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
Diaphyseal tuberculosis (TB) is a rare case of the skeletal TB. The following report documents the case of a 52-year-old Moroccan woman with a swelling over the right forearm followed by pulmonary TB under treatment for 3 months. The radiographs of the forearm show a lytic image located at the radius mid-diaphysis. The histopathology confirmed the diagnosis. The patient received surgical drainage with trepanation of the bone. The antibacillary chemotherapy was administered for 6 months. It is, therefore, indispensable to bear in mind the possibility of such atypical presentations of TB when making a rapid and pertinent diagnosis and prescribing the appropriate treatment.
Assuntos
Diáfises/microbiologia , Antebraço/microbiologia , Rádio (Anatomia)/microbiologia , Tuberculose Osteoarticular/diagnóstico , Tuberculose/diagnóstico , Antituberculosos/uso terapêutico , Diáfises/patologia , Feminino , Antebraço/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Radiografia , Rádio (Anatomia)/patologia , Tuberculose/complicações , Tuberculose/tratamento farmacológico , Tuberculose Osteoarticular/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológicoRESUMO
For a long time the use of bone grafting has demonstrated its interest in orthopedic surgery and traumatology. The autografts which are still very frequently used present various problems. On the one hand, it is necessary to find a correct mechanical quality and a sufficient quantity of bone. On the other hand, the graft removal lengthens the operative time and generally painful in postoperative. These disadvantages of autografts have led to the development of bone allografts. Indeed, the low immunogenic power of the bone, the good integration of the graft and the ease of bone preservation techniques make it possible to overcome the various problems posed by bone autografts. The increasing use of bone allografts has resulted in the need for a structure allowing the management of graft stocks. The purpose of this work is to demonstrate the mode of operation of a bone bank, whose conservation activity is limited to the femoral heads treated by cryopreservation and without secondary sterilization process. The bank collaborates with all orthopedic surgeons in the Rabat and Casablanca city at first and then with all orthopedic surgeons in Morocco. It provides allografts in quality and safety.
Assuntos
Bancos de Ossos/organização & administração , Transplante Ósseo/métodos , Procedimentos Ortopédicos/métodos , Transplante Autólogo/métodos , Autoenxertos/normas , Autoenxertos/provisão & distribuição , Cabeça do Fêmur/transplante , Humanos , Marrocos , OrtopediaRESUMO
The knowledge of the pathophysiology of patients with severe trauma and the hemodynamic and inflammatory consequences of initial surgical management has led many surgeons to change their approach to the treatment of patients with severe polytraumas associated with lesions of the pelvis or of limbs by integrating the principles of sequential treatment or Trauma Damage Control Orthopaedic (TDCO). We report the case of a patient involved in a public road accident, admitted to hospital in a state of shock with pelvic disjunction and hip dislocation complicated by vascular injury in the same limb. Our approach was based on TDCO concepts by favoring external fixation of the pelvis after hip dislocation reduction. The timeliness of our apprach allowed early limb revascularization while avoiding the hemodynamic and inflammatory complications of open surgery.
Assuntos
Luxação do Quadril/cirurgia , Traumatismo Múltiplo/cirurgia , Procedimentos Ortopédicos/métodos , Pelve/cirurgia , Acidentes de Trânsito , Adulto , Feminino , Humanos , Pelve/lesões , Lesões do Sistema Vascular/terapiaRESUMO
Pure subtalar dislocation is a rare condition. We here report the case of a young patient presenting with pure internal subtalar dislocation as a result of a sport accident. He underwent orthopedic therapy achieving a good functional outcome.
Assuntos
Traumatismos em Atletas/terapia , Luxações Articulares/terapia , Procedimentos Ortopédicos/métodos , Articulação Talocalcânea/lesões , Adulto , Humanos , Luxações Articulares/etiologia , MasculinoRESUMO
We report the case of a 40-year old patient referred by the Depatment of Dermatology at the Ibn Sina Hospital in Rabat for amputation of the index finger as a result of a melanoma diagnosed by biopsy. The amputation was performed according to Chase's method. Aesthetic and functional outcome was very good six months following surgical treatment.
Assuntos
Amputação Cirúrgica/métodos , Dedos/cirurgia , Melanoma/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Biópsia , Feminino , Dedos/patologia , Humanos , Melanoma/diagnóstico , Melanoma/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologiaRESUMO
The treatment of humeral pallet fractures is mainly based on reconstruction surgery with osteosynthesis. We collected the data of 40 patients with humeral pallet fracture from our archives in the Department of Orthopaedics and Traumatology at the Ibn Sina University Hospital, Rabat from january 2012 to december 2014. The aim of our study was to highlight the clinical, therapeutic and evolutionary features of these fractures as well as the challenges in managing these complex fractures and in evaluating the results. There was a clear male predominance (75% of cases) with an average age of 35 years. Etiologies were dominated by road accidents (56%). All our patients had an emergency hospital admissions and underwent surgery. Type C fracture, according to MÜLLER and ALLGOWER (A.O) classification was the most frequent: 62.5% of cases. Associated lesions were fairly frequent (52.5%) in polytraumas. All our patients underwent surgery (100% of cases), via posterior border in 70% of cases. This procedure included reduction and then osteosynthesis using a Lecestre-type plate in 82.5% of the cases. Our results were good and average in 85.5% of cases, according to literature data. The management of this type of fracture is based on perfect anatomic reduction, a solid assembly which should allow an early reeducation resulting in good functional result.
Assuntos
Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Traumatismo Múltiplo/cirurgia , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Idoso , Placas Ósseas , Feminino , Humanos , Fraturas do Úmero/patologia , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/epidemiologia , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
We report a rare case of 50-year-old Moroccan woman with local recurrence of a subcutaneous hydatid cyst in proximity to the medial surface of the tibia and another cyst at the tibialis posterior muscle in the absence of liver, lung und spleen involvement. The first surgery was done in another hospital three years ago; no adjuvant treatment was performed after surgery. Recurrence was diagnosed according to the MRI appearance, serological and pathological findings. The patient underwent complete excision of the subcutaneous cyst with two centimeters of the medial gastrocnemius muscle; the tibialis posterior muscle cyst was intraoperatively drained and irrigated with scolicidal agent as it was next to the posterior tibial pedicle. A periopertive anthelmintic chemotherapy was administered. Two years after the patient showed no recurrence. This case report and literature review describe an approach to the diagnosis and management of this pathological entity.