Modesty, eclecticism and scientific curiosity characterize Charles . Its long career which he wanted referred to well for csotcina.comedic Maîtrise gave the opportunity to him to be devoted to the rachidian deviations, the hip dysplasia and its processing. The surgery of overhaul of the hip prosthese constitutes the current pole of search for this inexhaustible pensioner.

 

. : For a reprocessed surgeon, you seem rather overflowing of activity.

: During my medical education, I always knew a managing staff arranged hierarchically strict which allowed the training on the heap of all the professional gestures thanks to a trade-guild, which was one of the good characteristics of the medicine of the time. My hospital course started in 1947 at the stage “of ” during the preparatory year of Physics, Chimie and Biology. It finished in 1965. My activity in private clinic lasted of 1962 to 1992. For 8 years, my “retreat” has been in fact a manual discontinuance of business which enabled me to be directed towards the clinical assessment, in particular overhauls of total prostheses of hips. I profited from the structure of a department of clinical assessment of a manufacturer, who functions with two graduate, an instructress and an assistant of clinical judgment. Displacements and work require a certain physical resistance, but my tonicity is maintained by stimulation very many friends.

. : You are wire and grandson of country doctors. How were you attracted towards the surgery?

: My father was country doctor during 40 years. From 1928, home-base, it has to face the labor, with the poliomyelitis, the purulent pleurisy. Its effective presence near the patients supported an acute clinical direction, with the diagnostic and therapeutic means of the time. After 1945, all changed with the improvement of the balance-sheets, of the medicines. I have the intact memory of the fantastic teachers who informed me at the elementary school to the certificate of studies whose level was remarkable at the time. From 1940, I made my secondary studies of Latin, Greek, German, philosophy with the College Amp and the school, in Lyon. After my vat, my father was of agreement so that I make my medicine, in the only condition which I would be surgeon. It was an obviousness for us two. I spent the first 11 years of my life, then every school vacation to my vat, in my village, a landscape of scrap-metal and ponds. The beauty of the forms of the animals, especially the insects and the frogs, the early knowledge of their anatomy and the effectiveness of their structures always fascinated me: , , hinges and muscles, all the ease of the locomotion: the guideline towards csotcina.comedy was very natural.

. : Which were your post-boarding school and house masters?

CP: I want initially to announce that during my day school, as from 1948, two six-month periods were devoted to the anesthesia under the control of the appointed sister: the doctors anesthetists appeared five years later. My boarding school contained 4 years of general surgery with integrated traumatology, and two six-month periods of csotcina.comedy and infantile surgery at Joseph and Maurice . My post-boarding school was held during 6 years at followed by 2 years at . My departure with Saint Etienne was carried out in 1965. Maurice devoted himself to the csotcina.comedic surgery and especially to the hip surgery, the first osteotomy of of the femur having been realized in 1952. He had in core to distribute the various techniques between his senior registrars and his assistants. Thus my thesis on the spondylolisthesis in 1959 was pretext with the honor to direct the Symposium of the in 1971 and that the technique of made me grant a conference of teaching on the birth defects of the shoulder girdle in 1973. Lucien Michel, the uncle of Claude-Governed, discussed the , the after-effects of poliomyelitis, the birth defects of the members. He was for me the example of csotcina.comedy: knowledge, perseverance in the care, by locating time in its inexorable, repairing or destroying role. My interest for the was worth me to be a speaker during the day of spring of the in Baden-Baden. Pierre was one of the pillars of the animal bank of bone created, in 1949, under the aegis of Charles , with the assistance of the veterinary surgeons of the Institute. Grafts of calf and skid were used during years successfully. The preparation was very long: degreasing, papain, freeze-drying, conservation out of dry tubes, with room temperature. The cortical grafts which reached up to 23 cm length, were used to support the scolioses before , and the blocks of cancellous bone were used for fillings as cavity. These grafts had remarkable, proven possibilities of integration 15 to 20 years afterwards, radiologically and histologically, with dimensions to make dream today. A symposium of the , in 1955, gave a report on very interesting results on hundreds of case. The disappearance of this bank was started mainly by the hardware of . I became acquainted very early with Albert , during a replacement of intern in his service. I always benefitted from his teaching of a technicality without reproach, with very sincere friendly exchanges. Each match of the team of of the “Greens” of Etienne Saint, then in full glory, brought for the collating before the match a flight of Lyons supporters of which he was the owner. Michel directed my activity to the laboratory of Anatomy of 1953 to 1965. I was successively deputy of anatomy, , assistant, then chief of work, during beautiful years devoted to contests and teaching. At the time, there were neither transparencies nor slides. The descriptive anatomy and topographic of the muscles of the eye or the diaphragm was made with the blackboard, in front of a full lecture theater: the students took their place for the lectures which followed. I learned much by the anatomy, the surgery and the exchange rates. Under the impulse of , Joseph , that I ran alongside of 1949 to 1965, was the first instructor of infantile csotcina.comedy. During its inaugural lesson, it justified separation between children and adults by arguments médico-anesthetic than . By a famous formula, it placed the surgery of the musculoskeletal system “at crossroads”. And to close its speech, sweeping the doubts and the pessimism of some, it was with quoted of Electra de , in front of the ruins of , and asked whether such a spectacle could have a name. The answer of the beggar was: “Yes, that has a name, that is called the Dawn”. It was in 1965.

