20 results on '"Thomas Demoures"'
Search Results
2. Repeated Induced-Membrane Technique Failure without Infection: A Series of Three Consecutive Procedures Performed for a Single Femur Defect
- Author
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Laurent Mathieu, Marjorie Durand, Thomas Demoures, Christian Steenman, Alain-Charles Masquelet, and Jean-Marc Collombet
- Subjects
Orthopedic surgery ,RD701-811 - Abstract
A 40-year-old male was treated using the induced-membrane technique (IMT) for a noninfected, 9 cm long femoral bone defect complicating a lengthening procedure. The interesting case feature lies in the three consecutive IMT procedures that were necessary to achieve complete bone repair in this unusual clinical situation. The first procedure failed because of the lack of graft revascularization likely related to an induced-membrane (IM) alteration demonstrated by histological observations. The second IMT procedure led to partial graft integration interrupted by the elongation nail breakage. At last, the third procedure fully succeeded after nail exchange and iterative iliac bone grafting. Complete bone union was achieved with a poor functional recovery one year after the last procedure and four years following the first cement spacer implantation. By means of clinical and histological observations, we demonstrated that the first and the second IMT failures had two distinct origins, namely, biological and mechanical causes, respectively. Although simple, a successful IMT procedure is not so easy to complete.
- Published
- 2020
- Full Text
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3. Prolonged tactical tourniquet application for extremity combat injuries during war against terrorism in the Sahelian strip
- Author
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Alexandre Sabate-Ferris, Georges Pfister, Jean-Louis Daban, Frédéric Rongieras, Thomas Demoures, G. Boddaert, Stéphane Travers, Laurent Mathieu, Alexandre Caubere, and Stéphane de Rudnicki
- Subjects
Adult ,Damage control ,medicine.medical_specialty ,Sports medicine ,medicine.medical_treatment ,Hemorrhage ,Critical Care and Intensive Care Medicine ,Compartment Syndromes ,Rhabdomyolysis ,Fasciotomy ,Young Adult ,External fixation ,medicine ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,Tourniquet ,Multiple Trauma ,business.industry ,Tourniquets ,medicine.disease ,Surgery ,body regions ,Mass-casualty incident ,Lower Extremity ,Amputation ,Emergency Medicine ,Terrorism ,Wounds, Gunshot ,business - Abstract
This study reports on complications following extended tourniquet application in patients with combat extremity injuries treated by the French Military Health Service in the Sahelian strip. A retrospective review was performed in a French forward medical treatment facility deployed in Gao, Mali, between 2015 and 2020. All patients treated for an extremity injury with the application of at least one tourniquet for a minimum of 3 h were included. Prehospital data were injury pattern, associated shock, tourniquet location, and duration. Subsequent complications and surgical procedures performed were analyzed. Eleven patients with a mean age of 27.4 years (range 21–35 years) were included. They represented 39% of all patients in whom a tourniquet was applied. They had gunshot wounds (n = 7) or multiple blast injuries (n = 4) and totaled 14 extremity injuries requiring tourniquet application. The median ISS was 13 (interquartile range: 13). Tourniquets were mostly applied proximally on the limb for a mean duration of 268 min (range 180–360 min). Rhabdomyolysis was present in all cases. The damage control surgeries included debridement, external fixation, vascular repair, and primary amputation. Ten injuries were complicated by compartment syndrome requiring leg or thigh fasciotomy in the field or after repatriation. Two severely injured patients died of their wounds, but the others had a favorable outcome even though secondary amputation was sometimes required. Extended and proximal tourniquet applications led to significant morbidity related to compartment syndrome and rhabdomyolysis. Hemorrhagic shock, mass casualty incident, and tactical constraints often precluded revising the temporary tourniquet applied under fire.
