J P Cahuzac

Paul Sabatier University - Toulouse III, Tolosa de Llenguadoc, Midi-Pyrénées, France

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Publications (88)79.03 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: This study presents the results of a prospective consecutive cohort of patients with Legg-Calvé-Perthes disease (LCPD) operated with triple osteotomy of the pelvis (TOP) between 1989 and 2005. We attempted to determine whether the results of TOP remain stable with time and consequently lower the risk of subsequent osteoarthritis. The primary study aims were to determine the maintenance of head coverage and joint congruity, and functional outcomes of this surgery. Forty-five patients with a mean follow-up of 15.2 years (range eight to 24) were included. At latest follow-up, two patients were lost to follow-up, and two required a surgical reoperation. Cumulative maintenance of head coverage and joint congruity rate for all TOP was 84.6 % (95 % CI: 82.3-90.6 %) at 15 years. Factors significantly associated with poor long-term results were the age at diagnosis and Greene index. TOP in LCPD provides satisfactory and reproducible long-term clinical results.
    No preview · Article · Feb 2015 · International Orthopaedics
  • R. Darmana · J.-P. Cahuzac
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    ABSTRACT: El morfotipo de los miembros inferiores del niño evoluciona durante todo el crecimiento en los tres planos del espacio. En el plano transversal, tanto en el fémur como en el complejo tibioperoneo se desarrolla una torsión fisiológica. Esta transformación no sigue una evolución lineal en el tiempo y tiene la singularidad de que puede compensarse. Las anomalías resultantes están bien descritas, pero no es fácil comprenderlas debido a su origen multifactorial, y las consecuencias sobre las articulaciones, en especial su relación con la artrosis, no están claramente definidas. Los estudios clínicos y biomecánicos al respecto no son muy numerosos, aunque los relativos a las consecuencias durante la marcha revelan nuevos parámetros para la comprensión de los trastornos biomecánicos. Después de describir las transformaciones fisiológicas y sus anomalías, se analizan las consecuencias sobre la marcha en los tres planos del espacio y bajo dos aspectos: cinemático (modificación del ángulo de progresión del pie, reducción de la flexión dorsal, aumento de la abducción de la cadera) y cinético (modificaciones de las fuerzas de reacción del suelo y de los momentos de fuerzas en la rodilla, el tobillo y el pie.
    No preview · Article · Aug 2014
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    ABSTRACT: Percutaneous techniques for the correction of foot deformities are gaining popularity in the adult population, but remain poorly explored in children. Of the several surgical techniques described to treat persistent severe metatarsus adductus (MA) deformity in children, neither was percutaneous. The purpose of the study was to describe a percutaneous technique for MA correction in children, to report the outcomes, and to discuss the advantages it offers. We designed a prospective study on 34 consecutive feet with MA deformity from 26 children undergoing percutaneous correction. All operated feet had severe, rigid MA deformities, most of which were components of residual/recurrent clubfoot deformities. The mean age at surgery was 5.7 years and the mean follow-up was 55.2 months. For clinical evaluation, we used the bisector method; the first cuneometatarsal angle and metatarsal-metaphyseal angle measured in weight-bearing radiographs and AOFASf score were determined preoperatively and postoperatively. In unilateral cases, we used the contralateral foot measurements as control. The operating time and the hospitalization time were also recorded. The surgical technique consisted of performing the Cahuzac procedure for MA correction with a percutaneous approach. At the final follow-up all feet presented a normal heel bisector line. Radiologic parameters were normalized when compared with control feet. The mean surgical and hospitalization time was 14 minutes and 6 hours, respectively. Mean AOFAS score improved from 78 to 98. A minimally invasive percutaneous technique allowed a successful correction of MA deformity in children and resulted in a substantive decrease in both surgical and hospitalization time and better cosmetic results. Level II.
    Full-text · Article · Nov 2013 · Journal of pediatric orthopedics