. : Were your future spheres of activity profiled as of this moment?

CP: The flashback is such as it is necessary to note what disappeared: the poliomyelitis, ostéo-articular tuberculosis, the congenital dislocation of hip, and also what appeared: the early csotcina.comedy of the hip dysplasia and that of the scoliosis, posterior and former rachidian instrumentations and articular prosthetic surgery, this for the only innovations which related to very directly our speciality. Absolutely fabulous progress.

. : How was your hospital career directed?

CP: The contest of of the Hospitals for which I was in runway was abruptly replaced by the contests, with dual membership. The anatomy suddenly became fundamental science, without clinical service, very temporarily, just time that I refuse the post. In 1965, I left Lyon, for Saint Etienne and I became the third member of the for a town of 215 004 inhabitants, and for the departments of the Loire, the High Loire and Ardèche. Since 1962, I had taken part in the plans of the radiological and csotcina.comedic private clinic that the Reciprocity of the Loire built. A radiologist of point, O. , ensured an irreproachable quality and brought all the innovations: , discography, etc the department of csotcina.comaedics contained an important adult sector, that with joy I was going to share with Jean-Claude , as from 1970. Programmed and finished before the definition of , a service of children had been arranged and was to function with me during 17 years, understanding ten and functioning with a personnel specialized and many. We had a doctor appointed pediatrist and the service functioned in opening with the pediatrists of the city. Two doctors full-time directed the service of rehabilitation which counted seven kinesitherapists full-time. B. is still in exercise currently. The care like the behavior of the files was irreproachable and are it still today, in particular for the few 300 csotcina.comedic processing regularly in progress. 20 to 30 years later our files are exploitable and conceal data whose retrospective study holds good surprise sometimes. For example, the costal play carefully had been measured always and this parameter indeed showed its importance in the forecast of a scoliosis. The succession of P. in the Center of the Bludgeons justified my return to Lyon.

. : You knew the time when luxations were mainly discovered at the age of the functioning. How do you discuss them and when systematic tracking it was introduced?

CP: In 1835, Charles tried to impose his results by the progressive reduction of hip dislocations: the models of its bed of progressive traction, just as those of its systems of rehabilitation are with the museum of the Hotel God of Lyon. For congenital hip dislocation, I obviously knew the method of , implemented to the age of the functioning. The progressive reduction standard , the removable splints with free hips of Pierre Petit brought progress in the effectiveness and the security of the reduction. Whereas some recommended the systematic , I personally preferred the progressive reduction by seeking the centering of the head by his complete lowering, almost exaggerated initially. The creep of the to the top and the reconciliation of the horns of with the shortening of the transverse ligament which links them are the consequence of the vacuity of during the installation in of the postural dysplasia. It is thus necessary to model the lower part of , capsules understood, before the head. All these obstacles were well-known with the pathological anatomy and the precise technique of the surgical . To benefit from all the possibilities of repair without surgery, and in agreement with the parents, the full-time aircraft grounding periods then partial, were prolonged. The surgery was more selective and later. 20 to 30 years later, a good percentage of excellent hips is noted. I do not accept the “systematic one”. By definition, an indication is reflected, and should be justified by the experiment. It must be a thought processe which answers the three fundamental questions: who? when? how? By the surgery, the correction of the delays of ossification and deformations are not immediate; it does not occur in the moment which follows the radiological amendment, for spectacular that it is. For the processing in the course of growth, therefore within the time of hoped modellings, one cannot claim to shorten all the deadlines healthily. In 1972, a tracking was made in the area inhabitant of Saint-Etienne, area of . The indications of early-therapy were posed only on the unstable hips and the hips at the risks. There were failures, but also a significant decrease of the cases seen tardily, with confirmed and worsened lesions. The ultra-early processing implemented with understanding and competence is obviously the only solution to avoid the famous residual dysplasia, which ultimately is only the official report of the failure of treatment or the absence of processing. I do not see well why, today, it would be licit to wait in the doubt, with a monitoring not armed which show an abstention while waiting for the confirmation and aggravation from the lesions, the more so as with the noninvasive complementary examinations, like echography and the MRI make it possible to visualize the obstacles and to perfect the reductions, therefore the very early result of stabilizations. To be in front of a luxation confirmed at the age of a few months appears difficult to me to explain to the parents, and to forgive with oneself.

