[Bhondroblastoma of bone]

Chondroblastoma is a rare and benign cartilaginous tumor of bone often localized in the epiphysis of long bones and affecting young persons between 10 and 20 years. To study the epidemiological, clinical and radiological aspects of bone chondroblastoma, to assess the outcome of chirurgical treatment and factors associated with recurrence. It's a retrospective study, concerning 13 patients with chondroblastoma of bone, attending the orthopedic department of Sahloul hospital between 1991 and 2007. The patients' age, sex, clinical features, radiological aspects, treatment and evolution were recorded. After initial clinical examination, all patients have had plane radiographs. Twelve patients were explored by Computed tomography. The treatment was surgical in every case: curettage of the lesion in 11 cases associated with bone grafting in 5 cases and cementation in one case, one in-bloc resection and one simple biopsy. Histology confirmed the diagnostic in all cases. The average age of patients was 18, 2 years and sex ratio was 2, 3. The long bones are the most commonly involved. The main presenting symptoms were pain in all cases and local swelling in 8 cases. Radiographs showed a lytic geographic well-defined lesion in 7 cases. Computed tomography showed better calcifications and soft tissue extension. The mean follow-up of our patients was 8 years [6 mois-18 ans]. Two recurrences were noted. Functional results were good in 11 cases. Chondroblastoma is a rare and benign cartilaginous tumor of bone which usually involves the epiphysis of long bones. Plane radiographs are sufficient for diagnostic in typical cases. MRI is interesting in unusual presentations and localizations. Curettage and grafting constitute the treatment of choice. Prognosis depends basically on a relatively high rate of recurrence. Aggressive feature of the lesion and incomplete curettage are the most important predictive factors of recurrence

[Results of deltpoid flap for the surgery of rotator cuff tears]

To evaluate the results of deltoid flap for the treatment of massive rotator cuff tears. This retrospective study included 20 shoulders in 20 patients with a painful massive, irreparable rotator cuff tears. The average patient age was 54 years, They were all treated with acromioplasty and a deltoid flap according to Augereau technique. Follow-up averaged 6 years 3 months [range 18 months - 11 years 4 months]. Clinical and radiologic evaluations were done before and after surgery. Function was evaluated according to Constant's score. The Constant's score increased from 24.6/100 to 54.45/100. Eighty five per cent of patients were satisfied. Results on pain were good, with an average of Constant's score of 11/15. However, improvement strength or motion was not significative, with an average of 7.1/25 and 228/40 respectively. This study concludes that, this technique is a simple surgical procedure and their results on pain were good. Therefore, we concider it is an excellent indication for the treatment of massive rotator cuff tears in adults after medical treatment failure

Arthroscopy of the shoulder technics and indications. about 64 cases

Arthroscopic surgery replaced at present more and more conventional articular surgery because its anatomic character, its less morbidity and its more simple post-poerative care. After knee, the shoulder is considere as the articulation witch benefit of the progress of arthroscopic technics. Autors reported their experience in shoulder arthroscopy witch is introduced in the service since 1999. The gol of this study is to describe the technic of the shoulder arthroscopy and to precise its main indications