- Published
- 2021
4. Treating osteoarticular infections in a Role 2 in Chad: a bacterial epidemiological study
- Author
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Olivier Barbier, Alexandre Caubere, Thomas Demoures, Laurent Mathieu, Camille Choufani, and C Contargyris
- Subjects
0301 basic medicine ,medicine.medical_specialty ,biology ,Medical treatment ,medicine.drug_class ,business.industry ,030106 microbiology ,Antibiotics ,Cephalosporin ,Retrospective cohort study ,General Medicine ,medicine.disease_cause ,biology.organism_classification ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,In patient ,030212 general & internal medicine ,business ,Staphylococcus ,Bacteria - Abstract
IntroductionThe treatment of osteoarticular infections in Africa is a medical and surgical challenge due to the difficulties in managing antibiotic therapy after the surgical procedure. The objectives of this study were to identify the types of bacteria in osteoarticular lesions in patients treated in Chad and to determine the spectrum of resistance encountered and the efficacy of available antibiotics.Material and methodsThis is a retrospective study of all intraoperative osteoarticular and soft tissue samples taken in a French Role 2 Medical Treatment Facility of N'Djamena during surgery for chronic osteoarticular infections, in Chad, for 1 year.ResultsA total of 160 bacterial strains were identified, with a predominance of Gram-negative bacillus (GNB) and staphylococcus infections. Among staphylococci, 80% were methicillin-sensitive streptococci which were generally multidrug-sensitive. Enterococci were resistant to third-generation cephalosporins, first-generation fluoroquinolones and gentamycin. Among GNB, there was a predominance of enterobacteria compared with non-fermenting GNB, of which 52% were multidrug-resistant and produced extended spectrum beta-lactamases (ESBL).ConclusionStaphylococcus aureusinfections are most often sensitive to available antibiotics and therefore have better prognoses than infections caused by other bacteria. In contrast, in half of the cases of GNB, infections were caused by bacteria producing ESBL, thus posing the problem of multidrug-resistance, the risks of which are increased in precarious situations. Therefore, the type of bacteria appears to be a major prognostic factor in the treatment of osteoarticular infections in a Role 2 in Chad. This criterion will need to be considered before any treatment decisions are made.
- Published
- 2021
5. Application of the Masquelet technique in austere environments: experience from a French forward surgical unit deployed in Chad
- Author
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Thomas Demoures, Camille Choufani, Nicolas de l’Escalopier, Olivier Barbier, Laurent Mathieu, and Marie-Pauline Chapon
- Subjects
Adult ,medicine.medical_specialty ,Chad ,Sports medicine ,medicine.medical_treatment ,Long bone ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,External fixation ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Prospective Studies ,Tibia ,Stage (cooking) ,Retrospective Studies ,Fracture Healing ,030222 orthopedics ,Bone Transplantation ,business.industry ,030208 emergency & critical care medicine ,musculoskeletal system ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Debridement ,Orthopedic surgery ,Emergency Medicine ,Observational study ,business - Abstract
We sought to evaluate the results of the Masquelet-induced membrane technique (IMT) for long bone defect reconstruction within the limited-resource setting of a French forward surgical unit deployed in Chad. A prospective and observational study was conducted in all patients with a traumatic segmental bone defect in any anatomical location treated by IMT from November 2015 to December 2019. Although IMT was applied by various orthopedic surgeons with variable expertise, all followed the same surgical protocol. Endpoint assessment was performed 12 months after IMT application. Sixteen patients with a mean age of 32.7 years were included in the study. Bone defects were located on the tibia (n = 8), the femur (n = 6) or the radius (n = 2). Thirteen bone defects were infected. After debridement, the mean bone defect length was 4.3 cm. External fixation of the tibia and femur was predominant in both stages. Bone union was achieved in only 8 of the 16 cases at a mean time of 7.6 months. All failures were related to persistent infection or insufficient fixation stability in the second stage. This series is the first to report IMT use in a forward surgical unit. Despite frequent complications, local patients can benefit from this procedure, which is the only available method for bone reconstruction in areas with limited medical resources. A rigorous technical completion at both stages is crucial to limit septic or mechanical failures.
