RESUMO
Hamatometacarpal fracture-dislocation is a rare condition. Only a few cases have been reported in the literature. We present the case of a 26-year-old male patient who sustained a coronal fracture of the body of the hamate with the fifth metacarpal base interposed between volar and dorsal fragments on his right dominant hand. The patient underwent open reduction and internal fixation of the hamate with a 2.0-mm cortical screw and stabilization of the dislocated fifth metacarpal with Kirschner wire. At six months follow-up, total range of movement was allowed, the patient experienced no pain, and had successfully returned to work.
RESUMO
Hydatid disease is still endemic in several regions worldwide including Morocco, and is caused in most cases by the larval form of 2 species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Primary hydatid disease of the bone without systemic involvement is rare. The disease has a silent clinical evolution until it reaches complicated stages. Complications may include pathological fracture, neural deficit, infection, and fistulization of the abscess. Preoperative diagnosis is based on clinical history, imaging findings, and serological tests, which lack high sensitivity and specificity. Although the interpretation of imaging studies can prove to be very confusing because the bone changes evolve with time, and the nonspecificity of these findings often leads to a mistaken diagnosis. The diagnosis requires a high index of suspicion, especially in patients who reside in or travel to sheep-raising areas where hydatid disease is endemic. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice remains surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is indicated when surgery is not possible or as an adjuvant treatment. The prognosis is often poor. We report the case of a 28-year-old woman with long-standing pain in the left hip joint in which the imaging findings were thought of as being either tuberculous or neoplastic. The result of a CT-guided biopsy concurred with an unexpected diagnosis of a hydatid cyst. This case highlights that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in the bone to those of other skeletal pathologies can lead to misinterpretation.
RESUMO
Elbow dislocations are very frequent. We conducted a retrospective study of 40 patients with dislocations of the elbow whose data were collected between 2013 and 2015. All patients underwent emergency reduction under sedation or under general anesthesia. Treatment was completed with antalgic immobilization for about ten days followed by active mobilization. After a mean follow-up period of 24 months, flexion and extension mobility greater than 100ο was obtained in more than 80% of patients and only two cases had severe stiffness. Overall outcomes assessed using Mayo Elbow Performance Score ranged from good to very good in 35 patients, they were medium in three patients and bad only in two cases.
Assuntos
Lesões no Cotovelo , Luxações Articulares/terapia , Procedimentos Ortopédicos/métodos , Anestesia Geral/métodos , Emergências , Seguimentos , Humanos , Luxações Articulares/etiologia , Masculino , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
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.