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    ABSTRACT: The purpose of this study was to evaluate a minimally invasive subscapularis-preserving arthroscopic release of capsule in the treatment of internal rotation contracture of the shoulder due to Erb's palsy. We performed our procedure (subscapularis-preserving arthroscopic release of capsule) in 10 paediatric shoulders with an average age of 20.2 months and followed them for an average period of 41.5 months. All the patients were assessed clinically and radiologically preoperatively and postoperatively at regular intervals. The Mallet scoring system was used for analysing the results. The average gain in passive external rotation was 50°. The active internal rotation was preserved in all the cases. With the mid-term follow-up, there was no loss of the gained external rotation or the recurrence of internal rotation contracture of the shoulder. Our hypothesis has achieved its goal in preserving subscapularis, active internal rotation and treatment of internal rotation contracture of the shoulder. The success of this procedure lies in the early identification of starting of internal rotation contracture and early surgical intervention to prevent progressive permanent glenohumeral osseocartilaginous deformity.
    Full-text · Article · May 2012 · Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America
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    ABSTRACT: Internal rotation contracture of the shoulder in brachial plexus birth palsy frequently leads to shoulder dysplasia. Six children underwent anterior arthroscopic release sparing the subscapularis. Clinical examination and MRI were performed preoperatively and repeated at the 5-year follow-up. MRI was carried out for assessment of glenohumeral dysplasia. Passive external rotation was improved by 63.3° without any limitation of active internal rotation. Active antepulsion/abduction was improved by 90°. Remodeling of the glenoid and improved coverage of the humeral head were observed in all cases. Shoulder arthroscopic release sparing the subscapularis seems to be an efficient procedure to restore external rotation without affecting active internal rotation.
    No preview · Article · Apr 2012 · Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America
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    ABSTRACT: La synostose calcanéo-naviculaire est une cause fréquente de douleurs avec un pied plus ou moins plat et raide chez l’enfant. Le traitement classique consiste à réséquer le pont par un abord dorsolatéral. La qualité de la résection et l’interposition s’associent à l’absence de récidive. Les complications les plus fréquentes sont l’hématome, l’infection et le névrome. L’arthroscopie représente une alternative mini-invasive de traitement. Cependant, les voies d’abord restent imprécises. Nous décrivons la technique opératoire avec des abords basés sur la proéminence antérolatérale du calcanéus et appliquée sur trois cas avec un an de recul. La résection arthroscopique présente des avantages. La récupération est plus rapide, et le résultat esthétique meilleur. L’abord instrumental requiert une incision cutanée superficielle suivie d’une discision du tissu sous-cutané afin d’éviter de léser le nerf fibulaire superficiel. En attente d’un plus grand recul, l’arthroscopie s’avère comme une technique mini-invasive séduisante pour ce type de pathologie.
    No preview · Article · Sep 2011 · Resuscitation
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    ABSTRACT: Dans la classification de Wassel le type IV correspond à une duplication au niveau de l’articulation métacarpophalangienne (MCP) du pouce et représente plus de la moitié des cas. Il est subdivisé en quatre types dont le type IV-D ou divergent (9 %) représente la forme la plus complexe puisque les deux hémipouces sont hypoplasiques avec une divergence au niveau de la MCP et une convergence au niveau de l’interphalangienne. Dans le traitement des types IV-D, la méthode de reconstruction d’un des deux hémipouces expose à des déviations et à l’instabilité alors que le procédé de Bilhaut-Cloquet pose souvent un problème de dystrophie unguéale. Afin d’éviter ces complications, nous proposons une procédure de Bilhaut-Cloquet modifiée et nous rapportons les résultats préliminaires de quatre cas.
    No preview · Article · Sep 2010 · Resuscitation
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    ABSTRACT: PurposeCongenital scoliosis resulting from hemivertebrae can be treated surgically through resection or convex epiphysiodesis. Our purpose was to assess the results obtained in a series of children operated using both methods.
    No preview · Article · Feb 2009 · Revista Española de Cirugía Ortopédica y Traumatología
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    ABSTRACT: Purpose: Congenital scoliosis resulting from hemivertebrae can be treated surgically through resection or convex epiphysiodesis. Our purpose was to assess the results obtained in a series of children operated using both methods. Materials and methods: A clinical and radiological review was carried out of a non-comparative series of 27 isolated hemivertebrae of which 16 had been treated by means of resection and 11 by means of epiphysiodesis. Mean age at surgery was 50 months (24-132) and Cobb's angle was 33° (20°-75°). In the case of lumbar hemivertebrae, resection was performed through an anterior and posterior approach; compressive CD instruments were used. Epiphysiodesis for the thoracic vertebrae required a prior excision phase at two levels, followed by a subsequent 4-level decortication phase: in 6 cases they were instrumented and in 5 a plaster cast was applied in the reduced position. Results: No neurological complication was found. With respect to the 16 resections, mean reduction was 75% postoperatively and 73% at the end of the study. For the 11 epiphysiodeses mean correction obtained was 25% postoperatively and 39% at 4 years' mean follow-up (1-8 years). There were 2 cases of long-term failure in the absence of instrumentation. Conclusions: Resection of hemivertebrae provides immediate and stable satisfactory results. However, in the thoracic area, and given the neurological risk involved, instrumented convex epiphysiodesis guarantees a good long-term result.