- Published
- 2020
6. Induced membrane technique with sequential internal fixation: use of a reinforced spacer for reconstruction of infected bone defects
- Author
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Laurent Mathieu, Arnaud Baus, Thomas Demoures, Nicolas de l’Escalopier, Léon Tossou-Odjo, Michel Brachet, and Alain Charles Masquelet
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Bone grafting ,law.invention ,Intramedullary rod ,Fracture Fixation, Internal ,03 medical and health sciences ,External fixation ,Fixation (surgical) ,0302 clinical medicine ,law ,Humans ,Medicine ,Internal fixation ,Orthopedics and Sports Medicine ,Retrospective Studies ,030203 arthritis & rheumatology ,030222 orthopedics ,Bone Transplantation ,business.industry ,Osteomyelitis ,Middle Aged ,Bone defect ,Fracture Fixation, Intramedullary ,Surgery ,Treatment Outcome ,Debridement ,Orthopedic surgery ,business ,Induced membrane - Abstract
To evaluate a novel sequential internal fixation strategy using a reinforced spacer for infected bone defect reconstruction by the induced membrane technique (IMT). A retrospective case study was performed among patients treated for infected bone defects by applying this strategy. Following radical debridement, temporary stabilization was provided by a massive cement spacer combined with minimal intramedullary fixation during step 1. Definitive internal fixation was performed together with bone grafting at step 2. Eight patients with a mean age of 58 years were reviewed. The mean bone defect length was 8.8 cm. The spacer armature mostly consisted of elastic nails and Steinmann pins. Iterative debridement was required in one case after step 1. The mean interval between steps was 12 weeks. Definitive internal fixation was performed by intramedullary nailing (n = 4) or plating (n = 4). At a mean follow-up of 21 months, bone union was achieved in seven cases without additional bone grafting or infection recurrence. Sequential internal fixation using a reinforced cement spacer seems to be a valuable option for avoiding external fixation between IMT steps and limiting the recurrence of infection.
- Published
- 2020
7. Evaluation of a fellowship abroad as part of the initial training of the French military surgeon
- Author
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Olivier Barbier, Sylvain Rigal, Thomas Demoures, Laurent Mathieu, and Camille Choufani
- Subjects
Surgeons ,Medical education ,Active military ,Military surgery ,Teaching ,media_common.quotation_subject ,Judgement ,General Medicine ,Military Personnel ,Initial training ,Feeling ,Software deployment ,Surveys and Questionnaires ,Preparedness ,Humans ,Relevance (law) ,Education, Medical, Continuing ,France ,Fellowships and Scholarships ,Psychology ,Retrospective Studies ,media_common - Abstract
IntroductionMilitary surgery requires skills that in general cannot be easily learnt in civilian training. Participation in a fellowship abroad adapted to the particular operating conditions of the foreign deployment is one route that might secure the necessary supplementary training. We therefore assessed the relevance of such a fellowship in the preparedness of young military surgeons in their first deployment.MethodsThis study included all active military surgeons who had completed a fellowship abroad during their initial training from 2004 to 2017 in Tchad or Senegal or Djibouti. The collection of data was performed using a questionnaire. The main judgement criterion was the rate of positive answers awarded to the relevance of this fellowship in the preparedness of respondents’ first foreign deployment.ResultsSixty-nine of 73 surgeons answered. Sixty-one estimated the fellowship had allowed them to feel more operational during their first mission, with 83.61% rating this feeling as important. Also, 61 recommended the use of a fellowship for war surgery training. The grade assigned to the surgical benefit was 8.48/10.ConclusionA fellowship abroad permits one to become familiar with surgical practice under austere circumstances and the particularities of the surgical structures at the front. Current trainees’ feedback confirms its relevance.
- Published
- 2020
8. Savoir évoquer le diagnostic de textilome en post-opératoire d’une chirurgie
- Author
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Christelle Cattelin, Hugues Lefort, Camille Choufani, Thomas Demoures, Olivier Barbier, and Isabelle Rebours
- Subjects
General Nursing - Abstract
Lors des suites de soins, locaux notamment, effectue dans le prolongement d'une chirurgie, les infirmieres exercent une surveillance etroite de l'evolution du site operatoire autant pour la cicatrisation que pour le risque infectieux local, regional ou general. Dans ce cadre, elles sont en premiere ligne pour reperer et signaler tout tableau clinique suspect. Presentation d'un patient avec un textilome a la suite d'une chirurgie orthopedique de l'epaule.
