[Pott's disease of the upper cervical spine [three cases and literature review]]

Sub-occipital Pott's disease is rare, but dangerous. To recall diagnostic aspects and spatially the neuroradiological ones of sub-occipital Pott's disease. We describe three patients with sub-occipital Pott's disease followed in our department from 2002 to 2007. there were two women and one man [mean age at onset: 48 years]. The early clinical picture was non specific. Exploration, in addition to standard radiographies included a computerized Tomography [CT] [n=2] and MRI [n=1 and n=3]. The diagnosis was confirmed histologically on a biopsy of the abscess [n=1], a bacteriological evidence [n=2] and retained thanks to argument presumption [n=3]. The treatment was based on quadruple antituberculous chemotherapy with external traction [n=2 and n=3] associated with urgent surgery [n=1] because of the worsening of the neurological complications. The evolution was fatal [n=1] and positive [n=2 and n=3]. Tuberculosis should be suspected in patients with chronic torticollis and residing in an area when tuberculosis is endemic. Medical treatment is based on a quadruple antituberculosis chemotherapy with fraction in the presence of atlanto-axial instability. Surgery is reserved in case of neurological worsening or persistent instability

Criteres predictifs d'une effraction articulaire meconnue apres osteosynthese d'une fracture du col du femur

On the basis of a retrospective study comprising 91 cases of femoral neck fracture treated by DHS, unrecognized screw articular penetration was observed in 9 cases [9,9%]. The coxa valga [Garden 1] fractures are the most interested by this complication [7 cases out of 9]. With a practical purpose and to avoid remarking each time complex measurements again we found that the distance "d" separating the end of the implant from subchondral bone calculated on antero posterior and lateral views and so the angle measured on the lateral view were two criteria significantly predictive of this technical error with respectively P 0,005 and P 0,0005.Thus during the surgical procedure taking these two measurements after the installation of the pin guide would allow attention on the risk incurred. In case of doubt, we have changed the way of this pin before resorting to drilling and tapping

Traitement conservateure des fractures du col du femur a trait vertical de l'adulte a propos de 153 cas

The authors return 153 fractures of collar pauwels III, the middle age of patients is 47 years. The angle of Pauwels is of 62 [°]. The fracture Garden IV represents 30% of the set. The material of osteosynthesis is: DHS: 54 cases: 37 cases parallel visage 56 cases the reduction was judged insufficient in 26% of cases. The association between trochanterian osteotomic and valgisation was achieved at 15 patients. The results was analysed with a middle receding 3 years, one raised a global rate of pseudarthrosis on 23.5% and 25% of necrosis of the femoral head, this last arises to 47% in case of arthromy when to the rates of pseudarthrosis, he increases in case of montage by screw [40%] and in case of insufficient reduction [55%], however, this rate fall when one associates an intertrochanterien osteotomy of valgisation [7%]