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The surgical treatment of synovial osteochondromatosis fluctuates between the desire of doing the most complete synovectomy to avoid the formation of new loose bodies, and the technical possibilities of realising it without compromising the stability and the expansion of the ulterior mobility of the articulation. The histological examination of 44 operatory pieces allow us to suggest a histological classification of 4 evolutive stages based on the aspect of the synovial and without taking into consideration the existence or not of loose bodies which can exist in all stages. The surgical operation should be large in the stage of full fluorescence, it can be limited in the regression stage. This evolutive diagnostic can be done through the histological examination of the biopsy obtained by arthroscopy.

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We report 58 cases of humeral shaft non union following 28 times an orthopaedic treatment where persisted a space between the two fragments and 30 times an osteosynthesis but only 6 where satisfying. The sery contains 2 infected non union, dried in several months and 3 pseudarthrosis we did not operate because they were not inconvenienced. Among the 53 aseptic pseudoarthrosis the union has been to obtained after one operation for 42, two operations for 6 and three operations for 5. We analyse the consecutive mistakes having brought to the failures. We confirm that only an osteosynthesis not sufficient and that an associate graft is necessary. It could be an osteoperiosteum decortication, a spongious graft or a tibial graft (this last one is more safe but reserved to the iterative cases of the one with a big defect). The long evolution (more than a year for half at the cases) explains the fragment repercussions on shoulder or elbow.

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The cutaneous blood-supply of the limbs is ensured by three types of arteries: the large septo-cutaneous arteries, the slender musculocutaneous arteries, and the rare satellites of the cutaneous nerves. The skin cover of the outer aspect of the leg is particularly well vascularized thanks to its special situation, centered on the intermuscular septa bounding the outer compartment of the leg. Neuromuscular arteries are rare at this site, but there are numerous septo-cutaneous arteries at intervals along the septa. This anatomic study is based on 20 dissections and a radiologic survey and provides findings confirming the reliability of a distally based lateral leg flap. This pedicle arises from the fibular artery behind and the anterior tibial artery in front. It is situated, on average, 10.8 cm from the lateral malleolus, thus allowing coverage of peripheral losses of substances at the malleoli and heel.

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The talo-navicular joint takes a part in both talocalcaneal and midtarsal joints's motion. Its arthrodesis produces all but suppression of subtalar joint motion. If there is surgical indication for deformed but flexible foot, better than a standard resectional subtalar arthrodesis, talo-navicular arthrodesis, with easy technique, is successful to maintain correction in right position, specially for valgus flat foot.

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The study of 102 cases of talar dome osteochondral lesions allows to class them in different categories: The lateral lesions are almost always osteochondral fractures. They are often discovered as fresh lesions. Frequently the ankle lateral ligament is also injured. They can be immobilized or fixed using a screw. In a second category, where the lesions are medial, it has been impossible to find any argument in favour of a traumatic origin. Most of the patients are young, still growing up. The prognosis is favorable. In the third category, the lesions are also medial, but their aspects are different. We cannot deny the traumatic origin, but we cannot demonstrate it, and the explanation of these lesions are hypothetical. Here the lesions are often severe, the surgical treatment is necessary with good clinic results in spite of radiological signs persistence and of late arthrosis evolution.

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An original pattern of nail flap is described. It consists of a longitudinal band of lateral nail matrix and bed associated with its lateral wall. A vascular anatomic study with latex neopren infusion has been performed. The dorsal branch of the medial phalangeal artery could be shown to be the arterial pedicle of the flap. The venous system was shown to be concomitant. Eight nail autoplasties have been performed in eight cases, proving the reliability of the flap. It provides an interesting way of reconstruction of the nail in tumors, black longitudinal nail bands, posttraumatic and also post-infectious lesions of the nail.

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Seventy-five surgically soft-tissue lesions of the hand were examined prospectively by real-time ultrasound and correlated with surgical and pathological findings. The normal ultrasonic anatomy of the hand is described. The use of real time sonography allowed a reliable diagnosis of the cystic or solid nature of soft-tissue tumors, an accurate estimation of their volume and their precise three-dimensional localization. Sonography facilitates the location of foreign bodies, and appears as a new promising technique for the evaluation of tendons.

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The authors propose a technique of spatial reconstruction of serial sections using the modern methods of computer graphics. The technical problems encountered and the duration of the classical Born method render the proposed technique difficult to apply as a routine procedure. The results of this work show that computer assisted image reconstruction could be used in daily routine work only when appropriate software programs and sufficient memory capacity become available to allow rapid image restitution. With the technique described in this paper, the reconstruction and display of a single image require 7 to 8 h of computer time.

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