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International audience; Spine deformity during adolescent idiopathic scoliosis can induce a rib-cage deformity. This bone deformity can have direct consequences on the chest-wall muscles, including intercostal muscles, leading to respiratory impairments in individuals with severe cases. The aim of this study was to determine whether shear-wave elastography can be used to measure intercostal-muscle shear-wave speed (SWS) in healthy children and those with adolescent idiopathic scoliosis (AIS). Nineteen healthy participants and 16 with AIS took part. SWS measurements were taken by three operators, twice each. Average SWS was 2.3 ± 0.4 m/s, and inter-operator reproducibility was 0.2 m/s. SWS was significantly higher during apnea than in normal breathing (p < 0.01) in both groups. No significant difference was observed between groups in apnea or in normal breathing. Characterization of the intercostal muscles by ultrasound elastography is therefore feasible and reliable for children and adolescents with and without scoliosis.

Resume Introduction Dans la population pediatrique, les fractures du col du radius representent 1 % de l’ensemble des fractures et leurs consequences peuvent etre severes. Compte tenu de la popularite croissante de la pratique de l’equitation et des traumatismes a haute energie que celle-ci peut engendrer, nous avons cherche a evaluer le pronostic des fractures du col radial survenues en pratique equestre. Hypothese Les fractures, survenues a la suite d’un traumatisme equestre, sont plus severes et plus frequemment associees a d’autre lesions osteoarticulaires du membre superieur ipsilateral, grevant leur pronostic. Materiel et methode Nous avons realise une etude retrospective, multicentrique, comparative, dans une serie continue de 39 patients. Les criteres d’inclusion etaient l’existence d’une fracture du col du radius chez des enfants de moins de quinze ans. Les criteres de jugement principaux etaient l’existence de lesions associees au moment du traumatisme et l’arc de mobilite en pronosupination et en flexion/extension du coude au dernier suivi. Resultats Comparativement a celles causees par d’autres mecanismes, les fractures du col radial survenues a la suite d’un accident d’equitation etaient plus frequemment associees a d’autres lesions osteoarticulaires (p = 0,0002), necessitaient plus de chirurgie a ciel ouvert (p = 0,0409) et plus de reeducation postoperatoire (p = 0,041). Cependant, il ne fut pas constate de difference significative de mobilite au dernier recul, dans tous les mouvements etudies (p > 0,05). Discussion Les fractures du col du radius liees a la pratique de l’equitation chez l’enfant semblent plus severes que celle causees par d’autres mecanismes. Des campagnes de sensibilisation dans les centres equestres ainsi que le developpement de protections specifiques devraient etre envisages afin de limiter leur survenue. Niveau de preuve Therapeutique III – etude comparative retrospective.

Defined as the union of two adjacent digits, syndactyly is one of the most common congenital deformities. The severity of the malformation depends on the fusion level, the tissues involved in the union, and whether it is isolated or syndromic. In order to improve the hand's appearance and function, surgery is recommended in the great majority of cases, ideally during early childhood (i.e., before entering school). Web space reconstruction is done using local flaps. Depending on the flap design, digital resurfacing can be done with or without skin grafts. While graftless techniques have shorter operating times and no morbidity associated with skin harvesting, their cosmetic outcomes seem to be worse than those of traditional grafting techniques, with more postoperative complications; furthermore, such techniques cannot be used in all cases, especially those with osteoarticular fusions. When the fingertip is involved, paronychial reconstruction is carried out with pulp flaps. The prognosis for these deformities directly depends on their severity, with excellent outcomes in cases of cutaneous fusion, and much less predictable ones when osteoarticular and/or tendinous tissues are involved.

International audience; The aim of this work was to determine the feasibility of combined ultrasonography and elastography measurement to characterize the mechanical properties of the intercostal space during breathing. Eighteen asymptomatic participants (ages 13 ± 2 y) and six participants with adolescent idiopathic scoliosis (AIS) were included (Cobb angle 60° ± 12°). Ultrasonographic and elastographic clips were acquired of T8–T9 ribs and the intercostal space. The two adjacent ribs were tracked to infer the breathing cycle. Shear-wave speed (SWS) was measured in the intercostal space at different stages of the breathing cycle. SWS was symmetric in the control group, during both expiration and inspiration. In AIS, the SWS during inspiration was higher in the convex side than in the concave one (p = 0.02). Furthermore, SWS was higher during inspiration than expiration in the control group and in the AIS convex side, but not in the AIS concave side (p > 0.05). This new method combining echography and shear-wave elastography allowed measurement of the mechanical characteristics of the intercostal space at different phases of the breathing cycle and highlighted differences between the AIS and control groups. This approach opens the way to further analyses of the biomechanical characteristics of breathing in severe AIS.

Introduction: Achilles tendon is the most frequently ruptured tendon, but its optimal treatment is increasingly controversial. The mechanical properties of the healing tendon should be studied further. Shear waves elastography (SWE) measures the shear modulus, which is proven to be correlated to elastic modulus in animal tendons. The aim of our study was to study whether the shear moduli of human cadaveric Achilles tendon, given by SWE, were correlated with the apparent elastic moduli of those tendons given by tensile tests. Materials and methods: Fourteen cadaveric lower-limbs were studied. An elastographic study of the Achilles tendon (AT) was first done in clinical-like conditions. SWE was performed at three successive levels (0, 3 and 6 cm from tendon insertion) with elastographic probe oriented parallel to tendon fibers, blindly, for three standardized ankle positions (25° plantar flexion, neutral position, and maximal dorsal flexion). The mean shear moduli were collected through blind offline data-analysis. Then, AT with triceps were harvested. They were subjected to tensile tests. A continuous SWE of the Achilles tendon was performed simultaneously. The apparent elastic modulus was obtained from the experimental stress-strain curve, and correlation with shear modulus (given by SWE) was studied. Results: Average shear moduli of harvested AT, given by SWE made an instant before the tensile tests, were significantly correlated with shear moduli of the same AT made at the same level, previously in clinical-like condition (p < 0.05), only in neutral position. There was a statistical correlation (p < 0.005) and a correlation coefficient R² equal to 0.95 ± 0.05, between shear moduli (SWE) and apparent elastic moduli (tensile tests), for 11 tendons (3 tendons were inoperable due to technical error), before a constant disruption in the correlation curves. Discussion: We demonstrated a significant correlation between SWE of Achilles tendon performed in clinicallike conditions (in neutral position) and SWE performed in harvested tendon. We also found a correlation between SWE performed on harvested tendon and apparent elastic moduli obtained with tensile tests (for 11 specimens). As a consequence, we can suppose that SWE of AT in clinical-like conditions is related to tensile tests. To our knowledge, the ability of SWE to reliably assess biomechanical properties of a tendon or muscle was, so far, only demonstrated in animal models. Conclusion: SWE can provide biomechanical information of the human AT non-invasively.