[A supported employment experience in western Switzerland for persons with mental health disorders].

Access and maintenance of competitive employment represent a challenge for people with mental health problems. Effective methods to support employment attain only a fraction of people who wish to re-enter the labour market. The objective of the article is to describe the development of a service to support competitive employment for mental disorders in collaboration between public psychiatry, disability insurance and social welfare.

Nonunion after fracture of the anterior tibial spine: case report and review of the literature.

Nonunion of anterior tibial spine of tibia in children is quite rare, but it could be associated with significant instability of the knee as it involves the fixation of anterior cruciate ligament. We report one case in which open reduction and internal fixation was carried out with good functional results. A literature review was performed to identify the cases reported of tibial eminence nonunion in children.

[Osgood-Schlatter disease].

Osgood-Schlatter disease is a painful affection of the knee which touches particularly the active teenagers. Etiology of this frequent affection is unknown. This disease appears as an anterior knee pain and swelling started and worsened by the sports activities.

Congenital joint dislocations caused by carbohydrate sulfotransferase 3 deficiency in recessive Larsen syndrome and humero-spinal dysostosis.

Deficiency of carbohydrate sulfotransferase 3 (CHST3; also known as chondroitin-6-sulfotransferase) has been reported in a single kindred so far and in association with a phenotype of severe chondrodysplasia with progressive spinal involvement. We report eight CHST3 mutations in six unrelated individuals who presented at birth with congenital joint dislocations. These patients had been given a diagnosis of either Larsen syndrome (three individuals) or humero-spinal dysostosis (three individuals), and their clinical features included congenital dislocation of the knees, elbow joint dysplasia with subluxation and limited extension, hip dysplasia or dislocation, clubfoot, short stature, and kyphoscoliosis developing in late childhood.

[Gait disorders and lower leg deformities in children].

Gait disorders and lower legs deformities in children are frequent causes of parental concern and of medical advice. These deformities should be analysed systematically as well as their consequences for daily activities. We should define precisely type, localisation and importance of the deformity: femoral or tibial torsion, knock knees, bow legs.

[Legg-Calve-Perthes disease].

Treatment of Legg-Calvé-Perthes disease remains, in spite of realized progresses, difficult and disturbing. The important factors for establishing diagnosis concerning definition, etiology, physiopathology and clinical manifestations are reminded. The role of present complementary investigations as well as their evolution are very important to better establish the prognosis and the treatment.

[Superficial angiomyxoma: report of four cases, including two subungueal tumors].

We report four cases of superficial angiomyxomas, including two cutaneous tumors and two subungueal tumors. Histological analysis revealed a recently described tumor, so called superficial angiomyxoma. This is a myxoid paucicellular tumor lobulated and poorly circumbscribed, containing numerous small blood vessels surrounded by a mixed inflammatory cell infiltrate with notable neutrophils.

[Foot orthotics: indication and realization].

Feet problems are a very often reason for searching medical advice: one out every people after 65 years of age have foot problems. Conservative medical treatment associated with insoles, braces and special shoes is a very important part of treatment. Patient with foot problem could have just a simple conflict due to too narrow shoes or be as severe as an destructive diabetic arthropathy.

Dynamic foot-pressure measurement in the assessment of operatively treated clubfeet.

Background: Decreased motion of the subtalar joint is common after operative treatment of idiopathic clubfeet. The purposes of this study were to validate parameters of dynamic foot-pressure measurement that enable detection of physiological pronation of the subtalar joint and to analyze the consequences of absent or decreased pronation following clubfoot surgery on long-term functional results.

Methods: To validate parameters of dynamic foot-pressure measurement, we initially analyzed two control groups: one of forty asymptomatic normal feet and the other of five feet with a previous subtalar joint arthrodesis.

Post-traumatic overload or acute syndrome of the os trigonum: a possible cause of posterior ankle impingement.

The purpose of this paper is to discuss the post-traumatic overload syndrome of the os trigonum as a possible cause of posterior ankle impingement and hindfoot pain. We have reviewed 19 athletes who were referred to our foot unit between 1995 and 2001 because of posterior ankle pain, and in whom a post-traumatic overload syndrome of os trigonum was diagnosed. All these patients were followed up over a period of 2 years.

