[Vesicoureteric reflux in children: long-term results of endoscopic treatment by Macroplastique injection].

Objective: To evaluate the long-term efficacy (from the fifth year after injection and up to seven years) of endoscopic treatment by Macroplastique implant for vesicoureteric reflux (VUR) in children, sometimes associated with urological malformations or renal complications. The secondary objective was to evaluate the local tolerance of the Macroplastique implant and the development of any local (haematuria, stones, ureteric stasis) or distant complications.

Material And Methods: Retrospective analysis of the medical files of 389 patients, representing a total of 590 refluxing ureters treated by Macroplastique injection in eight different centres.

Extra-articular subtalar arthrodesis. A long-term follow-up in patients with cerebral palsy.

Of 23 children (35 feet) with cerebral palsy who had undergone a Grice extra-articular subtalar arthrodesis for a valgus hindfoot between 1976 and 1981, we reviewed 17 (26 feet), at a mean of 20 years (17 years 3 months to 22 years 4 months) after operation. Seven were quadriplegic, eight spastic diplegic, and two hemiplegic. They were all able to walk at the time of operation.

Role of laparoscopy in vaginal malformation.

Background: The aim of this study was to assess the role of laparoscopy in the management of vaginal malformations in children, a subject not often discussed in the literature.

Methods: Between 1980 and 2002, we treated 22 children for vaginal malformations. Two main patient populations were distinguished: younger children with asymptomatic hymenal imperforation and hydrocolpos, and adolescents with hematocolpos.

[Varicella complicated with necrotizing fasciitis caused by group A hemolytic Streptococcus].

Unlabelled: Chickenpox has a high risk of invasive group A streptococcal disease and necroziting fasciitis.

Case Report: A five-year-old girl, during chickenpox treated with ibuprofen, developed sepsis and edematous and necrotic lesions of the pelvis and the abdominal wall. The child improved with surgical treatment and adjunction of clindamycin to the antibiotic therapy.

Toe-walking in children younger than six years with cerebral palsy. The contribution of serial corrective casts.

Our aim in this retrospective study was to analyse the value of serial corrective casts in the management of toe-walking in children aged less than six years with cerebral palsy. A total of 20 children (10 hemiplegic and 10 diplegic) had elongation of the triceps surae by serial casting at a mean age of four years and one month. The mean passive dorsiflexion of the foot with the knee in extension was 3 degrees (-10 to +5) and 12 degrees (0 to +15) with the knee in flexion.

[Neonatal curettage of giant congenital nevi].

Objective: All agree upon the need for early treatment of giant congenital nevi, basically because of the risk of melanoma degeneration, estimated at about 5 p. 100. Another reason is the cosmetic, psychological and social impact of such nevi.

Tracheobronchial ruptures from blunt thoracic trauma in children.

Background/purpose: Tracheobronchial ruptures in blunt thoracic trauma in children are rare. The aim of this study was to suggest the means of an early diagnosis and a conservative management as often as possible.

Methods: Sixteen cases of tracheobronchial ruptures by blunt thoracic trauma were observed over 26 years in 9 regional pediatric centers.

Predicting the outcome of adductor tenotomy.

This study reviewed 57 hips in 30 children (18 girls and 12 boys) with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy (23 hips). Results were evaluated by the Reimers migration percentage (MP). The hips were split into three groups: group A (12 hips) a preoperative MP of less than 20%, group B (25 hips) between 20 and 40%, and group C (20 hips) more than 40%.

[Treatment of blunt splenic trauma in children].

Unlabelled: The conservative management of blunt splenic trauma in children has been generally accepted for about twenty years, in order to avoid serious post-splenectomy infectious complications. The objective of this study was to evaluate the results of conservative management.

Patients And Methods: 21 cases of blunt splenic trauma were treated between 1 January 1991 and 31 December 1995.

[Intra-thoracic costal sites of osteogenic exostoses in the child].

Purpose Of The Study: The authors report 2 cases of internal costal exostosis in children.

Observations: Case 1: A 15-year-old boy with hereditary multiple exostosis presented for chest pain. Radiograph and CT scan showed an internal rib exostosis.

[Surgical management of malignant bone tumors in the child. Saint-Etienne Hospital experience, apropos of 17 cases].

From 1980 to 1997, seventeen children were treated for malignant bone tumors in the Department of Paediatric Surgery of the Saint-Etienne Hospital, with an average follow-up of 6 years and 3 months (2M-17Y). The histologic diagnoses were osteosarcomas (12 cases) and Ewing's sarcomas (5 cases). All children were treated surgically.

[Continent urinary diversion using a tubulized sigmoid segment. An alternative to trans-appendicular diversion].

Objective: The authors propose the use of a sigmoid tube reimplanted submucosally in the bladder and brought out onto the skin in the midline or in the umbilicus as a method of continent urinary diversion allowing urinary catheterization several times a day when the appendix cannot be used.

Materials And Methods: Three adolescents with neurogenic bladder were treated according to this procedure; the summit of the sigmoid colon loop was selected to form a continent tube from a segment 4 cm wide, opened along its antimesenteric border and sutured longitudinally.

Results: The postoperative course was uneventful in all 3 cases.

[Muscular lengthening of the triceps by successive casts in children with cerebral palsy].

Purpose Of The Study: Twenty children with cerebral palsy who underwent elongation of the triceps surae using successive plaster-casts (28 short triceps) were reviewed. This study was retrospective.

Material And Methods: Among the eighteen children, 10 were hemiplegic, 8 were diplegic and 2 were spastic quadriparetic.

[Scrotal panniculitis due to cold: a pseudo-tumoral lesion in the prepubertal child. Report of a case].

We reported a case of scrotal panniculitis in a 7 year-old boy after exposure to cold by swimming in cold sea water. Scrotal cold panniculitis is an unusual, confined to prepuberal patients. This entity must be known to avoid surgical exploration because injuries subside spontaneously within few weeks.

Laparoscopic versus open appendectomy in children--comparative study of 403 cases.

Laparoscopic appendectomy (LA) has not achieved widespread acceptance among surgeons, open appendectomy (OA) being a simple and secure technique. We compared retrospectively 200 LAs and 203 OAs in children and adolescents (mean age = 10 years) from January 1, 1989, to March 31, 1993. The introduction of LA did not modify our operative indications.

Laparoscopic appendectomy in children: report of 1,379 cases.

The authors present a retrospective analysis of 1,379 pediatric laparoscopic appendectomies. The patients' average age was 10 years (range, 2 to 16 years). On gross examination, 90% of the appendixes appeared inflamed; on microscopic examination, 93% had evidence of acute appendicitis.

[Peutz-Jeghers syndrome. A case in an adolescent].

The Peutz-Jeghers syndrome includes periorificial melanin spots and digestive adenoma, transmitted according to an autosomal dominant mode. We report on a case discovered in a 13 year-old girl presenting with anaemia.

[Value of aortopexy in infants in the treatment of segmental tracheomalacia].

We report two cases of localized tracheomalacia, one associated with esophageal atresia, and one isolated. The pathophysiology explains that the symptoms are more important during or shortly after eating, the alimentary bowl crushing the trachea against the aorta, or the innominate artery. The exact cause of tracheomalacia is unknown.