- Published
- 2019
9. Utilisation de l’enclouage centromédullaire en situation sanitaire dégradée : expérience du service de santé des armées français
- Author
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Camille Choufani, Thomas Demoures, Alexandre Caubere, Victore Huynh, and Olivier Barbier
- Subjects
030222 orthopedics ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Orthopedics and Sports Medicine ,Surgery - Abstract
Resume Introduction L’enclouage centromedullaire est la technique de reference dans le traitement des fractures des os longs dans les pays developpes du fait de son caractere mini-invasif et de ses qualites biomecaniques. En condition precaire, l’exofixation ou les osteosyntheses a foyer ouvert par plaque sont plus souvent realisees devant le manque de moyens pour realiser un enclouage centromedullaire. Elles peuvent etre responsables de complications infectieuses et de faillites mecaniques. L’objectif de notre d’etude etait d’evaluer les resultats et les complications postoperatoires du traitement par enclouage centromedullaire des fractures fermees des os longs chez des patients operes au sein d’une antenne chirurgicale (role 2+) francaise. Notre hypothese est que l’enclouage centromedullaire reste une technique fiable a faible morbidite pour le traitement initial des fractures des os longs meme en situation precaire. Materiel et methodes Il s’agit d’une serie prospective monocentrique et descriptive de patients operes entre avril 2016 et novembre 2017. Tous les patients presentant une fracture fermee du tibia ou du femur, quel que soit le delai de la fracture, traites par un enclouage centromedullaire etaient eligibles. Le recul minimum etait fixe a 3 mois. Le critere d’evaluation principal etait l’absence de complication infectieuse et le critere secondaire etait la consolidation. Resultats Cinquante-huit patients ont ete revu avec un recul moyen de a 4,7 mois (min–max : 3–15 mois). L’âge moyen etait de 35,2 ans (15–85 ans) avec une majorite (n = 52) d’hommes. Les fractures concernaient le femur dans 74,1 % (n = 43) et le tibia dans 25,9 % (n = 15). Le delai entre la fracture et sa prise en charge chirurgicale etait en moyenne de 122,3 jours (min–max = 7–720 jours) avec une mediane de 60 jours. Dans 74 % des cas (n = 43), la fracture necessitait un abord chirurgical. Les suites etaient considerees comme simples dans 96,6 % des cas (n = 51). Aucun cas d’infection n’etait survenu au dernier recul. La consolidation etait acquise en moyenne en 4 mois dans 70,7 % des cas (n = 41). Il existait 3 cas de pseudarthrose apres 6 mois. Discussion L’enclouage centromedullaire dans des conditions precaires reste une methode fiable et efficace avec un faible risque de complication et un taux de consolidation osseuse eleve pour le traitement des fractures negligees des os longs. C’est un traitement chirurgical adapte aux conditions precaires sur le territoire africain. Niveau de preuve II, prospectif de faible puissance.
- Published
- 2019
10. [Dressing management in limb traumatology]
- Author
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Christelle, Cattelin, Thomas, Demoures, Isabelle, Rebours, Olivier, Barbier, and Camille, Choufani
- Subjects
Humans ,Wounds and Injuries ,Extremities ,Bandages - Abstract
The nurse's role in the management of dressings in limb trauma is essential: conditioning of the patient, correct and complete assessment of the site concerned, before care is provided. She is a privileged partner in planning the follow-up. At each stage, the nurse must be aware of the tasks to be carried out so that the overall management leads to rapid and correct healing.
