[Intra-articular distal radial fracture with lunate fossa rotated, about 4 cases: interest of surgical procedure by volar medial approach]. / Fracture articulaire du radius distal avec fragment de fossette lunarienne retourné, à propos de 4 cas : intérêt du traitement chirurgical par voie antéro-médiale.

INTRODUCTION: Intra-articular distal radial fractures in young subjects occur in severe trauma. Articular reduction needs to be anatomical. We report four cases with the particularity of having a 90° or 180° rotated lunate fossa. Our goal is to bring out the positive aspects of surgical procedure by volar medial approach and to assess long-term functionnal and radiological results. MATERIAL AND METHODS: Our study focused on four men whose average age was 27 (age range from 19 to 43). The fractures were type IV according to Melone's classification. The associated lesions included: one fracture of the base of the ulnar styloid, one fracture of the distal quarter of the ulnar diaphysis and one scapho-lunate diastasis. We used a volar medial approach between the flexors tendons and the ulnar bundle in order to pin the fragment of lunate fossa. The rest of the radial epiphysis was pinned after a 5mm skin incision. In two cases, this pinning was complemented with a brachial-antebrachial-palmar cast and in the other two cases with an external fixator. RESULTS: The follow-up period averaged 68.8 (18 to 115) months, all the patients were clinically examined through antero-posterior, lateral and dynamic X-rays. The objective results assessed according to Green and O'Brien's criteria, later modified by Cooney, were as follows: two very good, one good, one average. The X-rays showed consolidated fractures. According to Knirk and Jupiter's classification of arthritis, we had three grades 0, one of which showed a subchondral sclerosis of the lunate fossa, and one grade 3. DISCUSSION AND CONCLUSION: Imaging with simple radiographs is not sufficient and needs to be complemented with CT scan. Our approach allows for direct access to the fragment of the lunate fossa and easier visualization of the distal radioulnar, compared to Henry's approach, thereby avoiding excessive traction of the median nerve. TYPE D'ÉTUDE: Niveau IV.

[Avulsion fracture of the posterior cruciate ligament in a child: surgical treatment. a case report]. / Fracture avulsion du ligament croisé postérieur chez l'enfant : prise en charge chirurgicale. A propos d'un cas.

Avulsion fracture of the posterior cruciate ligament (PCL) is a less frequent injury in children than in adults. Directed by a meticulous clinical examination, magnetic resonance imaging confirms the diagnosis. Surgical treatment provides good functional results in the majority of cases. We report a case of avulsion fracture of the PCL treated with a standard Twinfix surgical anchor.

[A rare case of polyorchidism: review of the literature]. / Un cas rare de polyorchidie: revue de la littérature.

Polyorchidism is a rare congenital anomaly. We report 1 case in a Malagasy young man revealed by left scrotal mass. The diagnostic was suspected by clinical examination and confirmed by testicular sonography. Management is conservative, based on clinical and sonography surveillance of supernumerary testicle.

Large Adrenal Pseudocyst. Report of a Case

Authors report a case of large adrenal pseudocyst in a 53 year-old woman. A voluminous abdominal mass with malnutrition and dehydration symptoms were found. Surgical excision was difficult but complete after 6L fluid aspiration. Histologic examination showed fibrous and inflammatory cystic wall with groups of adrenal cells. No epithelial lining was present and the diagnosis of adrenal pseudocyst was made. Pathogenesis; histology; diagnosis and management were discussed

Teratome intra pulmonaire. A propos d'un cas

La localisation intra pulmonaire des teratomes est inhabituelle. La forme maligne de cette pathologie constitue une eventualite rare et particuliere des cancers du poumon. Nous rapportons un cas de teratome intra pulmonaire de forme maligne chez une femme de 52 ans. Notre objectif; a travers ce cas; est de faire connaitre cette pathologie et de realiser une revue de litterature afin de soulever les aspects clinique; therapeutique et evolutif

[Digital myxoma. A case report and review of the literature]. / Localisation digitale d'un myxome. A propos d'un cas et revue de la littérature.

Myxoma is a benign mesenchymatous neoplasm, but can be locally invasive. We describe a rare case of digital myxoma managed in Antananarivo (Madagascar) main hospital. A 16 year-old young man had a 10 mm diameter myxoma located inside the flexor sheath next to the first phalanx of the left long finger. Surgical excision was curative, and there was no recurrence after two years follow-up. It is probably the first description of such a case.