Avascular necrosis after osteotomy of the talar neck to correct residual club-foot deformity in children. A long-term review.

In order to determine the incidence of avascular necrosis after osteotomy of the talar neck, we re-evaluated 11 patients (16 feet) with idiopathic club foot who had undergone this procedure at a mean age of eight years (5 to 13) to correct a residual adduction deformity. All had been initially treated conservatively and operatively. The mean follow-up was 39 years (36 to 41).

The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases.

This study reviewed the subjective, clinical and radiological outcome of 71 patients (84 feet) treated by scarf osteotomy for hallux valgus deformity at our institution from 1995 to 1998 with an average follow-up time of 22 months (range, 17 to 48 months). At the time of follow-up, 39% of the patients were very satisfied, 50% were satisfied and 11% were not satisfied. The mean AOFAS score raised significantly from 43 points (14-68) preoperatively to 82 points (39 to 100) at follow-up (p < 0.

Mechanical characterization of brushite and hydroxyapatite cements.

Compression, tension and torsion tests were designed and completed successfully on a brushite and a precipitated hydroxyapatite cement in moist condition. Elastic and strength properties were measured for these three loading cases. For each cement, the full set of strength data was fitted to an isotropic Tsai-Wu criterion and the associated coefficients identified.

Clear cell syringofibroadenoma (of Mascaro) of the nail.

Eccrine syringofibroadenoma (ESFA) is a rare disorder. We report the first case of ESFA of the nail apparatus, which presented as a yellow longitudinal onycholytic band of the left fourth finger over an intermittently painful subungual filamentous tumour. Histological examination showed features of ESFA with a digitate pattern of papillomatosis due to the specialized physiological longitudinal arrangement of the ridges in the nail bed.

["Round back" in children and adolescents].

The hyper-kyphosis or "the postural round back" is one of the most common complaints in orthopedic practice. In the majority of cases, the thoracic kyphosis are painless and flexible. The vertebral bodies are normal on radiograms.

["My child walks on his tiptoes"].

Toe walking is a symptom that occurs frequently in the normal childhood population. The management of children who walk in a symmetrical and permanent way on the toes is presented. In most cases no etiology of toe walking is found.

Simplified 3D-evaluation of periacetabular osteotomy.

Reorientation osteotomies are widely used for the treatment of residual dysplasia of the hip. Preoperative planning is mandatory, and 3D-evaluation is of utmost importance for precise definition of direction and magnitude of displacement of the acetabulum. Instead of a 3D-CT scan reconstruction which needs multiple slices, we developed a 3D-reconstruction from a single AP pelvic view.

A proven case of materno-foetal transfusion determined by cytogenetic and DNA analysis.

We report a case of materno-foetal transfusion in a phenotypically normal male foetus after death in utero at the 35th week of gestation. We have used cytogenetic and polymerase chain reaction (PCR) microsatellite analysis to determine the presence of maternal cells in foetal blood collected by intracardiac puncture. In the intracardiac blood sample, maternal cells were estimated to comprise between 5 and 10% of nucleated foetal blood cells.

Pathologic fracture of the femur neck as first manifestation of a minute columnar cell carcinoma of the thyroid gland.

This case report concerns a 64 year-old woman who presented a pathologic fracture of the femur neck. Histologic examination of the performed bone biopsy disclosed the presence of a carcinomatous metastasis with unusual microscopic features. The site of the primary tumor could be unequivocally determined as being the thyroid gland, as immunostaining of the tumor cells showed positivity with anti-thyroglobulin.

[Percutaneous epiphysiodesis in the treatment of adolescent genu valgum].

Unlabelled: Persistent genu valgum in adolescent induce abnormal gait and functional disturbances. Surgical correction should prevent secondary osteoarthritis.

Material And Methods: Twenty three percutaneous epiphysiodesis in 12 children are reviewed at the end of growth.

Talocalcaneal bar resection.

The purpose of this retrospective study is to report the author's experience with talocalcaneal bar resections in eight young patients, mean age 14.1 years, with a mean follow-up of 54 months (range, 36-136 months). All patients were submitted before surgery to conservative treatment during 20.