Epidemiological and therapeutic aspects of acetabular fractures in elderly.

INTRODUCTION: Management of acetabular fracture in the elderly patients is becoming an increasingly topic of debate. Data from different parts of the world specified particularities of their patients. AIM: To describe patterns of these fractures in the Tunisian patients aged > 60, which can contribute to management and preventive plans. METHODS: We performed a retrospective review from 1997 to 2016 treated at the Charles Nicolle university hospital. Information regarding demographics, co morbidities, mechanism of injury, Injury Severity Score (ISS), types and levels of injury, treatment type, and mortality were collected. RESULTS: The mean age of our patients was 68,6 years (range 60-94 years). The male to female ratio was 3:85.Main causes were motor vehicle accident. Most of our patients were in good health. The associated lesions were very frequent and present in 64.7% of cases with a clear predominance of cranio-fascial trauma, with a median of the ISS score at 11. According to the Judet and Letournel classification, 18 elementary fractures and 16 complex fractures were reported with predominance of the anterior column-posterior hemitransverse fracture pattern. Posterior wall fracture in the elderly is often associated with comminution and / or marginal impaction and / or posterior dislocation of the hip. Fractures of the anterior segment are often associated with hip protrusion and / or quadrilateral plate involvement and / or the superomedial roof impaction or "Gull sign". CONCLUSION: As our population continues to age, traumatic acetabular fractures will become more prevalent. Appropriate screening strategies, treatment and prevention plans will need to be developed to improve outcomes in this devastating injury.

Tumoral calcinosis: a rare disease.

Idiopathic tumoral calcinosis is a rare affection. It is defined by the presence of calcified deposits in periarticular tissues. The diagnosis is suspected on imaging and confirmed by histology. The treatment consists of a precocious and complete surgical exeresis. Despite the risk of recidivism, the prognosis is always excellent. We report a new case of tumoral calcinosis in a patient of the fifties and clear phototype. The clinical exam found a voluminous mass of soft tissues and the radiological exam showed the presence of voluminous periarticular calcifications with no bone involvement. The diagnosis was confirmed by the anatomopathological exam. The treatment remains essentially surgical.

Isolated tuberculosis of the navicular bone in a child.

Tuberculosis is a topical issue in endemic countries. Foot involvement is rare and accounts for 5-10% of all osteoarticular tuberculosis. Pediatric cases of osteoarticular tuberculosis are uncommon especially in well vaccinated children. The clinical presentation is not specific and can be confused with common germ like staphylococcus. Biopsy is mandatory in endemic zone, and if the evolution is not good with antibiotherapy. Debridement can be indicated but must be gentle, because of the risk of navicular necrosis.