Outcomes of surgical management regarding acetabular fractures: cases from African countries.

BACKGROUND: The management of acetabular fractures, which are severe injuries and often complex, is difficult and costly especially for poor and developing African countries. AIM: To analyze and evaluate the functional and the radiological outcome of patients with acetabular fracture treated with open reduction and internal fixation. MATERIALS AND METHODS: It is a retrospective study on 24 patients treated with ORIF and followed up in the Trauma Orthopedic Surgery Department of the Military Hospital of Moulay Ismail of Meknès (MHMIM) between January 2014 and December 2019. The average follow-up duration was 35 months (range: 9-81 months). The functional and radiographic outcomes and complication were considered as the main facts in this study. RESULTS: Twenty-four patients (male: 18, female: 6) with average age 38 years (range: 16 to 65 years) were operated for acetabular fracture. With Matta criteria use for assessing the radiological outcomes, the anatomical and good reduction was achieved in 79.1% of the patients. The functional results based on the modified Merle d'Aubigne and Postel criteria were judged excellent in 70.83%. Postoperative complications of acetabular fracture such as heterotopic ossification were found in 16%, post-traumatic arthritis in 20%, and avascular necrosis in 12.5% of patients. CONCLUSION: As there is a strong correlation between anatomic reduction and clinical outcome, the ORIF constitutes an effective method for treatment of displaced acetabular fracture in young aged patients who are considered as the most vulnerable categories in our continent.

Percutaneous iliosacral screw fixation in unstable pelvic fractures.

Surgical treatment of unstable pelvic fractures Type C, has a vertical instability that is not controlled by traction and supine; therefore, orthopedic and functional treatments undertaken by default are sources of complications. The closed reduction with percutaneous sacroiliac fixation solves the problem of vertical instability; but at the cost of learning the method. Five patients with unstable pelvic fractures; were treated by percutaneous sacroiliac fixation. This reliable and useful method in the stabilization of unstable pelvic fractures. Good functional results are predictable based on the severity of pelvic fractures and associated injuries. The low rates of complications and the minimally invasive nature are the advantages of this method.

[Pertrochanterian fracture revealing multiple myeloma: how is it treated?] / Une fracture pertrochanterienne révélant un myélome multiple: quelle prise en charge?

Skeletal involvement is the major clinical complication of multiple myelomas, resulting in pathological fractures. Proximal femoral fractures are very frequent during multiple myeloma evolution and they seriously compromise survival and quality of life of patients with cancer. Early surgical treatment allows mortality and morbidity improvement. Cervicomedullary Gamma locking nail osteosynthesis allows efficient, sustainable and stable fixation associated with early patient mobilization and survival improvement. However, prolonged survival imposes regular monitoring of the osteosynthesis in order to detect and to treat equipment failure. We should not overlook the fact that the recovery of independence after pertrochanterian fracture also influences myeloma control through the possibility to perform bone marrow autograft or not.

[A rare cause of talalgia]. / A propos d'une cause inhabituelle de talalgie.

Talalgie is one of the most common symptoms involving the foot. Intra-bone lipoma is one of the most rare bone tumors of the calcaneus. We report the case of a patient presenting with intermittent and spontaneous chronic heel pain. Clinical and radiological examinations confirmed the diagnosis of lipoma of the calcaneus. This study aimed to educate clinicians about the existence of this rare lesion.

Neglected bilateral rupture of the patellar tendon: A case report.

Simultaneous bilateral rupture of the patellar tendon (PT) is extremely rare and is generally associated to some chronic diseases. When the rupture becomes chronic, it is more difficult to repair that as it remained untreated. The diagnosis, which is clinical, is often delayed, guided by standard radiography and confirmed by ultrasound or MRI. The management of a bilateral neglected, chronic patellar tendon rupture must address some serious difficulties: the proximally retracted patella, the reconstruction of the patellar tendon, finally, the temporary protection of this repair. We report a case of neglected bilateral rupture of the patellar tendon in a chronic hemodialysis patient, treated with a plastic surgery of the ipsilateral quadriceps tendon.

Fracture of the Fabella: An Uncommon Injury in Knee.

The fabella is a sesamoid bone that may contribute to the stabilization of the posterolateral knee corner and it can very occasionally act as a source of atypical and rare knee pain and functional impairment. Fracture of the fabella is a rare but important clinical entity which may be overlooked clinically and radiographically. However, it causes an intermittent mechanical pain of the knee and it can mistakenly harm another knee pathology like intra-articular loose body. We report a case of a 21-year-old man who was sustaining a fracture of fabella following vehicle accident.

Carpal tunnel syndrome due to fibrolipomatous hamartoma of the median nerve.

Nervous lipofibromatous hamartoma is a rare tumor-like condition involving the peripheral nerves, whereby the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissues that infiltrate between and around nerve boundaries. The median nerve is much more likely to develop a hamartoma than other nerves with a predilection for the carpal tunnel. We present a case of carpal tunnel syndrome in an adult caused by fibrolipomatous hamartoma of the median nerve, successfully removed by excision of the fibrolipomatous tissue and decompression.

Chondroma in a sesamoid bone of the thumb: case report.

Sesamoid tumors of the hand are uncommon. We report a 50-year-old man presenting with a right thumb sesamoid chondroma. Surgical excision was successfully performed. At 12-month follow-up, the thumb function is normal, and there is no evidence of other lesions or recurrence.