[Patelloplasty for extensive lesions of the patellar cartilage].

We have been able to review 100 cases of patelloplasty for extensive lesion of the patellar cartilage with an average follow up of 5 years. The technic for the procedure is described. The study of the results (64% of good and very good results) allow us the emphasize the criteria for best indications and technic.

[Reconstruction of loss of bony substance in limbs by free vascularized fibula transplant].

The authors present their experience of bone-loss reconstruction by a free vasculized fibular transfer. 62 cases were operated, with an average follow-up of 6 years (between 24 to 13 years). Studied were 15 upper limbs (10 humerus, 3 ulna, 2 radius), 28 femurs and 19 tibias.

[Late results of Mac Murray's osteotomy].

From a total of 817 cases, 133 cases were reviewed where a Mc Murray osteotomy had been carried out more than 10 years previously. Operative results were favourable, but the authors stress the very precise indications for this procedure. Deterioration occurred in one case where the indication appeared dubious.

[Stiffness of the knee of joint origin].

The knee usually loses its mobility following trauma, such as fracture of the femur, fracture of the upper extremity of the tibia, or fracture of the patella. We are concerned here only with joint stiffness, exclusive of any case presenting limited mobility of the knee articulation associated with retraction and/or adhesions of the entire quadriceps muscle of the femur. Forceful mobilization is strongly discouraged.

[Anterior approach in total hip arthroplasty].

The anterior approach to the hip is first between the tensor muscle of fascia lata and the sartorius muscle, then laterally to the vastus externus. Desinsertion of the fascia lata from the ilium is necessary in only slightly more than one half of the cases, and it is always limited. Access to the capsule is wide and, provided one works on an orthopaedic operating table, the manoeuvres required to dislocate the joint and expose the femoral head and neck, then the cotyloid cavity, are simple.

Vascular microsurgery in orthopaedics.

Three applications of free vascularised bone grafts are described. Free fibular grafts have been performed in 19 cases of avascular necrosis of the femoral head. The grafts are placed along the anterior femoral neck and into the femoral head with a microvascular anastomosis between the nutrient vessels of the fibula and the anterior circumflex pedicle of the hip.

[Revascularization of the femoral head for avascular necrosis (author's transl)].

The authors present an original technique for the treatment of avascular necrosis of the hip. The femoral head is dislocated and the articular cartilage is opened. The necrosed bone is excised and replaced by new cancelous bone.

[Flat foot: treatment by sub-talar arthrodesis with reposition of the talus calcaneum (author's transl)].

Since 1962, the authors have used a technique of sub-talar arthrodesis combined with talar-calcaneal reposition ("horseman" operation) in cases of valgus flat foot, accompanied by symptoms, in moderate forms with exaggerated talar-calcaneal divergence and verticalisation of the talus. This operation involves only the sub-talar joint. The mid-tarsal joint is untouched.