Obturator hip dislocation associated with contralateral luxatio erecta humeri: An unusual traumatic association (case report).

INTRODUCTION AND IMPORTANCE: Obturator hip dislocation and luxatio erecta humeri are two extremely rare injuries. We are reporting a very rare case that involves the association of these two injuries. CASE PRESENTATION: We reported the case of a 34-year-old male who was a victim of a high-energy road accident. Initial examinations showed a right obturator dislocation associated with a left luxatio erecta humeri without vascular-nervous complication. Further examinations have ruled out life-threatening injuries. A closed reduction for both joints has been performed under general anesthesia less than 6 h following the trauma. Postoperative examination showed two congruent joints. Functional treatment has been implemented. Weight-bearing was permitted after 6 weeks, and physical rehabilitation of the shoulder was initiated 3 weeks after the trauma. Last examination (20 months after trauma) showed a painless two-joint with a full range of motion. There was no sign of shoulder instability, and radiographs showed no signs of avascular necrosis of the femoral head. CLINICAL DISCUSSION: Both injuries are two rare orthopedic emergencies that require prompt diagnosis and immediate reductions. CONCLUSIONS: A good outcome can be expected if functional treatment is applied after prompt closed reduction. Hence, regular monitoring is required to detect complications such as avascular necrosis of the femoral head for the hip and signs of instability for the shoulder.

A case of sacral hydatid cyst.

INTRODUCTION: Hydatid cyst of bone constitutes only 0.5-2% of all hydatidoses. The thoracic spine is the most common site of spinal hydatidoses. Primary hydatid cyst of the sacral spinal canal is rare. PRESENTATION OF CASE: A 19-year-old man had cauda equina syndrome with pelvic pain 15 days ago, the pelvic radiography shows a lytic image depend on the left sacral wing. MRI showed an intra-pelvic cystic image invading the sacrum T1 hypointense and T2W hyperintense. The Hydatid serology was positive.Surgical treatment consisted of a wide drainage of hydatid cavity dug in the left sacral wing, and by which it communicated intra pelvic, with removal of the entire cyst by gentle aspiration, abundant rinsing with hypertonic saline, release and sacred roots encompassed in a puddle of fibrosis hydatid.The evolution was good with recovery of perineal sensation and anal tone. The sacroiliac joint was considered stable and did not require synthesis or reconstruction. DISCUSSION: Hydatid cysts predominantly occur in liver and lungs. Involvement of other organs is uncommon. Neither surgery nor medical therapy is generally effective for bone, especially spinal hydatidosis. The initial treatment of choice is surgical excision for neural decompression and establishing diagnosis. Albendazole is the drug of choice against this disease, when suspected, presurgical use of Albendazole in Echinococcus infestations reduces risk of recurrence and/or facilitates surgery by reducing intracystic pressure. CONCLUSION: A missed diagnosis of hydatid cyst could be devastating. Hence, hydatid cyst should be kept as a differential diagnosis, when encountered with a cystic lesion of sacrum. In addition, longterm follow-up is mandatory as recurrence is high despite use scolicidal agents.