[Bony tuberculosis of the thumb revealed by a trauma]

Tuberculous dactylis is uncommun which is difficult to differentiate from tumorous and metabolic affections. The histological studie constitutes a reliable and easy element to achieve for the positive diagnosis especially as the biologic studie can be negative. We report the case of a 43 year old woman who consulted for a post traumatic painful inch of the right hand. The x-ray of the hand visualized a fracture of the first phalanx of the inch with a lyse bony. Pathology examination of a biopsy specimen reveled granulomatous with caseous necrosis specific of tuberculous. The clinical signs and radiographs resolved after anti tuberculosis treatment for 12 months

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