[Malignant nerve tumors about 8 cases]

Malignant nerve tumors, currently called malignant peripheral nerve sheath tumors, are uncommun, and represent less than 10 percent of adult soft tissues sarcomas. The authors report in this article a series of 8 cases of malignant nerve tumors and propose an epidemiologic, diagnostic, therapeutic study and the outcome of these tumors

[Surgical treatment of the rheumatoid forefoot about 18 cases]

Forefoot deformity in rheumatoid arthritis is a common occurrence leading to significant disability and impingement. Surgical options are frequently used to correct these deformities. The purpose of the present, retrospective study is to report our experience in surgical treatment of the rheumatoid forefoot: forefoot reconstruction with first metatarsophalangeal arthrodesis first metatarsal osteotomy and lesser metatarsal head resection performed on 18 patients. After surgery the results were good 14/17 patients were without pain during weight bearing and were able to wear casual shoes. Three patients were suffering from persistent pain. The average angle of the fused hallux was 19 2°. This surgical procedure is simple and efficient at the same time allowing a good correction of the rheumatoid deformity and respecting the concept of united family forefoot

[ importance of barb wire in surgical treatment of mallet finger a study of 12 cases]

The authors report a series of 12 cases of mallet finger treated surgically by steel wire of barb-wire, all the patients were men with an average age of 32 years and the injury occurs basically in the little finger of the dominant hand. The patients were examined again about 2 years later on average. The results were good in 11 cases with recuperation of complete joint motion, a neuro algodystrophic syndrome with joint stiffness had been noted in one neurotonic patient. No complications such as infection or skin necrosis nor deformity or trophic or dysesthesia trouble had been noted

[ importance of pediculous latissimus dorsi flap in reconstructive surgery about 44 cases]

The authors present a series of 44 cases of pediculous latissimus flaps operated these last ten years at Sahloul Hospital Sousse. They insist on the vascular reliability of this flap and on the importance of its rotation arch for covering the lost of cutaneous substances of the cervico-thoraco-brachial area

[ wrist dorso radial flap about 10 cases]

The wrist dorso-radial flap is another procedure to cover the hand defects. The authors report a series of 10 patients in whom we performed wrist dorsoradial flap. The operative technique, application and results of the use of this flap are described with reference to our clinical series. Various methods of applications to hand reconstruction are described along with a discussion of the various advantages and disadvantages

[Treatment od dorsal fracture dislocation of the proximal interphalangeal joint with arthrodesis technic: about 19 cases]

Trojan fracture is an unstable lesion which associate an anterior marginal fracture of the second phalanx base and a dorsal dislocation of the first interphalangeal joint under the influence of the extensor traction. The instability of this lesion is more important when the anterior marginal fragment is big. Various techniques were described, we report our experience using the arthrorise's technique to treat this lesion. The procedure associate a reduction of the fracture and the dislocation using a dorsal pinning. This procedure is simple and allows an early physiotherapy, important for this joint. We used this procedure in 19 Trojan fractures between 1995 and 2002 awl at 3 years follow-up our results based on functional, clinical and radiological criteria were satisfactory

[ sural flap: a study of 16 cases]

The sural flap is a fasciocutaneous flip pediculed on the sural nerve artery. This flap represent a good solution to cover soft tissue defects of the distal lower limb and proximal foot. 16 patients with age ranging from 12 to 45 years and with soft tissue defects of the lower leg due to various causes were treated with sural flap. On this basis we would like to reintroduce the safe and reliable use of the swat flap to treat large soft tissue defects of the distal lower limb and the proximal foot which sometimes is the only solution to cover those regions

[ chinese flap about 26 cases]

The chinese flap, alsow called antebrachial radial flap is a fascio-cutaneous flap based on the radial artery. Since the description, it opened indisputably a new chapter in plastic surgery. Through a series of 26 cases realized in our service of which 24 pediculed and 2 free flaps, we ware able to confirm it's reliability, and we studied its advantages and the inconveniences. It's a quite simple flap who can gives a good quality of skin supple and thick. The principal inconvenient is that it scarify a main artery of the hand, that is why, we have to think about it before potting its indication, although we had no complication inherent to this taking. The zone donor always keeps an unaesthetic scar at the level of the fore arm; and consequently the indication at the woman most be studied well I Finally to hairy subjects this flap must be avoided in certain locations such as the palm of th hand and the face

[Lipoma of the hand a study about 15 cases]

The lipoma are a fat tumors which are rare in the hand they can be lonely or take part of diffuse lipomatose. The physical examination is discerning of the other benign tumors by the "ice cube test" which is reliable and cheap. The treatment consist in surgical excision of all the tumor. Our work is based on retrospective study of 15 cases of hand ilpoma. The analysis shows that lipoma was more frequent in male, the avenge age was 40 years, the dominant hand was morely affected and the anatomopathologic analysis confirmed the diagnostic in all cases. None occurrence was happened after the excision of the tumor

[Erysipelas at the upper limb about 3 cases]

Erysipelas is an acute bacterial infection of the dermis and hypodermis generally caused by streptococcus. This affection is rare at the upper limb. The authors report the observation of three patients of the 4[th] and the 7[th] decade presenting an erysipelas at the upper limb having evolved favorably under antibiotic treatment and hospitalisation in two cases. The erysipelas is of clinical diagnosis basing on general and local signs. The portal of entry must be always looked for and treated. It represents with the diabetes, the obesity and the lymphedema a factor of gravity of this pathology

[ traumatic dislocation of the trapezio metacarpal joint about 5 cases]

The high voltage electrical bums cause an exceedingly high rate of morbidity resulting from the massive necrosis of deeper structures often necessitating major limb amputations. The authors report two rare cases of high voltage electrical burns occurring accidentally with a 49 and 19 year old men after an indirect contact with a high voltage line. These high voltage electrical burns caused massive necrosis and extended necrosis m the upper limb requiring the recourse to a disarticulation the shoulder. The indications and the operative techniques used are discussed

[Lower limp ischemia due to femoral artery thrombosis after rectal excinian in lithotomy position]

Lower limb ischemia is an unusual and severe complication of abdominal surgery. We report a case of left femoral artery thrombosis following elective low anterior resection for rectal cancer in lithotomy position. Despite thrombectomy and femoro-femoral bypass the patient lost the involved limb due to irreversible ischemia. We discuss the factors that my have a role in the occurrence of this complication