[ neurogenic Paraosteoarthropathies from the hip]

The neurogenic paraosteoarthropaties of the hip is the ossifications ectopiques sitting around the coxo-femoral joint respecting the articular surfaces.We report seven cases of neurogenic paraosteoarthropaties of hip collected to the service of traumato-orthopedic in the UHC Ibn Rochd of Casablanca of the period 1992 until January 2002. These seven cases having in middle age of 28 years a sex-ratio of 0.75. All cases having like etiology the head injury with deep coma either. All cases have been operated for the hip, a three of then were operated for other localizations [2 elbows, 1 knee] according to the functional priority. For the seven cases operated for the hip intervention consisted in an arthrolyse of the hip with exerese of the osteoma. The ways were first the previous way in two cases, the postero-lateral way in three cases and the antero-external way.in two cases. Any case had a postoperative complications there. All these cases followed a rehabilitation of the postoperative with anti-inflammatory, in one case, the radiotherapy was used. The results according to the quotation of Merle d'Aubigne were excellent for 2 cases and good for the five other.The surgical treatment is obligatory when the osteoma is mature [scintigraphy, alkaline phosphatases] or in the case of compressive complications or great functional difficulty. On the other hand, the association of medical and surgical treatment in a pre and postoperative protocol is promising

[Autogenous bone graft reconstruction and Kerboull ring aseptic acetabular loosening]

62 cases of acetabulum reconstruction by Kerboull cross were performed from 1998 to 2003. This reconstruction was realized in 62 cases of acetabulum loosening with bone defect : type III or IV of the SOFCOT classification. The mean follow up was 4 years. We note an increase of PMA score in 92% and 1 losening due to infection. Reconstruction of the acetabulum. Its fixation, the reconstruction of the acetabulum with Kerboull cross is a good alternative to bone defect in acetabulum. Its fixation, the reconstruction of the acetabulum by the bone grafting and the automatic centralization of the hip seems to be the major points of this technique

[Fractures of the tibial shaft [Report of 61 cases]]

Sixty one tibial pilon fractures have been collected at the department of orthopaedic and traumatologic surgery. The fracture of the tibial pilon represents 8% of the ankle traumatisms, it is the prerogative of the young person as the mean age of our patients was 36 years old with neat male predominance [71%]. The etiologic circumstances are dominated by the fall of a high place in 52%. The cutaneous lesions were present in 53% of cases. According to Vives classification, the complete complex fractures represent 46% of cases. The surgical treatment by internal osteosynthesis was practiced in 35 cases [57%], the osteosynthesis of the fibula fractures was systematic. The external fixator has been rise in 26 cases [22 Hoffman's type, 4 Ilizarov's type]. The functional results according to Lechevallier's criteria have been good in 30 cases [58%], medium in 11 cases [21%] and bad in 11 cases. We couldn't notice a correlation between functional results and radiological results; the latter's have been good in 20%, satisfactory in 46% and bad in 43%. The internal fixation proved its superiority in relationship with the external fixation

[Carpometacarpal dislocation of long fingers. [Report of 2 cases]]

We report two cases of carpometacarpal dislocation of the fore long ringers. They were diagnosed in emergency and treated by closed reduction and immobilization in a plaster cast for the fist case, and by open reduction and stabilised by pins for the second case. They were followed for an average of 31 month. The results were rated good and two patients had a good function with no deformity, no instability

Patellar ligament ruptures concerning 6 cases

In this study, six cases of patellar ligament ruptures [five recent ones and one inveterate] affecting only the tendon fibers were reported. The osseous stripping of the rotular point and of the anterior tibia tuberosity was not considered. A surgical treatment was done. More sutures were undertaken to wipe out lesions [five cases] or transosseous points [one case]. A protection centering in the Mac Laughlin way achieved the repair in all the cases. An immediate reeducation was undertaken for five times. There were excellent results over the active extension [six cases]

[ dislocation-fracture of the Hip [correlation between the type of injury, therapeutic process and the anatomo functional evolution]]

In this retrospective study of 44 cases collected between 1982 and 1992, we try to analyse the lesional relation ship of the luxations - fractures of the hip, the therapeutic processes and the anatomic and functional evolution of this articulation. The mean age of our patients is 35 years old, the extreems are 13 and 70 years. The highway accident is the most fruquent etiology. In 77% of the cases, the luxation has been associated to the fracture of the posterior panes. The lesional association was varied [cranial traumatism, sciatic lesion]. The treatment was orthopedic especially and consisted in the reduction of the luxation emergently and the traction. The surgical treatment of the fracture depended on the result of the reduction, the articular congruence, the fracture type and the residual displacement. The delay was 1 to 10 years, we noticed 24% of bad result, the cephalic necrosis is more frequent in the luxation -fracture than in pure luxations. The risk of arthrosis is important in relation ship with the fractures of isolate socket, we noticed a non neglectable frequency of the periarticular ossifications. We insist on the rigorous pathologic complete physical examination, the emergent treatment, the accurate value of the state of articular congruence [roof theed, socket head] in order to diminish the risk of complications [necrosis, senile coxarthritis]

[Liver abcesses: clinicals aspects and actual treatment]

A serie of 32 liver abcesses during a trial of 7 years is reported by the authors. The male sex is predominant [90%] The symptoms of the illness are typicaly those of the classic liver abcess. The treatment has improved with the progress of the imagery and especially the echography. The punction under echography had been tried in 7 cases, of which 6 were cured. When the seize of the liver abcess is small the medical treatment permits recovery in 68% of the cases. Only new cases that do not answer to medical treatment and punction are candidate to surgery