- Published
- 2021
11. Towards understanding therapeutic failures in Masquelet surgery: First evidences that defective induced membrane properties are associated with clinical failures
- Author
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Jean-Marc Collombet, Thomas Demoures, Marjorie Durand, Laurent Mathieu, Jean-Baptiste Souraud, Alain-Charles Masquelet, Laure Barbier, and Thomas Poyot
- Subjects
Pathology ,medicine.medical_specialty ,induced membrane ,lcsh:Diseases of the musculoskeletal system ,Angiogenesis ,Endocrinology, Diabetes and Metabolism ,lcsh:Medicine ,Matrix metalloproteinase ,Article ,Extracellular matrix ,03 medical and health sciences ,masquelet technique ,0302 clinical medicine ,Gene expression ,medicine ,Macrophage ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,030222 orthopedics ,business.industry ,Mesenchymal stem cell ,lcsh:R ,General Medicine ,bone defect repair ,Surgery ,medicine.anatomical_structure ,Immunohistochemistry ,lcsh:RC925-935 ,Induced membrane ,business ,Cancellous bone - Abstract
The two-stage Masquelet induced-membrane technique (IMT) consists of cement spacer-driven membrane induction followed by an autologous cancellous bone implantation in this membrane to promote large bone defect repairs. For the first time, this study aims at correlating IMT failures with physiological alterations of the induced membrane (IM) in patients. For this purpose, we compared various histological, immunohistochemical and gene expression parameters obtained from IM collected in patients categorized lately as successfully (Responders, n = 8) or unsuccessfully (Non-responders, n = 3) treated with the Masquelet technique (6 month clinical and radiologic post-surgery follow-up). While angiogenesis or macrophage distribution pattern remained unmodified in non-responder IM as compared to responder IM, we evidenced an absence of mesenchymal stem cells and reduced density of fibroblast-like cells in non-responder IM. Furthermore, non-responder IM exhibited altered extracellular matrix (ECM) remodeling parameters such as a lower expression ratio of metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinases (TIMP-1) mRNA as well as an important collagen overexpression as shown by picrosirius red staining. In summary, this study is the first to report evidence that IMT failure can be related to defective IM properties while underlining the importance of ECM remodeling parameters, particularly the MMP-9/TIMP-1 gene expression ratio, as early predictive biomarkers of the IMT outcome regardless of the type of bone, fracture or patient characteristics.
- Published
- 2020
12. Repeated Induced-Membrane Technique Failure without Infection: A Series of Three Consecutive Procedures Performed for a Single Femur Defect
- Author
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Marjorie Durand, Jean-Marc Collombet, Thomas Demoures, Christian Steenman, Alain-Charles Masquelet, and Laurent Mathieu
- Subjects
Orthopedic surgery ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,Bone union ,medicine.medical_treatment ,Cement spacer ,030208 emergency & critical care medicine ,Case Report ,General Medicine ,Bone healing ,Functional recovery ,Revascularization ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Iliac bone ,Medicine ,Femur ,business ,Induced membrane ,RD701-811 - Abstract
A 40-year-old male was treated using the induced-membrane technique (IMT) for a noninfected, 9 cm long femoral bone defect complicating a lengthening procedure. The interesting case feature lies in the three consecutive IMT procedures that were necessary to achieve complete bone repair in this unusual clinical situation. The first procedure failed because of the lack of graft revascularization likely related to an induced-membrane (IM) alteration demonstrated by histological observations. The second IMT procedure led to partial graft integration interrupted by the elongation nail breakage. At last, the third procedure fully succeeded after nail exchange and iterative iliac bone grafting. Complete bone union was achieved with a poor functional recovery one year after the last procedure and four years following the first cement spacer implantation. By means of clinical and histological observations, we demonstrated that the first and the second IMT failures had two distinct origins, namely, biological and mechanical causes, respectively. Although simple, a successful IMT procedure is not so easy to complete.
- Published
- 2020
13. [Diagnosing textiloma post-surgery]
- Author
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Camille, Choufani, Thomas, Demoures, Christelle, Cattelin, Isabelle, Rebours, Olivier, Barbier, and Hugues, Lefort
- Subjects
Shoulder ,Postoperative Complications ,Nursing Diagnosis ,Humans ,Orthopedic Procedures ,Foreign Bodies - Abstract
During care follow-up, specifically local post-operative care, nurses closely monitor the surgical site both for healing and for local, regional or general risk of infection. In this context, they are on the front line of identifying and reporting any suspicious clinical conditions. We use the example of a patient who presented with textiloma following orthopaedic shoulder surgery.
