[Total hip replacement as a result of coxalgia: about 10 cases]. / Prothèse totale de hanche dans les séquelles de coxalgie: à propos de 10 cas.

Coxalgia causes osteocartilaginous destructions of the hip joint; these lesions are responsible for severe pain leading to functional discomfort and limitations in everyday life. Their surgical treatment is still not well established. The aim of our study was to demonstrate the interest of total hip arthroplasty associated with anti-tuberculous chemotherapy to improve patients' quality of life. We report a retrospective study of 10 cases of total hip replacement following coxalgia at the Department of Orthopaedics and Trauma of Rabat University Hospital from 2002 to 2011. The average age of our patients was 38 years. The discovery of coxalgia was made under different circumstances according to the patients. The surgical approach we used was exclusively posterolateral (Moore). All prostheses were cemented. Four patients required acetabulum reconstruction. Intraoperative biopsy was positive in a patient, negative in the remaining nine. All patients underwent anti-tuberculous treatment. No recurrence was noted after a minimum follow-up of 3 years. Results according to Merle d'Aubigné score were considered good. In case of advanced bone destruction with badly tolerated functional impact in mature subject, total hip arthroplasty always associated with effective anti-tuberculous chemotherapy is the treatment of choice for sequelae of coxalgia.

[Cubitus varus: external subtraction osteotomy, should it still be recommended? Retrospective study of 25 cases]. / Cubitus varus: l'ostéotomie de soustraction externe a-t-elle toujours sa place? Etude rétrospective à propos de 25 cas.

Cubitus varus or malunion is most often secondary to displaced supracondylar fractures of the lower end of the humerus in children. Various surgical techniques have been proposed with different success rates but also with different reported complication rates. Our retrospective study of 25 cases diagnosed at the University Hospital of Rabat evaluated the results of the technique of external subtraction which was used in our training to handle this deformation.

Schwannoma of the median nerve: diagnosis sometimes delayed.

Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

The Monteggia fracture: series of 20 cases.

The Monteggia fracture is one of the pitfalls of conventional diagnosis of upper limb trauma. Through a retrospective study of 20 cases diagnosed at the Department of Orthopaedic Surgery and Traumatology, University Hospital Center, Ibn Sina, Mohamed V University, Rabat, Morocco, between 2010 and 2014, we have tried to do an update on the management of Monteggia fractures either at of paraclinical exams or the surgical management. We support the idea that the dislocation of the radial head should be sought systematically to any isolated fracture of the ulna, for not to miss fracture Monteggia authentic. Rehabilitation of the upper limb must be done as soon as possible.

Nonoperative treatment of closed total talus dislocation without fracture: A case report and literature review.

Complete dislocation of the talus not accompanied by a fracture is a very rare injury. Most cases reported are open talus dislocations; closed dislocations are rarely seen. The functional prognosis is poor due to osteonecrosis of the talus which develops in the majority of cases. We present a case of lateral dislocation of the left talus in a 29-year-old road accident victim, but no fracture could be detected in the talus and any of malleolus. Reduction of dislocation had been performed in emergency by external manipulation. At 1-year follow-up, the right ankle was pain free and stable. Motion was satisfactory: 15° dorsal flexion, 30° plantar flexion; the talus didn't show subluxation and avascular necrosis could not be detected.

Osteoblastoma of the carpal navicular: a case report and review of the literature.

Osteoblastoma of the scaphoid is an infrequent cause of hand and wrist pain. The few reported cases emphasize the rarity of osteoblastoma in hand and wrist localizations. Pathological examination is mandatory before treatment due to lack of distinctive clinical and radiological features. We report the case of a 17-year-old right-handed girl who presented with a more than 7-month history of progressive right-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. The authors present the diagnostic difficulties and the treatment that was applied: proximal row carpectomy. Treatment options, according to the literature, also include scaphoidectomy and tumor curettage with bone grafting.

A rare cause of chronic sciatic pain: Schwannoma of the sciatic nerve.

Schwannomas are common, benign tumors of the shelth of peripheral nerves. Sciatic schwannomas are rare. Their symptomatology usually mimics sciatic pain due to a herniated disc, which can delay the diagnosis. If there is no lumbar pain and lumbar MRI is normal, the sciatic nerve must be clinically and radiologically examined all along its course. We report a case of sciatic nerve schwannoma presenting with chronic sciatica which was diagnosed and monitored radiologically for several years before successful surgical resection.

Bilateral anterior dislocation of the shoulders at the start of a backstroke competition.

Bilateral anterior dislocation of the shoulders is very rare. A 20-year-old man presented with bilateral anterior shoulder dislocation as a result of a diving incident. He complained of pain and restriction of movement in both shoulders with abducted and externally rotated arms. Radiographs revealed that the shoulders were dislocated. The patient was treated with closed reduction and was able to resume swimming 3 months later. To our knowledge, this is the first bilateral anterior dislocation of the shoulders during a backstroke swimming competition that was caused by this mechanism of injury. The rarity of this lesion and its uncommon mechanism prompted us to relate this observation.

Hydatidosis of the pelvic bone: case report and review of the literature.

The authors report three cases of pelvic bone hydatidosis: two men and a woman aged from 25 to 42 years. The lesions were extensive: In two cases, they extended to the entire hemipelvis, and in one case, the extension was to the sacrum, which makes it difficult to carry out a radical surgery. In two cases, computed tomography was evocative and allowed for the completion of a local and precise checkup for a patient through MRI. At the therapeutic level, the first patient was treated by curettage and sterilization with oxygenated water followed by medical treatment, but with recurrence few months later. The second patient was put only under medical treatment because of the extent of the lesions, allowing therefore for clinical and radiological stabilization. Concerning the last patient, she benefitted from the resection of the femoral head and the right iliac wing followed by a medical treatment. The evolution was favorable with a three-year recession. The actual treatment of the osseous echinococcosis would be a combination of albendazole and surgery.