[Surgical treatment by percutaneous pinning of articular fractures of the base of the fifth metacarpal (descriptive study of 20 cases)]. / Traitement chirurgical par embrochage percutané des fractures articulaires de la base du cinquième métacarpien (étude descriptive à propos de 20 cas).

OBJECTIVES: The aim of this study is to show the benefits of surgical treatment of intra articular fractures of the base of the fifth metacarpal by intermetacarpal double pinning. PATIENTS AND METHODS: It is a retrospective study of 20 cases of intra-articular fractures of the base of the fifth metacarpal treated by percutaneous pinning, between January 2004 and December 2010. All patients had a closed reduction and intermetacarpal double pinning. RESULTS: After a mean of 19 months, we could review only 18 patients. The overall results were satisfactory, except for two patients who reported intermittent pain with changing weather and intense use of the hand, and a case of reflex sympathetic dystrophy syndrome after surgery. The evaluation of results was based on clinical criteria related to pain, mobility and grip strength, and on radiological criteria after analysis of specific hemato-metacarpal radiographs. CONCLUSION: Intermetacarpal double pinning is a technique of choice in surgical treatment of intra-articular fractures of the base of the fifth metacarpal. It ensures good closed reduction and a satisfactory functional result.

[The intermetacarpal double pinning in the surgical treatment of Bennett fracture (report of 24 cases)]. / Le double embrochage intermétacarpien dans le traitement chirurgical de la fracture de Bennett (à propos de 24 cas).

OBJECTIVES: The interest of this work is to show the benefits of surgical treatment of Bennett fractures by intermetacarpal double pinning. PATIENTS AND METHODS: It is a retrospective study of 24 cases of Bennett fracture treated by intermetacarpal double pinning, between January 2005 and December 2009. The treatment was surgical for all patients. The intermetacarpal double pinning using the technique of Iselin has been reserved for fractures with small fragment found in the series in 18 cases (72% of operated patients), and by Tubiana in six cases (24%). RESULTS: After a mean of 36 months, we could follow only 21 patients, the evaluation of results was based on clinical criteria relevant to pain, mobility and the pinch grip, and on criteria after radiological analysis of radiographs specific trapezo-metacarpal. All fractures were consolidated. Two cases of moderate osteoarthritis were observed. Overall, the results were excellent in 15 patients (71%), good in four patients (19%) and poor in two patients (10%). CONCLUSION: Intermetacarpal double pinning is a technique of choice in surgical treatment of Bennett fracture. It ensures a good closed reduction and a satisfactory functional result.

[The current risk factors for hydatidosis in Tunisia]. / Les facteurs actuels d'endémicité de l'hydatidose en Tunisie.

Hydatidosis is a major public health problem in Tunisia. The presence of numerous stray dogs, widespread practice of sheep rearing and frequent slaughter of animals outside slaughterhouses are the main risk factors for spread of this zoonotic disease. Human behaviour associated with poor understanding of the parasite life cycle also has a negative impact. Health education is crucial for effective control. It should emphasize the damaging effects of uncontrolled slaughter, the exact role of dogs in parasite transmission and above all the need for adequate measures to sterilize infested viscera.