[ tibial tuberosity avulsion from previous among Adolescents [about one review of the case and litterature]]

Avulsion fracture of the anterior tibial tuberosity is rare. This lesion occurs in the sportive adolescent. The authors report a case of 16 years old boy who presents an avulsion of the anterior tibial tuberosity, treated by surgery. Epidemiologic, etiopathogenic, therapeutic and pronostic aspects are analysed

[ common peroneal nerve compression by a synovial cyst]

The synovial cyst compressing the fibular common nerve is a little known entity at the origin of diagnosis mistakes. The authors recall about a new case the clinical symptomatology: pain of the knee followed by steppage. The palpation can recover a swelling at the level of the fibular neck. The electromyogram permits to localize the nervous lesion comfortably . Our observation puts in evidence the interest of the magnetic resonance imaging. The surgical intervention must search for a possible communication of the cyst with the proximal tibio-fibular joint. The neurological prognosis is generally good in case of recent deficit

lesions osseuses de la sarcoidose

Sarcoidosis is a chronic granulomatous disease of undeterminable aetiology affecting multiple organs. Bony affection is rare, and often difficult to be diagnosed. Through observation of two cases we tried to characterize clinically the osseous lesions and their effect on prognosis by clarifing the interest of osseous scintiscanning in the early detection of these lesions. Observation 1: A female patient aged 44 years, treated from pulmonary sarcoidosis since 6 years. Diagnosis of bony sarcoidosis of the right radius has been suspected depending on the clinical picture, radiological and isotopic scanning features. Bone scanning also spotted other lesions in the controlateral left wrist. Observationn 2: A female patient aged 56 years, in whom a neurological sarcoidosis with a cranial bone affection has been diagnosed by a direct osseous scintigraphic bone biopsy. Discussion: Osseous sarcoidosis affection predominates at the hands and feet bones. Often starting, with phalengeal pain tumification. In our observation, bony scintigraphy has been individualised by accurate precession of different diseased sites if compared with standard x. ray images and also by discovering asymptomatic lesions. This exploration also contributes in evaluation of the disease similar to the biological assessment, ensuring early mangement of infammatory attacks

Surgical treatment of the metastatic fracture and of the long bones metastsis

Analysis of surgical modalities and techniques used in treatment of fractures of long bones. Material and methods: The authors reported 72 metastatic fractures and perfracture bony metastatics in 68 patients collected from traumato-orthopedic departement in the university hospital center Ibn Sina of Rabat, through a period of 10 years between 1989 and 1999. Average age was 59 year [27-78 year]. Females was more affected [36 women equ 53% of cases]. The classical localisations were femoral and humeral respectively 47 cases [63%] and 24 cases [32,5%]. Sixty four patients were treated surgically, abstinence for four patients. Fracture femur was treated according to its localisation, either by prosthetic replacement for fracture neck, or by symmetrical or non internal osteosynthesis for other localisations. The humeral fructures were treated by centromedulary cement nailing. The association of adjuvant treatment [chemotherapy, radiotherapy and horomotherapy] was needed according to the histological type of the primitive tumour. Evoluation was marked by the functional replacement of limbs and relief of pains in 21 patients [31%] with average follow up of 9,5 months with extremes of 1 month to 5 years. Long bones metastases must be dealt with the prefracture state in order to help the practitioner to do precosious diagnosis