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Background: Due to the potential reduction of morbidity and mortality, unicompartmental knee arthroplasty (UKA) may represent an interesting solution for older patients with unicompartmental arthritis. It was our hypothesis that UKA can represent an alternative to total knee arthroplasty (TKA) for patients older than 75. We, thus, aimed to compare in those patients (1) functional results, (2) rates of forgotten joint, and (3) survivorships of UKA vs TKA.Methods: In this retrospective matched-pair study, 101 patients who underwent UKA in our institution were included and then matched one-to-one with TKA group based on age, gender, body mass index, preoperative Knee Society Score (KSS). Inclusion criteria were age between 75 and 90 years on the day of surgery, knee arthroplasty performed for primary osteoarthritis or osteonecrosis of the knee. All patients were evaluated clinically (using KSS, Knee Injury Osteoarthritis Outcome Score [KOOS], and Forgotten Joint Score) at 1, 2, and every 5 years, thereafter. Survivorships of UKA and TKA implants were also compared.Results: At last follow-up, patients from UKA group had better KSS than in TKA group, (respectively, KSS function 82.8 ± 12.2 vs 79.2 ± 13.1 [P = .0448] and KSS knee 88.2 ± 8.9 vs 82.3 ± 12.5 [P = .0005]). Knee Injury Osteoarthritis Outcome Scores were also higher in UKA group (all P < .001) as well as the rate of forgotten knees (42% vs 25% P = .01). Sixteen-year survivorships free from revision for any reason were similar in the 2 groups (91.8% vs 94.6% P = .66).Conclusion: The results of our study showed that UKA provide higher function and better forgotten joint scores with similar survivorship, compared to TKA, for patients older than 75. [ABSTRACT FROM AUTHOR]

The treatment of three cases of double duodenum and review of 30 cases from the literature show the excess of certain surgical attitudes. Duplication is a benign lesion, most often found in the infant or newborn and for which treatment must remain simple. Mutilating excision procedures should be avoided: gastroduodenectomy, duodenopancreatectomy. Total resection, which is rarely possible, or subtotal resection with destruction of active mucosae, and internal duodenal or rarely jejunal bypasses are satisfactory forms of treatment in the immense majority of cases.

The authors present two personal observations of thoraco-abdominal duplications of the foregut and analyze 48 others cases collected in the literature since the first one related by Budde in 1912. Anatomic study, evolutivity of the malformation, fully expression of notochordodysraphia, allow an analysis of symptoms, which must actually lead to an acute diagnosis. Total excision in a single stage through a double thoracic and, after, abdominal approach is the logic treatment.

Report of a case of rare anuria in a newborn, secondary to bilateral ureteropelvic fungus balls obstruction. Urinary decompression by bilateral nephrostomy associated to Ketoconazole therapy allowed recovery.

We report our experience with 82 cases of congenital duodenal obstruction. Forty-seven had intrinsic and 35 extrinsic lesions. Treatment of duodenal occlusion resulting from maldevelopment of the common mesentery is well standardized. Treatment of occlusion due to duodenal atresia or complete diaphragmatic obstruction needs re-evaluation. Our critical study of the anastomoses commonly used emphasizes that duodenojejunostomy and gastrojejunostomy should be avoided. The recommended operative technique had the following aims in order to utilize fully the duodenal circuit: 1) Reduction in size and remodeling of the proximal dilated duodenal segment; 2) End-to-end anastomosis of the proximal duodenum with the distal duodenum or the jejunum. Only the "annular pancreas" lesion is not fully amenable to this technique but, even here, an end-to-side anastomosis is eminently feasible.

The authors review 54 cases of diffuse bone angiomatosis (one new case and 53 from the literature) and describe the major clinical, radiological and anatomical features. The difficulties of distinguishing between haemagiomata and lymphangiomata are emphasised. The diagnosis is often helped by the presence of visceral or cutaneous lesions and when such lesions are found, a skeletal survey should always be done. These conditions, which may be classified under the general heading of angiodysplasias of bone, are hamartomata and must be distinguished from other bone lesions of vascular origin.

