37. · 0.55 Impact Factor
  • J P Damsin, H Carlioz
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    ABSTRACT: The numerous possibilities for adapting the Ilizarov apparatus allows the progressive correction of complex angular deviations, for which flat apparatus are sometimes difficult to adapt and this report describes our experience using the Ilizarov apparatus to treat axial limb deformities. A total of 48 patients (22 girls and 26 boys aged between 2 and 18 years-old) suffering from 58 angular deformities were treated with an Ilizarov device. 40 of the deformities involved bones: 22 tibias, 13 femurs and 6 radius. The remaining 18 deformities involved joints, (17 knees and 1 elbow), 12 were total ankylosis and 6 were flexion contractures. 31 of the cases involved an isolated deformity (16 bones and 16 joints) and 27 were associated with other orthopedic problems. The cause of the deformities were either malformation or infection in most cases. In 39 cases the angular deformities were deviations in a single plane: 13 in two planes and 6 déformities were complex, involving deviation in all three planes. Correction was progressive in 49 cases and immediate in 9 cases. Unequal limb length was treated in 21 cases: 19 of these were caused by bone deformity. The apparatus should cover the entire bone segment to be corrected, from metaphysis to metaphysis. When the deformity is close to a joint, the joint should be bridged so as to stabilize the brace. The fastening of the sides of the deformity involves a maximum of three pins in two different planes. The apparatus must be absolutely rigid so as to avoid any lateral slipping or any movement of the rings relative to the segments of the limbs. The two parts of the apparatus fixed on either side of the deformity should be linked by two groups of three threaded rods with articulations at the ends. When the correction is in a single plane, it is effected around the axis formed by two threaded rods at the point of the deformity. When the deformity is major, 90 degrees or more, the rings tend to shift under the strain, and this leads to a loss of correction and cutaneous problems on the concave face. This may be avoided by fixing threaded rods to the ring, perpendicular to the plane of the deformity. For knee flexion contractures, the rods should be connected to the ring where it crosses the frontal plane passing through the femoral diaphysis. 48 angular deviations were completely corrected. In 10 cases the deformity persisted, but was less than 20 degrees. The deformity reoccurred in 6 of the children: in 3 cases due to the persistence of muscular imbalance, in two cases by assymetric growth, in the other case by plastic deformation on the insufficiently mineralized regenerated bone tissue formed during lengthening. In one case, the common, motor and sensor peroneal nerve was paralyzed, complicating the correction of an anterior dislocation of the knee. The paralysis occurred at the end of the correction and recovery began after 6 months. One 10 year old child, suffering from nail patela syndrome, was left with a completely immobilized elbow after treatment of a webbed, 100 degrees flexion contracture. A total of 9 epiphyseal separations (Salter I type) occurred during the correction of severe deformities, with little or no displacement, all occurred around the knee. These epiphyseal separations did not interfere with the treatment of the angular deviations in three cases, however, advantage was taken of these events to effect the intended lengthening of the bone. The Ilizarov method for correcting joint ankylosis is difficult to perform, and depends on a detailed knowledge of the apparatus and braceing system, and requires rigourous installation of the pins, ring, joints and rods. Whatever the position of the two rings in relation to each other, it is always possible to link them by a system which can be adjusted. This is not possible with other external braces which have only a single plane.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1994; 80(4):324-33. · 0.55 Impact Factor
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    ABSTRACT: Three patients with lumbosacral agenesis underwent surgery to lock the lumbopelvic instability. All three patients had an unstable sitting position and a kyphotic bearing that impaired intestinal transit or hampered further colostomy or ureterostomy. Luque instrumentation with iliac fixation performed according to Galveston was used in one patient. Cotrel-Dubousset instrumentation was used for the two other patients. Autografts plus allografts provided sufficient bone for fusion without requiring lower leg amputations. Increased hip flexion was obtained after pelvic stabilization, but knee flexion contracture remained the same. All patients showed improved intestinal transit or decreased urinary infections, and two patients attained a stable sitting position without aid.
    Spine 08/1993; 18(9):1229-35. DOI:10.1097/00007632-199307000-00018 · 2.45 Impact Factor
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    ABSTRACT: Spinal deformities are frequent in Marfan's disease. 37 patients were examined at the average age of 11 years. 32 showed a spinal deformity. The treatment of the spinal deformity was a brace in 15 cases, surgery in 16 cases (including 5 cases after brace-failure). 7 cases were just followed-up without treatment. Bracing was efficient only for mild curves, this treatment was satisfying 4 times out of 11 with adequate follow-up. The surgical treatment in 16 cases was a posterior fusion twice associated with anterior fusion. We used the same technique as for idiopathic scoliosis with Harrington instrumentation 5 times, Harrington with sublaminar wires 4 times and Cotrel-Dubousset instrumentation 7 times. The correction of scoliosis was achieved in 48.2 per cent. The use of segmental instrumentation compared with the use of the Harrington instrumentation can explain the small number of non unions and the improvement of the lateral spinal balance. We did not note any cardiovascular complication during or early after the operation. Aortic lesions were responsible of one death in the long term, three patients went through a surgical replacement of aortic valves or the aorta.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1992; 78(7):464-9. · 0.55 Impact Factor
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    ABSTRACT: We report 20 cases of ipsilateral supracondylar elbow fracture and forearm fracture in childhood. The mean follow-up was 20 months. For an analysis of the results, we used a global rotation of the upper limb. We appreciated the motion and the carrying angle of the elbow and the wrist. 15 cases were very good or good; there were 4 cubitus varus without functional impairment and 1 failure after one open Monteggia fracture. The therapeutic strategy is discussed. If one does not want to increase the damage to periosteum in the elbow during the forearm reduction, one must first reduce the supracondylar fracture and fix it by 2 pins like in Judet procedure. Then, the forearm fracture should be treated conservatively.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1992; 78(5):333-9. · 0.55 Impact Factor