- Published
- 2019
14. La gestion des pansements en traumatologie des membres
- Author
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Christelle Cattelin, Camille Choufani, Thomas Demoures, Olivier Barbier, and Isabelle Rebours
- Subjects
Nursing ,business.industry ,Medicine ,business ,General Nursing - Abstract
The nurse's role in the management of dressings in limb trauma is essential: conditioning of the patient, correct and complete assessment of the site concerned, before care is provided. She is a privileged partner in planning the follow-up. At each stage, the nurse must be aware of the tasks to be carried out so that the overall management leads to rapid and correct healing.
- Published
- 2021
15. Use of intramedullary nailing in poor sanitary conditions: French Military Medical Service experience
- Author
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Olivier Barbier, Camille Choufani, Victor Huynh, Thomas Demoures, and Alexandre Caubere
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Nonunion ,Long bone ,Tibia Fracture ,Infections ,law.invention ,Intramedullary rod ,03 medical and health sciences ,External fixation ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,law ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Tibia ,Prospective Studies ,Fractures, Closed ,Prospective cohort study ,Military Medicine ,Aged ,Aged, 80 and over ,Fracture Healing ,030222 orthopedics ,business.industry ,030229 sport sciences ,Middle Aged ,medicine.disease ,Surgery ,Fracture Fixation, Intramedullary ,Radiography ,Tibial Fractures ,medicine.anatomical_structure ,Treatment Outcome ,Fractures, Ununited ,Female ,France ,business ,Femoral Fractures ,Follow-Up Studies - Abstract
Introduction Intramedullary (IM) nailing is the gold standard for treating long bone fractures in developed countries because of its minimally-invasive application and good biomechanical properties. In precarious conditions, external fixation or open plate fixation are often performed because surgeons do not have the means to carry out IM nailing. However, these procedures can lead to infection-related complications and mechanical failures. The aim of our study was to describe the outcomes and postoperative complications of IM nailing of closed, long bone fractures in patients operated in a French front-line combat surgical unit (role 2+). Our hypothesis was that IM nailing is a reliable technique with low morbidity for the initial treatment of long bone fractures, even in precarious situations. Material and methods This was a prospective, single-center, descriptive study of patients operated on between April 2016 and November 2017. All the patients with a closed femur or tibia fracture who were treated by IM nailing were eligible, no matter their time to surgery. The minimum follow-up was 6 months. The primary endpoint was the absence of infection-related complications and the secondary endpoint was fracture union. Results Fifty-eight patients were reviewed after an average follow-up of 4.7 months (range, 3–15 months). The mean patient age was 35.2 years (15–85 years) and the majority of patients were men (52 of 58). The fracture was in the femur in 74.1% (n = 43) of cases and in the tibia in 25.9% (n = 15) of cases. The time to surgery averaged 122.3 days (7–720 days) with a median of 60 days. In 74% of cases (n = 43), fracture realignment required an open surgical approach. The postoperative course was considered normal in 96.6% of cases (n = 51). No infections were reported as of the last follow-up visit. Union occurred in an average of 4 months in 70.7% of cases (n = 41). There were three cases of nonunion after 6 months. Discussion Even in precarious situations, IM nailing is an effective, reliable method with a low complication risk and high union rate for the treatment of neglected long bone fractures. This surgical treatment is well suited to the poor sanitary conditions on the African continent. Level of evidence II, low-powered prospective study.
