[Combination of external fixator and internal synthesis in fractures and pseudoarthrosis of the leg. Principle indications and results].

A combination of internal and external fixation has been used on 58 occasions in fractures and pseudarthroses in the leg. In almost two-thirds of the cases, the fractures were compound. Several situations favour this combination of fixation: internal fixation complements an initial external fixation by stabilising the fracture site in the shaft or by allowing reconstruction of joint surfaces, external fixation complements any inadequate internal fixation due to comminution of the fracture or poor skin cover that only allows a minimum of internal fixation, external fixation secondarily comes to the help of internal fixation in cases of skin necrosis or secondary bone infection.

[Total hip arthroplasty in the presence of sepsis].

Sixty-seven cases of total arthroplasty of the hip in the presence of sepsis performed between 1974 and 1986 were reviewed. These prostheses were inserted in 57 cases to replace septic prostheses. Forty-six were infected total hip prostheses and 11 were infected head and neck replacement femoral prostheses.

External and internal fixation as complementary procedures in the treatment of trauma.

The use of combined internal and external fixation in the treatment of certain orthopedic traumas may seem a contradictory association, but can in fact be a quite judicious association In certain specific cases described by the authors, when basic principles of traumatology are strictly respected.

New biomechanics study of hoffmann® external fixation.

While remaining faithful to the Hoffmann Vidal external fixator, the authors have been trying for the past 15 years to improve both the stiffness and versatility of the double frame device. Taking into account the different btomechanical studies about the double frame made by different research laboratories, the authors have improved the double frame device by certain modifications in the pins and rods configuration. They have thus obtained the quadrangular triple frame mounting and the triangulate triple frame.

External fixation and arthrodesis.

Arthrodesis of joint is widely employed in case of infected nonunion especially after failed total knee replacement. Instead of the conventional methods of immobilization including plaster cast or internal fixation we think that the use of the external fixation is highly satisfactory, providing an excellent method of immobilization and allowing an early weight-bearing gait. In our series of more than 200 applications the Hoffmann external fixation has proved to be indicated most in arthrodesis of the knee, but has also been used in arthrodesis of the hip and in arthrodesis of the lower and upper extremities.

Guidelines for treatment of open fractures and infected pseudarthroses by external fixation.

There are three phases in the treatment of open fractures and infected pseudarthroses by the Hoffmann external fixator. During the initial phase a careful surgical debridement is performed in the bony tissues, and the external fixator is applied in a manner appropriate to the type and level of the lesion site (double- or triple-frame mounting; additional anchorages; neutralization, compression, or distraction; ligamentotaxis). During the intermediate phase both the nursing of the patient and care of the apparatus are critical for the avoidance of complications; it is during this period that granulation tissue must develop and bone infections must be controlled.

[Intramedullary locking nailing. Experimental study. Surgical technic. Results].

The authors describe a new type of intramedullary nail used mainly in the femur and or tibia. This nail can be locked by the provision of holes into which screws can be driven transversely. The technique of insertion is described and the use of ancillary devices.

[Scarification: its role in the treatment of chronic fistulated pyogenic osteoarticular infection].

The "scarification" technique is a reliable method of healing chronic bone infection by promoting revascularisation. A wide excision of scarred or infected soft tissue is first carried out. The bone is then carefully "scarified", or petaled, with minimal removal of bone substance.

[Prognostic elements at early stapes of severe spinal cord injuries (value of pain sensitivity].

The prognosis in serious spinal cord injury remains difficult. The neurologist has a large number of elements at his disposal, but their reliability is uncertain. Clinical information, experimental work and recent data on medullar vascularization makes it possible to isolate diagramatically in the spinal cord a medium layer which contains the pyramidal and spino-thalamic tracts.