[Idiopathic toe walker child. Diagnosis and spontaneous evolution].

Aim Of The Study: To analyse the clinical, the aetiological aspects, the evolution without treatment and the age of correction.

Material: This history of 69 children admitted between 1973 and 1998 was analysed. Forty-one were reviewed during the growth; only 6 were treated.

Perthes' disease after the age of twelve years. Role of the remaining growth.

In order to define the prognostic factors in Perthes' disease in children older than 12 years, we reviewed 15 patients at the end of growth who were aged 12.1 to 14 years at presentation. The patients with the worst long-term prognosis (Stulberg class V) were compared with the others for age, skeletal maturity and remaining growth (Oxford method), as well as Catterall and Waldenström classifications at presentation.

[Orthopedic surgery in adults with low intellectual quotients].

Purpose Of The Study: The object of this study was to define the requirements for successful management of polyhandicapped adults with low mental level. The goal of surgery was to improve motion performances, suppress pain, improve sitting position, and facilitate handicapped adults life.

Material: Thirty-five adults operated during a period of 20 years with a follow-up between 6 months and 20 years were studied.

[Apophysitis of the iliac crest. A little known cause of low back pain and pelvic pain in children].

The authors describe an iliac osteochondrosis in 98 teenagers aged of 12 to 17 years, responsible for anterior, medial or posterior pains of pelvis and the lumbar zone, squaring with the period of ossification of the iliac crest. The spontaneous pain was revived by pressing a precise zone of the iliac crest. These pains have the usual characteristics of the pains of ossification of apophysis.

[Supramalleolar derotation osteotomy for torsion of the leg in children and adolescents. Techniques and results: apropos of 22 patients (32 legs)].

We have performed 32 supramalleolar osteotomies described by Mc Nicol to correct excessive internal or external tibial torsion in 22 patients (aged from 4 to 8 years, with different indications, with a follow-up of 16 months to 7 years). The consolidation of the osteotomy was obtained in 6 weeks. Eighteen patients (27 osteotomy) have a good result, 2 results are fair and 2 patients have a poor result.

[Quintus varus supraductus. Results of the surgical treatment by cutaneous graft, internal capsulotomy and external transfer of the extensor of the 5th toe].

The overlapping fifth toe has often a congenital origin. It may be isolated or associated with an another pathology, congenital or acquired, but the relationship between them. Cannot be ascertained.

[Unilateral tibia vara in young children caused by focal fibrocartilaginous dysplasia. Apropos of 4 new cases].

The authors report 4 cases of tibia vara associated with focal fibrocartilaginous dysplasia observed in 3 boys and 1 girl between the ages of 11 and 17 months. Deformation was usually discovered when the child began to walk. It can worsen during the first years of life, thus explaining that two subjects were operated at 3 years and at 4 years and 8 months, with osteotomy for valgus rotation.

[Tendon surgery in equinovarus deformity of the foot in children and adolescents with cerebral palsy].

Fifty-eight children or adolescents with cerebral palsy who presented an equino varus deformity of the foot were operated on between the age of 4 to 21 by tibialis posterior tenotomy (23 cases), tibialis posterior transposition (18 cases), tibialis posterior (10 cases) or anterior (6 cases) transfer on the cuboid, with triceps lengthening (37 cases). 56 adolescents were reviewed, 45 had achieved their growth. The foot was painless and weight bearing improved.

[Flexion of the knee in poliomyelitis. Results and indications for femoral and tibial osteotomies].

Of 62 patients with a fixed flexion deformity of the knee due to poliomyelitis, 36 were treated by femoral osteotomy and 26 by tibial osteotomy. Their ages ranged between 10 and 30 years, with an average of 16. In 37 of the patients other procedures were also performed.

[Lengthening of the triceps surae muscle in children with motor disorders of cerebral origin performed before the age of 6. Results at the end of growth].

Thirty-seven patients with cerebral palsy aged between two and six years had a lengthening of the triceps by various methods: gastrocnemius recession alone or combined with soleus lengthening (Green), lengthening of the tendon Achilles by the Green method, or by Z-lengthening. All were reviewed at the end of growth. Recurrence was more frequent, in two cases out of four, in those operated on before the age of three years.

[Extensive excision of the upper end of the femur in children with motor handicap of cerebral origin].

The authors have resected the upper part of the femur on 17 occasions in 12 teenagers suffering from spastic paraplegia or quadriplegia. The patient had no hope whatsoever of walking. The hips were dislocated and painful.

[Congenital metatarsus varus. Value of orthopedic treatment and role of surgery. Apropos of 290 cases].

The authors have reviewed 252 children with congenital metatarsus varus as distinct from club foot with an adequate follow up. They describe fully conservative treatment of the condition and conclude that true correction was obtained in about 80 p. 100 of cases by the age of 3 years and that another 16 p.