Hamatometacarpal fracture-dislocation: A case report.

Hamatometacarpal fracture-dislocation is a rare condition. Only a few cases have been reported in the literature. We present the case of a 26-year-old male patient who sustained a coronal fracture of the body of the hamate with the fifth metacarpal base interposed between volar and dorsal fragments on his right dominant hand. The patient underwent open reduction and internal fixation of the hamate with a 2.0-mm cortical screw and stabilization of the dislocated fifth metacarpal with Kirschner wire. At six months follow-up, total range of movement was allowed, the patient experienced no pain, and had successfully returned to work.

Osseous hydatid disease: A mimic of other skeletal pathologies.

Hydatid disease is still endemic in several regions worldwide including Morocco, and is caused in most cases by the larval form of 2 species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Primary hydatid disease of the bone without systemic involvement is rare. The disease has a silent clinical evolution until it reaches complicated stages. Complications may include pathological fracture, neural deficit, infection, and fistulization of the abscess. Preoperative diagnosis is based on clinical history, imaging findings, and serological tests, which lack high sensitivity and specificity. Although the interpretation of imaging studies can prove to be very confusing because the bone changes evolve with time, and the nonspecificity of these findings often leads to a mistaken diagnosis. The diagnosis requires a high index of suspicion, especially in patients who reside in or travel to sheep-raising areas where hydatid disease is endemic. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice remains surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is indicated when surgery is not possible or as an adjuvant treatment. The prognosis is often poor. We report the case of a 28-year-old woman with long-standing pain in the left hip joint in which the imaging findings were thought of as being either tuberculous or neoplastic. The result of a CT-guided biopsy concurred with an unexpected diagnosis of a hydatid cyst. This case highlights that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in the bone to those of other skeletal pathologies can lead to misinterpretation.

Tuberculosis of radius diaphysis: Case report and review of literature.

Diaphyseal tuberculosis (TB) is a rare case of the skeletal TB. The following report documents the case of a 52-year-old Moroccan woman with a swelling over the right forearm followed by pulmonary TB under treatment for 3 months. The radiographs of the forearm show a lytic image located at the radius mid-diaphysis. The histopathology confirmed the diagnosis. The patient received surgical drainage with trepanation of the bone. The antibacillary chemotherapy was administered for 6 months. It is, therefore, indispensable to bear in mind the possibility of such atypical presentations of TB when making a rapid and pertinent diagnosis and prescribing the appropriate treatment.

[The role of the retrograde nailing in distal femur fractures: about 7 cases]. / Intérêt du clou rétrograde dans les fractures du fémur distal: à propos de 07 cas.

We report a series of seven cases of fractures of the distal end of the femur treated by retrograde centro-medullary nailing in the Orthopedic-Trauma Department at the Hospital Ibn Sina over the period 30/05/2010 - 30/04/2015. The average age of patients was 54 years, with a slight male predominance (57,1%). Road traffic accidents were the main cause of these fractures (71.4%) and they mostly affected the right side of body (57,1%). From a surgical point of view, the mean time between symptom onset and treatment initiation was 2 days. Spinal anesthesia was performed in five cases. The average length of stay in hospital was 5 days. The mean time of consolidation was 4 months in all patients, there was only one case of delayed consolidation (6 months). Patients had good functional outcomes with mean knee flexion 120°, with only one case of limited flexion 90°. There was one case of consolidation delay and one case of pseudarthrosis. No deaths, or superficial or deep sepsis, or thromboembolic complications or fat embolism were registered. In general we had satisfactory outcomes. Our study highlights that retrograde femoral nailing is an essential osteosynthesis technique for the surgical treatment of the distal femur fractures.

[Pure internal subtalar dislocation: about a case]. / Luxation sous-talienne interne pure: à propos d'un cas.

Pure subtalar dislocation is a rare condition. We here report the case of a young patient presenting with pure internal subtalar dislocation as a result of a sport accident. He underwent orthopedic therapy achieving a good functional outcome.

[Trochanteric tuberculosis, an often difficult diagnosis]. / La trochantérite tuberculeuse, un diagnostic souvent difficile.

Trochanteric tuberculosis is a rare disease (<2% of osteoarticular tuberculosis), even in high-endemic countries. It is characterized by insidious symptoms. For this reason, diagnosis is often delayed. The authors report a series of 9 cases, the diagnosis was made by bacteriological and histological examinations after imaging assessment (ultrasound, MRI, CT scan). The treatment of this disease is medical (anti-tuberculous antibiotic). Surgical treatment is usually reserved for complications and improves disease progression.

Neglected rupture of the quadriceps tendon in a patient with chronic renal failure (case report and review of the literature).

Spontaneous ruptures of the quadriceps tendon are infrequent injuries, it is seen primarily in patients with predisposing diseases such as gout, rheumatoid arthritis and chronic renal failure. A 32-year-old man had a history of end stage renal disease and received regular hemodialysis treatment for more than 5 years. He was admitted in our service for total functional impotence of the right lower limb with knee pain after a common fall two months ago. The radiogram showed a ''patella baja" with suprapatellar calcifications. The ultrasound and MRI showed an aspect of rupture of the quadriceps tendon in its proximal end with retraction of 3 cm. Quadriceps tendon repair was performed with a lengthening plasty, and the result was satisfactory after a serial rehabilitation program. The diagnosis of quadriceps tendon ruptures needs more attention in patients with predisposing diseases. They should not be unknown because the treatment of neglected lesions is more difficult. We insist on the early surgical repair associated with early rehabilitation that can guarantee recovery of good active extension.