[Subtrochanteric fractures [Report of 42 cases]]

The authors report a retrospective study of 42 cases of subtrochanteric fractures hospitalized in the orthopedic and traumatology surgery service of the hospital Ibn Rochd [wing 4] between January 1993 and December 2003. This study exposes the clinical, automical, biomechanic and therapeutic particularities and the difficulties of the hold in charge. The middle age was of 47 years with two peaks, one between 20 and 29 years, the other between 60 and 69 years. A higt masculine predominance has been noted with a sex-ratio of 1.3. The etiological circumstances is dominate by the raping traumatisms to high energy [58%]. These fractures have been treated surgically in 90.5% and orthopedically in 9.5%. The global functional results were satisfactory with a rate of excellent results in 55.3% of the cases and good results in 44.5% of the cases. The discussion is about the best technique of osteosynthesis. It is in favor of the centromedullary implants of second generation

[Unicondylar fractures of the femur]

Unicondylar femoral fractures account for 0.65% of all femoral fractures; they have not been studied extensively in the orthopaedic literature. Usually occurring following sports trauma or traffic accidents. These fractures involve the lateral condyle three times more frequently than the medial condyle. We bring back 11 cases treated at our institution from 1993 to 2003 [11 years]. They are 7 men and 4 women aged 45 years on average. The circumstances of occurred are as follows: 8 accidents of the public highway, 2 falls and 1 industrial accident. The left side was reached in 8 cases. The fractures were divided into 6 cases of the types TRELAT, 4 cases of the type HOFFA and case of an intermediate type. 6 patients had associated lesions; it acted of three polyfractured cases of, two cases of ligament lesions of the knee [LLI, LCA, LCP] and a case of meniscal lesion. The treatment consisted of a plating for all the fractures, the average time of consolidation was 4 months. The continuations were marked by occurred of pseudarthrosis in 1 case and a case of gonarthrosis. The functional results were very good among 5 patients [bending > 120°], good at 2 patients [bending to 90°] and bad among 4 patients

[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