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    ABSTRACT: Brachial plexus birth palsy remains a challenging condition. In the 1000 infants followed from 1977 to 1988, functional results were much improved over those obtained by observation only, if surgical exploration and repair were performed when no clinical recuperation of biceps function occurred by three months of age. Recovery is slow, and comprehensive follow-up study of reconstructed and conservatively managed children is required to prevent joint contractures. Children who will benefit from palliative procedures such as tendon transfers must also be identified.
    Clinical Orthopaedics and Related Research 04/1991; DOI:10.1097/00003086-199103000-00005 · 2.88 Impact Factor
  • G Filipe, H Carlioz
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    ABSTRACT: The hip grows by a complex process involving several growth cartilages, each one playing a specific role. Dysfunction of any of these cartilages, whatever its cause, may result in architectural defects of the hip. These defects must be perfectly known in order to foresee the consequences of some hip diseases in children and sometimes to prevent these diseases by orthopaedic measures. The copious blood supply of the acetabulum protects it against all traumas, in contrast with the poor blood supply of the upper end of the femur which exposes to the risk of femoral head necrosis.
    La Revue du praticien 03/1991; 41(6):497-500.
  • R Jawish, H Carlioz
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    ABSTRACT: We studied 52 congenital longitudinal deficiencies of the fibula in 44 children, 25 girls and 19 boys. We preferred equalization of leg-length discrepancy and correction of equinovalgus deformity of the foot, to amputation. Correction of the deformity in valgus and equinus is obtained at the price of the section of triceps, peroneus brevis and fibula, inserted on the calcaneum. In some cases an open osteotomy of the talocalcaneal synostosis, or an osteotomy of the lower part of the tibia are also necessary. Good correction of foot has been obtained in 62.8 per cent of cases. 39.5 per cent of children have had suitable foot for weight-bearing, with normal shoes, and 23, 25 per cent have had prosthesis for discrepancy. This procedure should be carried out in predictable discrepancies below 150 mm, whereas 89 per cent of children were saved from amputation; this latter is recommended, at early age, for more important discrepancies.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1991; 77(2):115-20. · 0.55 Impact Factor
  • H Carlioz, J P Damsin
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    ABSTRACT: Dwyer's technique for correction and anterior fusion of the spine was improved by using lockers at the level of each screw. So, like with the Zielke's technic this procedure allowed a global progressive and controllable correction and a real derotation of the spine.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1991; 77(6):438-40. · 0.55 Impact Factor
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    ABSTRACT: Osteochondral fractures of the glenoid fossa of the ulna are exceptional injuries in children. These lesions can present diagnostic problems because the fragments are often radiolucent. We followed four children for 3, 6, and 24 months and 12 years, respectively. The elbow was definitely dislocated in two, and was probably dislocated in two other, children. The most reliable paraclinical examination was conventional sagittal tomography. Open revision is mandatory for reduction of the fracture and, when performed early, may lead to excellent functional results.
    Journal of Pediatric Orthopaedics 01/1991; 11(5):638-40. DOI:10.1097/01241398-199109000-00014 · 1.43 Impact Factor
  • A Blamoutier, H Carlioz
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    ABSTRACT: Thirty-one children (43 hips) were reviewed after having sustained a Salter innominate osteotomy. The average follow up was 10 years. The indication for the osteotomy was a persisting dysplasia after conservative treatment of congenital dislocation of the hip. The X rays study allowed to describe the importance of the remodeling of the femoral head. The overall results were satisfactory in 60 per cent of the cases. The age of the patient at the time of surgery was important: the results being much better in children under 5 years of age. The failures were mostly related to technical faults. However some failures could not be predicted.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1990; 76(6):403-10. · 0.55 Impact Factor
  • H Carlioz, J P Damsin
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    ABSTRACT: Enlarging the thoracophrenic approach by a lumbotomy to reach the lower part of the dorsal spine and the upper part of the lumbar spine is not necessary every times. A thoracophrenotomy--if necessary extended in a classical TPL--allows the treatment of most of the kyphosis or thoracolumbar kyphoscoliosis from T9 to L3. This limited approach was used 13 times.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1990; 76(5):342-3. · 0.55 Impact Factor
  • N Khouri, P Ducloyer, H Carlioz
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    ABSTRACT: The authors report their experience with a series of 25 distal tibial triplane fractures: 13 two-fragment lateral triplane fractures, 10 three-fragment lateral triplane fractures and 2 medial triplane fractures. These cases were mostly adolescents near the end of the growth spurt period. Tomography or CT scanning allowed a better delineation of the anatomic type of the fracture and of the displacements. Treatment modalities, surgical versus conservative are presented. Therapeutic indications depended on the anatomic configuration of the fracture; closed methods were most often applied to the two-fragment lateral triplane fractures, surgical treatment for most of the three-fragment lateral triplane fractures and for the medial triplane fractures. Results were usually good after an intermediate term follow-up. Joint incongruity secondary to insufficient reduction was a more severe sequela than growth disturbances.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 02/1989; 75(6):394-404. · 0.55 Impact Factor

Publication Stats

277 Citations
28.15 Total Impact Points

Institutions

  • 1996–2007
    • Hôpital Armand-Trousseau (Hôpitaux Universitaires Est Parisien)
      Lutetia Parisorum, Île-de-France, France
  • 1988–1995
    • L'Institut de Chirurgie Orthopedique et Sportive
      Lutetia Parisorum, Île-de-France, France
  • 1991
    • Institut Français de Chirurgie de la Main
      Lutetia Parisorum, Île-de-France, France