Articular fracture of the base of the thumb metacarpal: Comparative study between direct open fixation and extrafocal pinning.

The treatment of intra-articular fractures of the base of the first metacarpal bone should aim to anatomically reduce the articular surface, restore the initial length of the first metacarpal and preserve the opening of the first web space. These objectives appear to be achievable with a well-conducted surgical treatment. In a retrospective study, we reviewed a series of 38 cases, which compared open reduction and internal fixation (ORIF) and extrafocal pinning to determine which option provided the best reduction and functional recovery in young, manual workers. Direct fixation was better at restoring the configuration of the joint, regardless of the age and sex of the patients and the fracture type. This complete reduction is associated clinically with better function. Thumb opposition was statistically better in fractures treated by ORIF. Thumb retroposition was better in the cases treated by ORIF, but not significantly. ORIF appears the best technique for treating intra-articular fractures of the base of the first metacarpal, as it results in better functional recovery.

[Floating elbow: retrospective study and review of literature]. / Le coude flottant : étude rétrospective et revue de la littérature.

The floating elbow represents an uncommon combination of lesions in traumatology. Few studies have described this lesion especially in adults. Over a period of 6 years, 12 floating elbows were reviewed retrospectively. One osteoporotic elderly patient was treated conservatively. Reduction and internal fixation using different implants was performed in the other patients. Consolidation was obtained at the humerus at 3 months (2.5-3.5 months) on average, and 2.6 months (2-3 months) at forearm bones. According to the classification of Lange and Foster, our functional results were good in 67% of cases, fair in 17% and poor in 16% cases. Good functional prognosis of the upper limb requires rapid and adequate management of floating elbows. Internal fixation followed by early rehabilitation is recommended. The choice of surgical acts depends on the location of fractures. This strategy gave satisfactory results.

[Dislocation of the carpometacarpal joint of the thumb associated with trapezium and Bennett's fractures]. / Luxation carpo-métacarpienne du pouce associée à une fracture du trapèze et de Bennett.

We report a case of a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. To our knowledge, no such case was found in the literature. The patient had open reduction internal fixation with pins and screws, with good functional outcome.

[Insulated leg pilomatrixoma: a rare localization]. / Pilomatricome isolé de la jambe. Une rare localisation.

Pilomatrixoma is a benign skin neoplasm of the hair follicle. It's common in the pediatric population. It's usually misdiagnosed and confused with other skin lesions. Head and neck represent the usual locations. The extremity remains an exceptional location. Through an observation of a pilomatrixoma of the leg in an adult patient treated surgically without recurrence, different diagnostic and therapeutic aspects of this pathology will be recalled.

Dislocation of the carpometacarpal joint of the thumb associated with trapezium and Bennett's fractures.

We report a case of a 30-year-old man with a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. Since, to our knowledge a similar case was not found in the literature. The lesion was managed with closed reduction and percutaneous pinning, resulting in good functional outcome.

Leiomyoma in an index finger: report of case and review of literature.

Leiomyoma is a rare benign tumor of nonstriated muscles. Its common elective localization is in uterus muscle, but it may involve the hand. Limb localization is rare, usually in the lower limbs. We report a case of a 70-year-old women who presents a leiomyoma of the right index finger. A surgical excision was performed. The result was good without recurrence. We report the diagnosis, prognosis, and therapeutic aspects of this tumor, with a literature review.