. : You gathered a famous collection of pads . Which lesson did you collect some?

CP: Thanks to the organization of Etienne Saint, since 1965, I wanted to correlate normal and pathological anatomy. I accumulated the documents of all the imageries. I could reconstitute developments on 50 or 60 years. I could follow patients during 30 years. My first slides of pads in the adult during are of 1970. The syndrome of the pad, syndrome typically meniscal, was known, its cause too. To evaluate the projections due to the imagery known as modern, least of the things is to refer to the old documents. Certain drawings are worth as much as the most beautiful three-dimensional rebuildings: in any event, for the ones as for the others, one needs well the same indoctrination of our vision and our space interpretation. The knowledge of the natural evolution of the so specific structures of the musculoskeletal system is essential. A balance-sheet whatever it is, biological or of imagery, is only one instantaneous. The enormous advantage of the MRI is to visualize little hitherto not objectified elements or. But, while taking the example of the pad, from grace, always let us not say that they are discoveries. On the other hand, all these imaging methods and of data processing will make us progress in quality of the indication and the gestures, thanks to more exact calculations and with the robotization of certain technical phases, in particular in the osteotomies of the mining area for dysplasia, in the child as in the adult.

. : Since when are interested you in the overhauls of prostheses?

CP: In May 1968, our group of voyage visited John . In a little more than 20 years, Michel, R. and me placed a little more than 03030 Friction . We were faithful: we do not regret it, our patients either. Two Lyons congresses celebrated birthdays full with teaching, with very long term. From 1988, I implied myself in the overhaul of failures of hip prosthese. Initially, it was because of my own disappointments due to an insufficient osseous rebuilding associated with unsuited prostheses: surface, screwed parts, etc I thus used the channel , recommended by in 1986, for the channel initially of the septic complications, described in the EMC and a conference of teaching of the . From 1988 to 1992, in 40 cases of failures, I chose the stem of Wagner. I quickly put myself at the distal locking suggested by Pierre Vives, and this, because of the true obsession which I had acquired with respect to the distal blocking of a femoral implant, that it is accidental or voluntary, and of all his annoying consequences: migration, fracture of stem, atrophy osseous , etc On the other hand, the association of the channel and distal locking seem well to be the proof of a remarkable reliability and an effectiveness. After 7 years, the observation of the results on the repair of very large damage is often amazing, and so much comforting. In our prosthetic surgery, we can find, and check again, the rules of biology and biomechanics . In Lyon, it is only returned justice with which described very precisely, inter alia techniques, the size and the translation of the scraps in the processing of the great losses of substance of the members, in his Treaty of the resections published at in 1885. Many colleagues invited me to discuss with open sky, with the surgical unit, for changes of femoral parts, with approximately 350 recoveries. Six years extraordinary were full with teaching and sympathy. I address my very deep thanks to all those which will be recognized.

. : You lived the first stammerings of the csotcina.comedic and surgical processing of the scolioses. Which memories do you have some?

CP: Stammerings, yes. I external in 1948 with Claude-Was governed Michel and Pierre was already in charge of the scolioses to the Pavillon T, at the time of the scolioses known as historical. My memory is marked by the time of observation which was forced to enter a progression towards aggravation in the course of growth, then the attack of the deformation by csotcina.comedic processing which had become inevitably constraining and fatally insufficient. “The good” result was stabilization at a stage of the deformation which would be aesthetically unacceptable today. The functional results were obviously not inevitably threatening for the future. But, moreover, the operative techniques did not contain powerful rachidian instrumentations, and the anesthesia required improvements. The csotcina.comedic processing existed since centuries, but, in this time there, it was to be started only beyond 30 with 35°. In fact, I must admit not having admitted to quantify an angular aggravation of the rachis in the course of growth, whereas, in other fields, all was to be curative or preventive, as for the clubfoot, the after-effect of polio, the deficits neuro-muscular,… and the unstable hip. From 1976, with B. , the proposal of the early implementation of the elastic orthotic device of Etienne Saint, copied from that rigid of Michel, for the lumbar and thoracolumbar scolioses was a discussion topic, even of discord, with P. . The same principle of assumption of responsibility early gave rise to orthotic device for the postural , with the purpose of avoiding the of the deformations. On its side, in Toulouse, far from Lyon, C. , since 1962, had inaugurated in France the earlier csotcina.comedic processing of the evolutionary idiopathic scoliosis, with the collar of Milwaukee imagined by and in 1949.