    No preview · Article · Feb 2009 · Revista Espanola de Cirugia Ortopedica y Traumatologia
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    ABSTRACT: L’objectif de cette étude est d’apprécier les résultats de l’arthrolyse antérieure sous arthroscopie de l’épaule dans les raideurs en rotation interne secondaire à une paralysie obstétricale haute du plexus brachial (C5, C6 ± C7). Chez huit enfants sur 14 présentant une rétraction en rotation interne de l’épaule, une arthrolyse antérieure avec respect des muscles subscapulaire et grand pectoral a été réalisée. Dans tous les cas un transfert du muscle latissimus dorsi a été associé. L’âge moyen lors de l’intervention était de trois ans et six mois. Les huit cas ont été revus avec un recul minimum de 12 mois et moyen de trois ans. Seules les mesures des rotations externe et interne passives ont été prises en compte en raison de l’âge des enfants. Les résultats montrent un gain sur la rotation externe de 50° en moyenne avec conservation de la rotation interne selon la cotation de Mallet et une amélioration importante du mouvement d’abduction–antépulsion. Aucune récidive n’a été notée. Ces résultats montrent que l’arthrolyse sous arthroscopie précoce et limitée au plan capsuloligamentaire antérieur et supérieur permet d’obtenir des résultats comparables aux autres techniques quant au mouvement de rotation externe passive. De plus, en conservant le muscle subscapulaire, elle limite le risque d’instabilité antérieure de l’épaule et permet de conserver la mobilité active en rotation interne. Son indication reste limitée dans les raideurs en rotation interne avec luxation postérieure de l’épaule.
    No preview · Article · Nov 2008 · Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur
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    ABSTRACT: Purpose Metatarsus adductus is an adduction deformity of the forefoot. Our purpose is to uphold the claim that the main anomaly is to be found on the cuneiform side of the cuneo-metatarsal joint and that the growth of the medial cuneiform is fundamental for correction further to capsulotomy. Materials and methods This is a radiological study of 23 children with idiopathic or clubfoot-related metatarsus adductus subjected between 1982 and 2000 to a release of the cuneiform metatarsal joint. X-rays were taken of the 30 operated feet and of 12 contralateral feet used as controls. The following measurements were made: cuneiform-metatarsal angle, distal inclination angle of the medial cuneiform bone, angle formed between the latter surface and the first metatarsal and the proximal articular angle of the first metatarsal. The mean pre-op, immediate post-op and post-op final values of these angles were compared using the relevant statistical tests. Results As regards idiopathic metatarsus adductus, the cuneiform metatarsal angle went from a preop value of 150.4° to 170.2° at the end of follow-up; the distal inclination angle of the medial cuneiform went from 62° to 81.1°; and the angle formed between the latter surface and the first metatarsal and the proximal articular angle of the first metatarsal went from 88.4° to 89.1°. With respect to clubfoot-related metatarsus adductus, the cuneiform metatarsal angle went from a preop value of 155.3° to 169.7°, the distal inclination angle of the medial cuneiform went from 61.9° to 79.7°, and the angle formed between the latter surface and the first metatarsal and the proximal articular angle of the first metatarsal went from 88.3° to 90°. On the healthy side, the angle values showed virtually no changes. Conclusions The obliqueness of the medial cuneiform-metatarsal joint is closely related to metatarsus adductus. Postsurgical correction also takes place at the expense of this bone, which tends to fill the space created by the capsulotomy.
    No preview · Article · Apr 2008 · Revista Española de Cirugía Ortopédica y Traumatología