Para-duodenal strangulated hernia is an unusual operative finding. The entraped position of intestinal loops in a vascularized pouch allow to recognize the lesion, the site of the neck of the hernia point out its anatomic form. Pre-operative diagnosis seems difficult to access in spite of numerous investigation'means. The strangulation is generally few tight, so the treatment is very easy outside of a carefully dissection of the neck of the left para-duodenal hernias.

5 cases of biliary stricture, 3 congenital, 1 malignant and 1 blunt traumatic are reported in 3 infants and 2 children. Jaundice is present in 4 patients only and is delayed in 2. Alkalin phosphatases are constantly elevated but ultrasound studies negative in 3 patients. Diagnosis was made by percutaneous cholangiography in 2 and per-operative cholangiogram in 3. Roux en Y hepaticojejunostomy is successfully performed in 4. Bile duct stricture is a rare cause of cholestatic jaundice in childhood and an even rarer sequela of blunt trauma. This series demonstrates the usefulness of percutaneous transhepatic cholangiography, more accurate than ultra-sonography in investigating cholestasis in childhood.

Lupus panniculitis usually affects the hypodermis and the dermis profundus (Irgang's lupus profundus). In our case, the systemic lupus erythematosus was preceded by an intraabdominal panniculitis, occurring as a voluminous tumor. Histological examination showed the usual picture of panniculitis, but there were also severe fibrinoid necrotic lesions, which should have alerted us. Lupus must be included among the etiologies of intraabdominal panniculitis.

The possibility for treating adults with renal stone by extracorporeal shock wave lithotripsy is proved to be an effective method. However, up to now, a few cases in the world were reported in childhood, never before the patient was 3 years old; although 65% of urinary stones in children can be observed before 3 years. We report the first successful application of the EDAP lithotriptor in the management of a twenty months little girl with upper urinary stone. We conclude that this treatment must be developed in future.

125 children were treated for acute intussusception with :-- Barium enema to establish the diagnosis and to do partial reduction--Even when total reduction is radiologically obtained a surgical control is done with routine appendicectomy.--The rate of recurrence is 3,2% occurring from 1 to 2 years after surgery. In 18% of our cases (23 patients) an organic etiology was discovered at surgery but in one patient only this was documented ona barium enema which demonstrated the necessity of systematic laparotomy.

Surgical sequelae from duodenal atresia treated by gastrojejunostomy or duodenojejunostomy are rarely encountered. They usually appear in the late course of gastrojejunostomies. They are related at the duodenal distension above the stenoses which constitute a poorly drained "blind-loop" usually developed from a side to side anastomosis as observed in the small bowel. The following complications, related to the duodenal pouch have been reported in the literature: peptic ulcer, duodenitis or gastritis, abdominal pain, dumping syndrom and malnutrition. One patient developed a gangrenous calculous cholecystitis at 10 years of age. 3 patients under went revision of their previous surgery because of sequelae. One had duodenal atresia above the ampulla, one had an anular pancreas: in one the duodenal atresia was at the ligament of Treitz. All patients had a revision according to our technic described in Annales de Chirurgie Infantile, consisting in: --calibration of the duodenal pouch --end to end or end to side duodeno-duodenal anastomonsis --suppression of previous anastomosis. A good result was obtained in all 3 cases.

We report one case of complete reduplication of lower urinary tract associated with bilateral vesico-urethral reflux, hip dislocation, incomplete sacral agenesis and neck malformation. The two bladders are physiologically functional and we only operated the bilateral reflux by Leadbetter-Politano procedure. A review is presented of the twenty-two published cases, with the classification.

A series of 17 cases of gallstones in children observed over a period of 10 years in the area of Marseilles is described and the literature reviewed. The majority of children were girls over 10 years old. Symptoms were constantly present and the disease revealed nine times by acute "mechanical" cholecystitis, compared to 16 infectious cholecystitis followed during the same period, three times by an accident of migration (cholangitis in a 14 years old girl, bile ascitis in two infants). A cholecystography should be performed in acute recurrent abdominal pain of unknown origin in children, gallstones appearing to be radiotransparent in six patients. Among causes of gallstone formation, the authors dig out only 6 hemolytic anemias, related to hemoglobinopathies in three patients, and they emphasize the frequency of idiopathic cholelithiasis which should lead to a more complete investigation of the enterohepatic cycle and chemical constitution of bile in such patients.