. : What happenhappen did operative treatment?

CP: Before , and for scolioses going of the minimum of 50-60° to the sad records of the curves of more than 100°, banal until 1471 9380, the plaster of strain of brought to the intervention made under plaster: a long cortical graft of the bank of bone supported the curve between the two thorny extremes; the hulling and the installation of grafts taken on the two posterior iliac crests ensured of very beautiful arthrodeses. Because of the preoperative , it was not astonishing to see later angular aggravations. Useless to speak about the pitiful respiratory capacity and the esthetic aspect afflicting. After these 14 years, in 1962, I saw Michel returning from the USA with the technique and the instrumentation of P. . All changed, then evolved/moved.

. : How did you discover the surgery of the scolioses by former channel?

CP: Instrumentations of P. , E. , , Y. and J. , and the later improvements of the posterior instrumentations seek the reduction of the curve i.e. much of requirements. To the reduction of the angle of Cobb are added the reduction of rotation, of the slope on the horizontal one, rotatory dislocation, and the of the areas of transition, as well as the safeguarding or the re-establishment of the sagittal balance of the trunk, with stabilization by arthrodesis. described its technique of former instrumentation in 1969. Since 1971, it is used in Lyon by Mr. , Michel, and R. . K. had organized a meeting of the with . We sympathized and I made three one week stays in his superb service of . He told readily that he had been carpenter during the war of 1940, before being able to become surgeon: one of the most skilful surgeons than I saw, of the skin to the skin, it made two per morning admirably. With an initially splendid and economic channel for the blood loss, not very prejudicial for vital capacity, an instrumentation remarkable for the reduction and the balancing, risk-free neurological, and with a stability of the results proven,… the technique of the allured only one small number of French surgeons. Will the thoraco-laparo-video-endoscopy rehabilitate the former channel? This activity in the field of the scoliosis was worth me a conference of teaching in 1986, about the therapeutic indications in the idiopathic scoliosis of the adult.

. : Speak to us about your arrival to the Bludgeons

CP: The Center of the Bludgeons was opened by P. in 1962. I was invited there to make first . One year before succeeding P. officially, I began the . I knew well the doctors, the kinesitherapists, all medical staffs of the Center. I greet here the memory of P. , which, with Mrs and P. , described the “ test”, discovered during an inopportune alarm clock . In 1982, in a hierarchical structure, functioning for 20 years with the same goods actors, I have thus arrived, not unknown, and I had in my luggage elastic orthotic device, the , and the was born. The directions for use caused by these novel methods and the consequence over the durations of stay brought changes.

. : And you continued to practice the hip surgery?

CP: Yes, why not? It was continuity with my personal recruitment which was notable, and I had opportunity of integrating me in the completely remarkable medical team of the center of the Bludgeons.

. : One often describes you like an impassioned research worker. Do you think of deserving this qualifier?

CP: With Y. Rochet, as interns, we worked in the laboratory of experimental surgery of P. Mallet-Guy, for the comparison of the respective effectiveness of the intravenous or transfusion in the serious hemorrhagic shock, between 1952 and 1954. This work was worth us the Price , and a place among the speakers of the national congress of the transfusion of blood, placed under the management of H. . In 1992, in connection with the channel , I made an experimentation in the dog, with . , Veterinary surgeon. In fact, I want to be more an appraiser that research worker, pushed by the desire to make well at the same time as the will to know how it goes and to prove that it goes. All that maintains the memory, memory which must be cultivated to also have the acute memory of why and of how of its own failures. 

. : You belong to many learned societies. What do you await these groups?

