Talar body fracture combined with medial malleolar fracture: a case report and literature review.

Fracture of the talar body is rare, it reaches articular congruence and determines the ankle's functional prognosis. The authors report a case of a combination of a sagittal talar body fracture with fracture of the medial malleolus in a 52-year-old following a road traffic accident. The association talus body fracture with a medial malleolus fracture is exceptional. Stable internal fixation can yield good functional results.

Simultaneous ipsilateral fractures of distal and proximal ends of the radius.

We treated a patient with a rare combination of ipsilateral fractures of the distal and proximal ends of the radius. A man aged 42 years had simultaneous fractures of the distal and proximal ends of the radius (radial neck) following a roadside accident. The distal end fracture of the radius was treated with surgical reduction and T-plate volar fixation, and the undisplaced radial neck fracture was treated by an above elbow splintage for 2 weeks. The elbow mobilization was started at 2 weeks. The distal radius was protected for another 4 weeks in a below elbow functional brace. Ipsilateral proximal and distal radial fracture is an uncommon injury pattern. The series illustrates a number of problems associated with this combination. Firstly, one should be aware of this rare injury pattern and there should be greater emphasis on clinical examination of elbow in cases of wrist injuries and vice versa. Once diagnosed, one faces the dilemma of appropriate management in these cases. The appropriate management will depend on the injury characteristics including the age of the patient and the fracture pattern. One should try to preserve the radial head to prevent a possible proximal radial migration especially in younger patients.

[Intramedullary nailing in bifocal leg fractures: about 16 cases]. / L'enclouage centromedullaire dans les fractures bifocales de la jambe: à propos de 16 cas.

We conducted a retrospective study of bifocal closed fractures of the tibia in order to assess the severity of this unusual lesion. We analyzed the entry point for intramedullary nailing as well as the different therapeutic options. Sixteen patients with AO type 42C2 bifocal leg fractures were treated in our Traumatology-Orthopedics Unit A at the University Hospital Hassan II, Fez. The subjects were young, victims of medium to high energy trauma. Five subjects were polytraumatized patients and two were poly-traumatized patients with fractures. Six patients underwent locked intramedullary nailing with reaming while seven patients underwent intramedullary nailing without reaming. Two cases of compartment syndrome were recorded after nailing. Mean fracture consolidation time was twelve months. Two cases of pseudarthroses were successfully treated by nailing with reaming. Bifocal leg fractures pose many challenges for the surgeon due to weak vascular supply of the intermediate segment and to severe deterioration of the surrounding soft tissues. They should be detected among the leg fractures based on their context of occurrence, difficulties in fixation as well as slow consolidation time.

[A rare case of external subtalar dislocation]. / Un cas rare de luxation sous-talienne externe.

Subtalar dislocation is a very rare injury. It is an orthopedic emergency. External dislocation is exceptional. It uncommonly occurs after a sport accident. We here report the case of a footballer presenting with Cauchoix and Duparc type II open external subtalar dislocation following an accident during a sport competition. The patient underwent orthopedic treatment. At 1-year follow-up, functional outcome was satisfactory.

[Anterior shoulder dislocation associated with fracture of the ipsilateral humeral diaphysis: about two cases]. / La luxation antérieure de l'épaule associée à une fracture de la diaphyse humérale homolatérale: à propos de deux cas.

The association of shoulder dislocation with fracture of the ipsilateral humeral diaphysis is a rare injury. We report two cases of anterior shoulder dislocation associated with concomitant ipsilateral humeral fracture. Reduction of shoulder dislocation followed by screw-plate fixation of the fracture of the humeral diaphysis was performed in both cases. At 4-months follow-up, the fracture of the humeral diaphysis was well consolidated. At 1-year both patients had returned to normal levels of activity. Primary reduction of shoulder dislocation followed by osteosynthesis of the humeral diaphysis yields good results.

[Classic and aggressive Kaposi sarcoma with bone involvement]. / L'atteinte osseuse dans le sarcome de Kaposi classique et agressif: à propos d'un cas.

Classic Kaposi sarcoma is a multifocal rare tumor originating from vascular endothelial cells with progressive evolution and little malignant predisposition. Although Kaposi sarcoma with extensive visceral involvement is sometimes observed among HIV-positive patients, tumor dissemination to visceral lymph nodes in classic SK remains very rare. We report a rare case of aggressive classic Kaposi sarcoma of the hand with a rapid and destructive development.

Intertrochanteric fracture non-unions with implant failure of the gamma nail.

Failure of internal fixation of intertrochanteric fracture is associated with delayed union or malunion resulting in persistent pain and diminished function. We report a rare case of implant failure of the gamma nail with intertrochanteric fracture non union treated by DCS plate screw and bone graft.

An unusual case of an intramuscular lipoma of the biceps brachii.

Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. Most lipomas are subcutaneous and require no imaging evaluation. When deep, large and unusual in location, MRI can identify and localise these tumours and is the best exploration to differentiate lipoma and lipo-sarcoma. We describe a case of a patient with an intramuscular lipoma of the biceps brachii.

Isolated radial volar dislocation of the fifth carpometacarpal joint: a rare injury.

Isolated palmar dislocation of the fifth carpometacarpal joint is an uncommon injury and classified as radio-palmar or ulno-palmar according to the direction of displacement of the fifth metacarpal base. This very rare injury is often difficult to recognize. A careful neurologic assessment of the patient is a necessity, as well as obtaining proper radiographs of the hand. The purpose of this report is to present a patient with a pure isolated volar dislocation of the fifth carpometacarpal joint that was satisfactorily treated with closed reduction and casting. A review of the literature is presented.

A rare case of unicondylar medial Hoffa fracture associated with ipsilateral vertical patella fracture.

An 18 year old male patient was hit by a car to his motorcycle causing a unicondylar Hoffa fracture and an ipsilateral patella fracture. Hoffa fracture is a rare lesion and this association of injury has not been reported before.

Unusual presentation of isolated metacarpal tuberculosis.

Metacarpal tuberculosis is a rare presentation of the disease; it represents only 1% of all bone sites. The following report documents the case of a 28-year-old female who sought a consultation for a painful right hand following an injury. Radiographs showed a fracture of the distal fifth metacarpal through a lytic lesion. Histology of a biopsy specimen revealed granulomas with caseous necrosis, specific to tuberculosis. The patient experienced a complete recovery with anti-tubercular treatment. This case of an unusual presentation of isolated metacarpal tuberculosis was reported with the intention of highlighting the rarity of this location. It is therefore imperative to bear in mind the possibility of such atypical presentations of tuberculosis when making a rapid and correct diagnosis and prescribing adequate treatment.

Open posterior dislocation of the knee with rupture of the patellar tendon and a tibial plateau fracture.

Knee dislocations are rare injuries. They represent a severe soft tissue injury following high-energy blunt trauma. We report a case of open posterior knee dislocation with rupture of the patellar tendon and a fracture of the tibial plateau. The treatment was surgical and consisted of reduction of the knee dislocation, fixation of the tibial plateau fracture by lag screws, and transosseous sutures for the patellar tendon protected by a patellotibial cerclage. The result was successful with full range of motion.

Periosteal osteoid osteoma of the distal femur.

Periosteal osteoid osteoma is extremely rare. The diagnosis is not always clear. We report a case of periosteal osteoid osteoma arising from the posterior surface of the right distal femur in a 21-year-old woman. After careful evaluation and excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma, showing the nidus, surrounding osteosclerosis, and catarrhal synovitis. The lesion was treated successfully with excision of the nidus.