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    ABSTRACT: Objetivo El metatarso adducto (MTA) es una deformación en adducción del antepié. Nuestro objetivo es apoyar la hipótesis por la cual la principal anomalía se encuentra en el lado cuneiforme de la articulación cuneo-metatarsiana, y que el crecimiento de la primera cuña es fundamental en la corrección tras la capsulotomía. Material y método Se trata de un estudio radiológico realizado con 23 niños con MTA idiopático o secundario a pie zambo, operados entre los años 1982 y 2000, con liberación de la articulación cuneo-metatarsiana. Se realizaron radiografías de los 30 pies operados, y de 12 pies contralaterales utilizados como controles, con las siguientes mediciones: ángulo cuneo-metatarsiano (FMCA), ángulo de inclinación distal de la primera cuña (DCAA), ángulo entre esta superficie y la del primer metatarsiano (PENTE) y ángulo proximal articular del primer metatarsiano (PMAA). Se compararon las medias de estos ángulos tomadas en pre, post-operatorio inmediato y final del seguimiento, mediante los pertinentes tests estadísticos. Resultados Respecto al MTA idiopático, el FMCA aumentó de 150,4° en el preoperatorio a 170,2° al final, el DCAA pasó de 62° a 81,1°, y el PMAA de 88,4° a 89,1°. Respecto al MTA secundario a pie zambo, el FMCA aumentó de 155,3° a 169,7°, el DCAA pasó de 61,9° a 79,7°, y el PMAA de 88,3° a 90°. En el lado sano los ángulos apenas se modificaron. Conclusiones La oblicuidad de la articulación cuneo-metatarsiana medial está estrechamente relacionada con el metatarso adducto. La corrección post-quirúrgica se hace también a expensas de este hueso, que tiende a rellenar el espacio creado por la capsulotomía.
    No preview · Article · Mar 2008 · Revista Espanola de Cirugia Ortopedica y Traumatologia
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    ABSTRACT: Ulnar styloid fractures are frequently ignored in the treatment of wrist fractures in children. Forty-six untreated ulnar styloid fractures (40 tip and six base fractures) associated with radial injuries (45 patients) were retrospectively analysed. At the removal of the cast, we recorded that 80% had a nonunion of the styloid fracture. Thirty-five patients were reviewed at an average of 19 months after treatment. Thirty tip fractures and five base avulsions were found. We recorded 28 patients with a good clinical result despite 21 cases of nonunion, whereas seven patients (all nonunions) had a fair result. All the fair results suffered from intermittent pain during sports and movement, radioulnar joint instability and tears of the triangular fibrocartilage complex. It can be concluded that both distal radius and ulnar styloid fractures should be taken into account in the initial treatment and pain associated with a nonunion of the ulnar styloid in a child may be due to a tear of the triangular fibrocartilage complex.
    No preview · Article · Feb 2008 · Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America
  • F. Accadbled · C. Mansat · J.-P. Cahuzac
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    ABSTRACT: Las anomalías rotacionales de los miembros inferiores en el niño se relacionan con el exceso o la insuficiencia de las torsiones fisiológicas del fémur y/o de la tibia. Dan lugar a seis cuadros clínicos fáciles de reconocer mediante el análisis de las posiciones respectivas de las rodillas y de los pies durante el inicio de la fase de apoyo en el ciclo de la marcha. De este modo, la marcha «con los pies hacia dentro» se debe a una antetorsión femoral exagerada o a una torsión tibial lateral insuficiente, mientras que la marcha «con los pies hacia fuera» deriva de una retrotorsión femoral o de una torsión tibial lateral exagerada, asociada o no a una antetorsión femoral exagerada. Estas anomalías, que suelen ser bilaterales, pueden ser también unilaterales. Es necesario cuantificar estos vicios de torsión mediante un análisis estandarizado y comparar los resultados con los datos fisiológicos en función de la edad y del sexo para poder situar estas anomalías. El seguimiento de estos niños muestra que las torsiones femorales o tibiales evolucionan durante todo el crecimiento, de tal forma que estos cuadros clínicos se modifican con el tiempo. Aunque la mayoría de estos trastornos de la marcha son idiopáticos y familiares, es preciso descartar en la exploración las alteraciones secundarias, sobre todo neurológicas (enfermedad motriz cerebral [IMC] mínima). La mayor parte de estas anomalías se considera de tipo benigno, bien porque se resuelven o bien porque los pacientes se acomodan a ellas con el tiempo. No obstante, unos pocos de estos morfotipos marginales, resultantes de una combinación de anomalías en los tres planos del espacio, persisten y pueden aparecer como factores favorecedores, más que determinantes, de una enfermedad de la rodilla. Por tanto, las indicaciones quirúrgicas sólo pueden implicar a un pequeño número de casos (0,1%). Estas indicaciones se basan en una cuantificación precisa de los síntomas y de las anomalías de torsión. Este tratamiento consiste en las osteotomías de desrotación femoral y/o tibial.
    No preview · Article · Dec 2007
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    ABSTRACT: AimEpidemiological analysis in a universitary paediatric emergency unit of children admitted after accidental injuries resulting from fingers crushed in a door.
    No preview · Article · Aug 2007 · Archives de Pédiatrie

