[Shoulder dislocation associated with polyfractures of the same member [Report of 2 cases]]

We return two rare cases of lesion's associations treated in our service. It was about a dislocation of the shoulder associated to lesions stacked of the same superior member revealing the violence of the initial traumatism. The mechanism of lesions and the therapeutic strategy were discussed. In the first observation the dislocation was associated to a fracture of the humeral shaft and a supra and intercondylienne comminuted fracture of the humeral pillar, the patient had benefitted from a surgical treatment with in first an access of the shaft home that allowed us to manipulate the proximal fragment and to feel humeral head for the reduction, so the shaft has been fixed by a screwed plate and the epiphyseal fracture by a plate of Lecestre. In the second observation the dislocation was associated to fracture of the humeral shaft, a simple fracture of the internal condyle of the humeral pillar and a comminuted fracture of all the third inferior of the radius. The patient had benefitted from an access of the shaft home permitting the reduction of the humeral head; the shaft has been fixed by a screwed plate and the internal condyle of the pillar by a simple srew. For the fracture of the third inferior of the radius we opted for the association of a plate screwed to a fixer for the epiphyseal distraction. The present receding is of more than 1 year. The functional results of our patients are correct

[Stress fracture of femoral neck [Report of 3 observations]]

Authors bring back 5 cases of fractures of stress of the femoral collar respectively at 3 patient aged of 26, 36 and 47 years with bilateral reach in 2 cases. The diagnosis of stress fracture has kept before a bundle of arguments to know: the traumatic absence and the existence of an obvious intense physical activity in case, the pathological antecedent absence, the normality of the biologic balance well as the reminiscent radiological aspect. The treatment consisted in a vissage in 4 cases total arthroplastie of the hip in a case. To the light of these 3 observations and a magazie of the literature, authors analyze epidemiologic, etiopathogenic and physiopathologic aspects aspects as well as the therapeutic possibilities of the fractures of stress of the femoral collar. They also underline especially the gravity of this pathology and the interest of data of the imagery to the precocious stadiums of the illness the scintigraphie and the IRM, the key of the treatment being the precocious

[Giant cell tumor of the pelvis about a case]

Giant cell tumours are osteolytical lesions usually located on the epiphysis most frequently near the knee and far from the elbow. Their localisation on the ankle is rare: 5 a 7%. Authors report the case of a 32 year old man with a anklean localisation treated with a curettage and acrylic cementation was good evolution

interest of nailing of Kuntscher to neck anchorage for treatment of trochanteric fructures

This study deals with a new locking method used in treatment of trochanteric fructures. Materials and methods: The study concerned with 25 patients, average age was 54-64 years Classifiedas 6 simple tronchanteric fructures, 16 Compound fructures, and 3 pathological fructures. These cases were treated by nailing of Kuntscher to neck anchorage using a new method based on making of locking hole followed by bone treapaning in face of this hole. There were 7 mechanical complications: 2 cephalic screw migration, 2 sweeped screws, 1 nail incurvation and 2 nail fructures. Finally follow up for more than 6 months showed: Consolidation occurred in 20 cases, 1 non-union, 4 cases disappeared of vision. The nailing of Kuntscher to neck anchorage is a safe and effective method for treatment of trochanteric fractures, it needs an appropriate previous experience in they way of using intramedellary nails

Les luxations sous astragaliennes [a propos de 12 Cas]

We present in this work the clinical and therapeutical fearures of suastragalor dislocation based on serie of 12 cases reported in the service of TraumatoOrthopedic of the U.H.C. of RABAT. Our patients are betwen 15 and 55 years aged.They have been followed-up for a period oscillating between 4 and 16 months. Thy are especialy male with slight prevalence of the internal form. The diagnosis was immediate in 7 cases, delayed in 5 cases with a dislocation age ranging from 2 months to 3 years.The orthopedic treatment is basic management in the isolated dislocation. The surgical management is imperious in the case of opening or no reductibility, and it is discussed, more particulaty in case of associated fractures. Arthrodesis can be carried out right away, and it is absolutely necessary in cases of ancient dislocation. The study of the results allowed to point on some factors that have influence on the prognosis of these desions. As for evolution, arthrosis is certainely the main risk. It's appearance seems to be favoured by existence of associated lesions

fractures bimalleolaires: resultats du traitement chirurgical

The authers analyse the results of 78 Bimalleolar fractures and discuss the interest of surgical treatment. They precise that the orthopedic treatment must be reserved to indisplaced fractures and the surgical treatment reserved every time the displacement is important and when the ligaments lesions are associated; this is the case in fractures due to external rotation pronation and adductim supination. Surgical therapy is more applied in several cases, because it is the efficacious one and give the best results [88% good results]