- Published
- 2018
16. Long-Term Results of a Monocentric Series of Soldiers After Latarjet Procedure for Anterior Shoulder Instability. Implications for the Assessment of Soldiers' Medical Ability
- Author
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Olivier Barbier, Thomas Demoures, Gilbert Versier, Didier Ollat, and Nicolas de l’Escalopier
- Subjects
Adult ,Joint Instability ,Male ,medicine.medical_specialty ,Shoulder ,Population ,Osteoarthritis ,Preoperative care ,Coracoid ,Arthroplasty ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Shoulder arthritis ,Humans ,education ,Retrospective Studies ,030222 orthopedics ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,030229 sport sciences ,General Medicine ,Anterior shoulder ,Latarjet procedure ,Middle Aged ,medicine.disease ,Military Personnel ,Treatment Outcome ,Research Design ,Radiological weapon ,Physical therapy ,Female ,business ,Follow-Up Studies - Abstract
Introduction Stabilizing surgery of the shoulder with a coracoid graft according to Latarjet is a recognized surgical treatment for anterior instability of the shoulder. This pathology frequently affects soldiers. Postoperatively, the potential risk of recurrence or of secondary shoulder arthritis can limit the practitioner in their ability assessment. The aim of this study is to analyze the long-term outcomes of this surgery in a military population, in order to assess the possible implications for French soldiers' medical ability. Material and Methods Twenty soldiers operated on the shoulder by Latarjet procedure by the same surgeon were retrospectively reviewed after more than 15 yr. All of them did regular physical activity for leisure or competitions. None had preoperative osteoarthritis injuries. The number of dislocation recurrences, the functional score, and the rate of radiographic osteoarthritis were assessed. Results After more than 16.3 yr (extremes: 15-24 yr), none displayed a dislocation recurrence. The average Rowe's score was 91.8 ± 9.9. The average subjective shoulder value was 89.2 ± 9.7. All patients had resumed sport. Three of them developed level 1 or 2 radiological signs of osteoarthritis according to Samilson. No level 3 or 4 osteoarthritis was found. Among all the patients, 14 still did regular physical activity. Discussion In view of our results and of those from the literature, the results of treatment for anterior shoulder instability with the Latarjet procedure are good, even very good in the long term. These data must be considered to favor this procedure for soldiers with shoulder instability and from a medico-administrative viewpoint for military patients in order to pursue their careers without any job restrictions.
- Published
- 2017
17. Anterior shoulder stabilization by Bristow-Latarjet procedure in athletes: return-to-sport and functional outcomes at minimum 2-year follow-up
- Author
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Thomas W. Bauer, Shahnaz Klouche, Philippe Hardy, Jean Sebastien Beranger, and Thomas Demoures
- Subjects
Adult ,Joint Instability ,Male ,medicine.medical_specialty ,Activities of daily living ,Time Factors ,Return to sport ,03 medical and health sciences ,0302 clinical medicine ,Bristow-Latarjet procedure ,Risk Factors ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Treatment Failure ,Retrospective Studies ,030222 orthopedics ,biology ,business.industry ,Athletes ,Shoulder Joint ,Retrospective cohort study ,030229 sport sciences ,Anterior shoulder ,biology.organism_classification ,Return to Sport ,Index score ,medicine.anatomical_structure ,Physical therapy ,Surgery ,Shoulder joint ,Female ,business ,human activities - Abstract
The aim of this study was to assess return-to-sport outcomes following the Latarjet–Bristow procedure. This retrospective study included all athletes
- Published
- 2015
18. Synostose radio-ulnaire
- Author
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Jonathan Gillard, Jeremy Comblet, Thomas Demoures, Charles Verdonk, and Weniko Caré
- Subjects
business.industry ,Library science ,Medicine ,General Medicine ,business - Abstract
La Presse Medicale - In Press.Proof corrected by the author Available online since samedi 14 novembre 2015
- Published
- 2015
19. [Primary mesenteric volvulus]
- Author
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Yvain, Goudard, Bruno, de la Villéon, Thomas, Demoures, Pierre, Aubert, and Vincent, Duverger
- Subjects
Humans ,Female ,Mesentery ,Middle Aged ,Peritoneal Diseases ,Intestinal Volvulus - Published
- 2012
20. [Thévenard's disease]
- Author
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Thomas, Demoures
- Subjects
Adult ,Male ,Electromyography ,Humans ,Hereditary Sensory and Autonomic Neuropathies ,Foot Ulcer - Published
- 2009
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