CP: The first element is the reciprocal requirement between members to communicate the experiments. But the right to speak and the duty of listening are not always also distributed…. The Office of the , most important of the national companies of Europe, can keep the direction of the measurement, the respect of its members and the ease of use. For my part, except tourist framework, I hardly appreciate a congress which fringe in 10 or 12 different rooms, during several days. Large European and Worldwide society, lost the relation between the leading authorities and the members. They function as of the firms which depend on the number of contributing and the cost of annual convention becomes unbearable, except legal sponsoring. The number of nations which compose them makes that the cycle of the reappearance of a national representation in the leading authorities is too slow. The effectiveness of the offices seems to be blunted. There is tendency to the depersonalization of environment and the discouragement of the basic member who must be satisfied to subscribe. I took part in many foundations of groups such as the , the or the . In 1982, Y. arrived from Osaka and worked for nths with me in the Center of the Bludgeons. The is an great adventure which officially started in 1990. A congress every two years, either in Japan, or in France, and exchanges of experienced surgeons mark the community activity. Cultural and friendly side, the exchanges are also rich. What to await Society? First of all obligations of disciplines and the respect of the others; then honest scientific exchanges; finally true meetings and friendships. It is also a skew to gum the differences between generations.

. : You the study trips. Which are the personalities which marked you the most?

CP: Our group of voyage was creates in 1969, and was composed of outstanding personalities from all the points of view. I cannot quote all these friends. I saw , in 1965, during my first voyage to the USA. It used the bilateral posterior osteotomy to close the pubic symphysis of the vesical exstrophies and to allow a correct rebuilding of the urogenital system. What struck me it is the example of a coherent therapeutic diagram and clearly definite which considers that a urogenital system, cardiopulmonary, or locomotor must be considered in the duration of a life, since the experiment proved, for a rather long time already, that a child had all the chances, or all risks, to become an adult who, alas, will become an old man. I cannot allow comments on the obviousness of the work of John and the work of Maurice and deep admiration that I carry to them. But I want to say that a colleague, more or less officially raftered, that I could meet, or one of my true friends impresses me much. He can influence me too.

. : Were you alone during these voyages?

CP: Apart from the group of voyage and his tour programmed each year, I profited from the irreplaceable greeting of those which made me the honor join their reflection and their work in the replacements of femoral prostheses. A certain number of surgeons had agreed to delegate clarification, and so far, the presentation of their files to me. They have now to do it: I enough was seen and understood with the , the EFFORT, the , the …

. : How do you organize your scientific activity since the stop of your clinical practice?

CP: I have some thorough draft studies on certain aspects of the lower limbs and the possible implications on certain joint prostheses. A more powerful technical plate in the evaluations of famous “the 3D” will be necessary for me. The indoctrination by the rachis improved this space vision: let us not forget only the notion of the scoliosis seen of profile and that the search for a plan of election of a rachidian curve go back to more than 25 years. The era of the softwares 3D was not so much diverting for the . Since, much of progress were made by the machines, and their users.

. : Do you regret not having been teaching hospital?

CP: I have just answered not, indirectly. First of all, I will have been obliged to choose between children and adults. This choice would have been impossible to me: I believe that I was clearly this side there. In the field of the technical equipment, and thanks to the teams in whom I had happiness to work, with accumulation of a rich person documentation, I was especially favoured during 30 years. I could teach the anatomy with Faculty during 12 years. In addition, I contributed actively to the drafting of about fifteen theses: gland of the brothers to the exceptional disease of , while passing by the rachis and the hip seen at all the ages, from every angle and at all the stages of their csotcina.comedic or surgical processing. Since 1992, I had an activity of an exceptional interest. I sincerely believe to have been very favoured in the contacts with young people. The activity known as scientific, the active participation with the life of many society and the contribution to the congresses occupied me much. But, I did not have the bond of Teaching hospital.

. : Do you have extra-medical passions?

CP: Fortunately yes, and very varied. I try to educate me in music: my development goes towards the sonatas. The human voting right, especially in the Opera and the Lied, me fascine. The accumulation of the slides and a good visual and auditive memory make me make confrontations of works of painting, sculpture and music which, for me, are absolutely obvious. Perhaps I in this field a little too surrealist am, with the clean direction of the term. Since always, attraction for the sea and its fish threw me in the plunge in apnea which is very large and very demanding school from the physical and psychic point of view. I have my world of silence. But it is richly populated.

. : Do you miss the surgery?

CP: Nicolas defined “csotcina.comedy or Art To warn and Correct in the Children the Deformities of the Body”. I make a point of quoting the whole bond of his work, going back to 1741, because it is moving for me: “the whole by means with the range of the fathers and mothers and all the people who have children to raise”. I largely exceeded this program, since my generation lived the splendid jump in front of the surgery of the musculoskeletal system. I miss the patients: privileged relations were tied; some have been adhered to for twenty five years and more.

. : Your friends say you that you are a modest, reserved and secret character, who does not deliver himself easily…

CP: Compared to level of oral communication that I endeavoured to make suitable in the professional field, including in English, I am not inclined to express the very strong feelings which I test towards many of those that I run alongside. I think that my World of Silence is there for something.