[Surgical treatment of acetabulum fractures [Report of 52 cases]]

This piece of work consists of a study of 52 cases of acetrabular fractures treated with open reduction and internal fixation in the service of Traumatology Orthopedics of the H.U.C Ibn Rochd of Casablance from 1994 to 2004. The average patient age was 37 years. A road traffic accident was the most involved causative mechanism [90%]. The left side was the most affected [60%]. The Judet and Letournel views confronted to the computed tomography data lead to establish diagnosis, to make classification by Judet and Letournel classification and to appreciate congruency by the Duquennoy-Senegas classification. The Kocher-Langenbeck approach was use in 88% of the cases. We have used plates to fix fractures. Screw were use in association with plates in 73%. The functional outcome is assessing according to the Postel Merle D'aubigne score and the results were excellent to good in 65%, fair in 25% and poor in 10% of the cases. We have won 47% on the both vertical and horizontal congruency TT3 and TC3. As complication, we noted 12 cases of osteoarthritis [30%], 9 cases of heterotopic ossifications [23%] and one case of osteonecrosis of femoral head [2.5%]

[Extra-articular malunion of distal radius. [Report of 20 cases]]

Malunion remains the most common complication following fracture of the distal radius. The consequences of the deformities on the wrist function are analysed and a therapeutic strategy is suggested. The authors report 20 cases of non-articular malunion of the distal radius. Preoperative evaluation requires a comparative analysis with clinical and radiological assessment. Corrective posterior osteotomy is performed on the radius in 47% of the cases, an anterior open osteotomy in 37% of the cases, a lateral osteotomy with a closing osteotomy in 10% of the cases, and in one case; an osteotomy of radius lengthening. The bone graft is associated in 50% the cases. At three years follow-up, the functional results are been studied following the lilloise school quotation. Also, the good results became of 0 to 30% and the bad results of 60 to 10%. The non-articular malunions are usually caused by an insufficient initial treatment. Also, the re-orientation osteotomies with bone graft make good results in long term

[Total hip prostheses in osteonecrosis of the femoral head [about 46 cases]]

The authors report a retrospective study about 50 THP realized at the department of the orthopedic-traumatism wing 32 in UHC Ibn Rochd of Casablanca between January 1992 and December 2001. The group includes 22 men [47,8%] and 24 women [52.2%]. The right hip hs been operated on in 30 cases [60%] and the left hip in 20 cases. 20 patients presented an aseptic osteonecrosis caused by a corticotheraphy, 7 patients suffered from ethylism and 5 patients had already been operated on. Postel and Merle d'Aubigne's quotation was used to value the state the hip before and after the operation. The postero-external tract of Moore was used in 47 cases [94%] and Harding in 3 cases [6%]. The THP were cimented in 34 cases [68%] and not cemented in 14 cases [28%]. After a recession of 4,7 years, we noticed as complications: 4 detachments [8%], 4 cases of the hip stiffness and 3 cases of periarticular ossifications, and accords DMA quotation, the results were satisfactory in 32 cases [64%], medium in 12 cases [24%] and bad in 6 cases [12%]. The THP is a choice method in the treatment of femoral head aseptic osteonecrosis, the success of the intervention depends on the respect of the indication and to correct realization of the operation

[Synovial osteochondromatosis of the shoulder. [Report of 3 cases]]

Synovial osteochondromatosis of shoulder is a rare affection, it becomes on the fourth place after the knee, elbow and hip. We report 3 cases in patients of more than 40 years old, the diagnosis suspected after radiologic study is confirmed by histologic study. All the patients benefited from open sky surgical treatment that permitted to make ablation of foreign bodies followed by a synovialectomy [cases n°l and n°2], a resection of the serous bursa with its synovial and a resection of the biceps tendon sheath for the case n°3. The results is affected by late diagnosis