[Anterior-superior dislocation of the shoulder: case report and review of the literature]. / Luxation antéro-supérieure de l´épaule: à propos d´un cas et revue de la littérature.

Traumatic dislocations of the shoulder joint are generally described as an antero-inferior dislocations. Anterior-superior dislocations are extremely rare. We report a rare case of traumatic dislocation of the anterior-superior shoulder in a 45-year-old patient whose physical examination showed an anterior-superior subcutaneous protrusion of the head filling the subacromial space. The diagnosis was radiologically confirmed. MRI showed total rupture of the supraspinatus and subscapularis tendons. Shoulder instability occurred after reduction of the dislocation. Temporary glenohumeral arthrodesis was subsequently performed with good functional results.

Madura's foot: reasons for the delay in diagnosis and consequences for the management (a case report).

Madura foot, relatively easy to diagnose in tropical countries, is very rare and unrecognized in Morocco, causing diagnostic delays. We present the case of a 54-year-old patient with mycetoma for 3 years who initially consulted two general practitioners, then an endocrinologist and finally a dermatologist in order to be diagnosed correctly. The diagnosis of mycetoma based on biological criteria was established at a late stage of irreversible bone lesions; requiring amputation by the orthopedic team. Mycetomas are fungal or bacterial. Delays in diagnosis and care are frequent in Morocco. The diagnosis is based on biology; however, radiological examinations are necessary to assess the extension. The initial treatment is medicinal. Surgery takes place in late stages.

Osteitis of the fourth metatarsal caused by a date palm thorn in a child: why the dorsum of the foot is the most commonly injured site.

The palms are frequent in the region of eastern Morocco. An insidious onset of a lytic lesion in the base of the fourth metatarsal caused by a date palm thorn in a 20-year-old patient is presented. An untreated embedded thorn can cause late complications, including periostitis or osteomyelitis. In most cases, removal of the foreign body is easy, and no surgical care is needed. If detected, these injuries can be treated without complications. In children, however, the diagnosis can be very easily missed, especially if the child has aphasia and deafness, which was present in our patient. These can influence communication between the child and family, such that the patient is unable to inform the family about what object pricked him (e.g., date palm thorn, toothpick, insect) and is unable to tell the family that the foreign object remains embedded. This major communication issue between the child and family can result in potentially avoidable complications such as osteitis. No other issues were present in our patient that could have caused a delay in diagnosis, such as fear of punishment or fear of medical treatment. We present a case of date palm thorn-induced periostitis of the base of the fourth metatarsal. Surgical exploration revealed a 2.5-cm palm tree thorn embedded in granulation tissue, forming an abscess. The lesion was successfully treated by curettage of the lesion and removal of the thorn embedded in the periosteum of the metatarsal base. The purpose of the present report was to explain the mechanism of this rare entity and the frequency of this lesion on the dorsal aspect of the foot rather than on the plantar. Despite the absence of a definite history of trauma, organic foreign material should be in the differential diagnosis of a lytic lesion of the bone, especially in patients who have a problem with deafness or aphasia.

Primary hydatid cyst of the thigh: on seven cases.

We report on seven cases that presented a benign soft-tissue mass in the thigh muscles. Ultrasonography provided the diagnosis of hydatid cyst. Total pericystecomy was performed. We point out the importance of preoperative diagnosis and the need for radical excision to avoid recurrence.

Dorsal dislocation of the first metatarsophalangeal joint associated with fractured second metatarsal head.

Traumatic dislocations of the first metatarsophalangeal joint were first described by Mouchet in 1931. The anatomical complexity of the first metatarsophalangeal joint makes this injury one of a kind. There have been a limited number of case reports of this injury. The ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. We report a case of a 35-year-old male with complete dorsal dislocation of the first metatarsophalangeal joint with second metatarsal head fracture. On review at 12 months he was pain free, fully mobile and pleased with the result. The papers principle message is that significant injuries to the metatarsophalangeal joint may be associated with fractures of adjacent bone segments, which may change diagnostic and therapeutic approaches. Also, the evolution of patients with this kind of injury after reduction is not well know today, at short, medium and long term. Thus could be considered to be a further development of Jahss's classification.

Internet and medical student in Marrakech.

BACKGROUND: The implementation of ICT in the academic curriculum is a part of the e-reform of the undergraduate education currently ongoing at the Moroccan medical school. In order to evaluate the efficiency of such reform, the authors have conducted a survey at the Marrakech school of medicine including 200 students. MATERIALS AND METHODS: A comparison between the third year medical students and sixth year medical students was performed in our university Hospital. RESULTS: The majority of the students have a personal computer and internet access. Our study shows no significant differences between third year medical students and sixth year medical students. In both students' groups the level of internet and computer access, the internet skills, the opinions on internet use and ICT implementation and the difficulties encountered when using internet for medical purpose were similar. This can be explained by the lack of no implementation of ICT in our university. CONCLUSION: The learning process is still based on traditional methods. Educational authorities have to train students to improve their internet skills.