  • No preview · Article · Jun 2007 · Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur

  • No preview · Article · Jun 2007 · Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur

  • No preview · Article · Jun 2007 · Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur
  • Franck Accadbled · Xavier Cassard · Jerome Sales de Gauzy · Jean Philippe Cahuzac
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    ABSTRACT: The goal of this study was to evaluate the results of meniscal repair in children and adolescents by a retrospective case series. Twelve arthroscopic-assisted meniscal repairs were performed on 12 patients younger than 17 years of age (8-16 years, mean 13 years). The anterior cruciate ligament was torn in three cases. Eight lesions involved the lateral meniscus and four involved the medial meniscus; there were no discoid menisci. All patients were seen at an average of 3 years 1 month follow-up (range, 2-4 years 10 months). Three patients required subsequent surgery for partial meniscectomy. We evaluated the remaining nine patients by clinical examination, International Knee Documentation Committee clinical score, Lyshölm score, Tegner's activity, and by computed tomography arthrogram or magnetic resonance imaging. Seven patients were asymptomatic at follow-up, two reported occasional pain, and none had experienced symptoms of locking. Their average Lyshölm score and Tegner's activity were 96.3 and 6.6, respectively. Eight patients were International Knee Documentation Committee A and one was International Knee Documentation Committee B. Healing status was assessed at follow-up in eight patients by computed tomography arthrogram or magnetic resonance imaging: the tear was considered as completely healed in three patients. The apparent failure rate was 66%. Indications for meniscal repair in children are not actually established. The pejorative outcome of meniscectomy at a young age has led us to consider symptomatic meniscal tears for repair. Objective results of meniscal healing are poor. The method to assess healing of the repaired menisci objectively is still a matter of debate.
    No preview · Article · Feb 2007 · Journal of Pediatric Orthopaedics B
  • F. Accadbled · C. Mansat · J.-P. Cahuzac

    No preview · Article · Jan 2007

Publication Stats

620 Citations
79.03 Total Impact Points

Institutions

  • 2000-2014
    • Paul Sabatier University - Toulouse III
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2004-2006
    • Muséum de Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2002
    • Clinique Jeanne d'Arc
      Naoned, Pays de la Loire, France