[Subtrochanteric fractures [Report of 42 cases]]

The authors report a retrospective study of 42 cases of subtrochanteric fractures hospitalized in the orthopedic and traumatology surgery service of the hospital Ibn Rochd [wing 4] between January 1993 and December 2003. This study exposes the clinical, automical, biomechanic and therapeutic particularities and the difficulties of the hold in charge. The middle age was of 47 years with two peaks, one between 20 and 29 years, the other between 60 and 69 years. A higt masculine predominance has been noted with a sex-ratio of 1.3. The etiological circumstances is dominate by the raping traumatisms to high energy [58%]. These fractures have been treated surgically in 90.5% and orthopedically in 9.5%. The global functional results were satisfactory with a rate of excellent results in 55.3% of the cases and good results in 44.5% of the cases. The discussion is about the best technique of osteosynthesis. It is in favor of the centromedullary implants of second generation

[Scaphoid fracture with unusual displacement [Report of one case]]

Authors bring back a case of carpal scaphoid fracture out of place forward with migration of proximal segment of the scaphoid in front of the radial metaphysis. This observation is interesting to describe because of the big displacement proximal fragment and the misleading radiological aspect on the profile view lending confusion with perilunar dislocation of the carp. The surgical treatment will permit the reduction then stabilisation of the fracture but won't warn the evolution toward the necrosis of proximal pole and/or the pseudarthrosis

[Septic pseudarthrosis of the leg. [Report of 22 cases]]

This retrospective study is about 22 cases of the leg septic pseudarthrosis collected at the department of traumatology and orthopedics [wing 4] in UHC Ibn Rochd in Casablanca during 10 years, from January 1992 to December 2001. 91% of our patients are male, the mean age was 36 years old. The first causal agent was the highway accidents [86.4%]. It is about atrophic pseudarthrosis in 59% of the cases, localized particularly at the level of the uppers 2/3. The treatment of these patients consisted in 20 cases in external fixator conception P[r]ZRYOUIL. In one patient, ILIZAROV'S technique has been used. The corticospongy graft has been necessary in 11 cases. PARINEAU'S method has been used in 7 cases. The results have been good in 11 cases, medium in 7 cases and bad in 2 cases with a rate of consolidation about 90%

[Radiological diagnosis of acetabular fractures]

The scanner and the radio are essential to pose a precise diagnosis of acetabular fractures. There are never urgencies to operate a fracture of acetabulum. The radiological assessment including a basin of face; one three wing quarter and one three obturing quarter also a scanner is necessary. The reading of this assessment must be methodical, initially the radiological assessment then the scanner and to confront their results. It is the best parking to pose the operational indication and to envisage the course of the intervention

[Unicondylar fractures of the femur]

Unicondylar femoral fractures account for 0.65% of all femoral fractures; they have not been studied extensively in the orthopaedic literature. Usually occurring following sports trauma or traffic accidents. These fractures involve the lateral condyle three times more frequently than the medial condyle. We bring back 11 cases treated at our institution from 1993 to 2003 [11 years]. They are 7 men and 4 women aged 45 years on average. The circumstances of occurred are as follows: 8 accidents of the public highway, 2 falls and 1 industrial accident. The left side was reached in 8 cases. The fractures were divided into 6 cases of the types TRELAT, 4 cases of the type HOFFA and case of an intermediate type. 6 patients had associated lesions; it acted of three polyfractured cases of, two cases of ligament lesions of the knee [LLI, LCA, LCP] and a case of meniscal lesion. The treatment consisted of a plating for all the fractures, the average time of consolidation was 4 months. The continuations were marked by occurred of pseudarthrosis in 1 case and a case of gonarthrosis. The functional results were very good among 5 patients [bending > 120°], good at 2 patients [bending to 90°] and bad among 4 patients

[Report of a neglected bilateral fracture dislocation of the shoulder]

30 years old women with bilateral schoulder fractures dislocation following a convulsive episode is presented, the seizure was caused by gravidic toxaemia. The diagnosis of anterior fracture- dislocation of both schoulders was confirmed by X- rays and CT scan. Open reduction and internal fixation was carried out with considerable difficulty. The relevant literature is reviewed with special focus on diagnostics, causes, trauma mechanisms, and treatment

Upper tibial osteotomy of valgization in the treatment of genu-varum arthrosis [36 cases]

The authors report 56 cases of upper tibial osteotomy of valgization for gonarthrosis upon genu-varum in 32 patients whose mean age is 57 years. The initial angular deviation is assested from 5° to 30° [average: 12.4°]. The tibial osteotomy is realized by external closing in 33 cases, by internal opening in 3 cases and its fixation requires Blount's staples in 64% of cases. 18 patients are followed with an average recall of 4 years. The results are assested according anatomic and functionnel patterns. They are good in 52% of cases, average in 38% of cases and mediocre in 10% of cases. In the light of this experience and after the literature's review, the authors emphasize the different prognosis factors that permit electing the candidates for this type of surgery

[Osteosynthesis of trochanteric bulk fractures by lamina plate material [67 cases]]

The retrospective study of 67 cases of pertrochanteric fractures treated by AO material showed their particular superviness at a relatively young age [mean age = 60,5 years] in males [70%], Opposite to elderly females in western countries. Support after osteosynthesis has been precocious for stable fractures, and was not authorised until 2 to 3 months in instable fractures, the necessary time for consolidation. This discharge time had reduced mecanic complications rate to 3 minor cases and one case of intracephalic scanning with protrusion of the plate. In other aspects it has influence on mortality rate 4,5%, that remains small in comparison with surmortality in developed countries. Vital prognosis depends essentially on age and pre-operatory physiologic state and not precocious non limited support

Galeazzi's fracture. About 28 cases

In a study of 28 cases involving a GALEAZZI Fracture or equivalent, the authors point out the relative importance of the arthrography of the wrist amongst the various radiologic explorations possible, and the necessity, in adult cases, of complete surgical treatemeat: that is, repair of all lesions of the triangular ligament of the wrist, the negligence of which can seriously affect the functional prognosis

Radial head fracture: surgical treatement

Treatement of cephalic fractures of the radius, type I and type II, remains controversial. In a series of 8 cases treated by osteosynthesis, the authors point out the advantages of this technique while insisting on active, early physical therapy