Stepping into the Unknown: Unveiling the Rarity of PCL Fracture-Avulsions.

Tears of the posterior cruciate ligament (PCL) are rare, and avulsion fracture of the tibial attachment of the posterior cruciate ligament is even rarer. These injuries usually occur in accidents such as car crashes, causing acute pain, swelling as well as total functional impotence of the knee. Studies on the incidence of these injuries show variable results, but there appears to be an upward trend. The surgical management of PCL avulsion fracture is not clearly established, although arthroscopic techniques are becoming more popular due to their potential benefits. However, some medical centers may have limited access to these methods, thus preferring open surgery options. A case of LCP avulsion fracture in a 36-year-old female patient was reported, and surgery was successfully performed, leading to full recovery after six months with full knee mobility and posterior stability.

Hamatometacarpal fracture-dislocation: A case report.

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.

Anterior cruciate ligament cysts: About a rare condition.

The purpose of this study was to provide information on cysts of the anterior cruciate ligament (ACL) of the knee. This included an anatomical and radio-anatomical reminder of the cruciate ligaments of the knee, along with details of the epidemiology, etiopathogenesis, anatomical risk factors, clinical presentation, differential diagnosis, and treatment of ACL cysts. A retrospective analysis was conducted, involving the review of 7 radioclinical records from the medical imaging department of Ibn Sina University Hospital in Rabat, covering a period of 3 years (2018-2020), during which 7 cases of ACL cysts were diagnosed. The results revealed that ACL cysts are a rare condition, frequently detected incidentally during the assessment of meniscal lesions. Symptoms commonly include knee pain and limited mobility, and MRI is considered the diagnostic modality of for distinguishing between simple fluid-filled cysts and infiltrative cysts, as well as for ruling out other differential diagnoses. Treatment options include radio-guided infiltration puncture and arthroscopic resection.

Rare case of Malign Peripheral Nerve Sheath Tumor complicating a solitary giant neurofibroma of the thigh.

INTRODUCTION AND IMPORTANCE: Malign Peripheral Nerve Sheath Tumor is rare and can occur on a solitary neurofibroma or as part of neurofibromatosis type 1. The occurrence of a giant solitary neurofibroma in the thigh is rare and its complication in MPNST is much rarer. The diagnosis is based on a combination of radiological, histological and immunohistochemical evidence. CASE PRESENTATION: We present the case of a 55 years old woman who presented a mass of the posterior aspect of the thigh without any other abnormality on systemic examination. MRI showed a T1 hyposignal and a T2 hypersignal and the biopsy performed was in favor of a neurofibroma. After surgical resection, the histological study of the surgical specimen revealed an MPNST developing on a pre-existing neurofibroma. After 5 months, the patient had moderate knee stiffness with thigh amyotrophy. CLINICAL DISCUSSION: The occurrence of MPNST on a giant solitary neurofibroma of the thigh is extremely rare. MRI allows evoking the diagnosis but radiologists are confronted with a problem of differential diagnosis. Histological examination supports the diagnosis in addition to immunohistochemical examination. Only surgical treatment can give hope for a cure. Recurrences remain frequent with a 5-year survival of 50 %. CONCLUSION: Early diagnosis is essential to prevent the evolution of the tumor and the occurrence of poor prognostic factors compromising the management, increasing the risk of recurrence and affecting the overall survival of patients.

Minimally Invasive Technique in the Management of Tibial Pilon Fractures: New Approach and Promising Results.

Background: Comminuted tibial pilon fractures are induced by high-energy mechanisms and are often associated with soft tissue injuries. Their surgical approach is problematic due to postoperative complications. Minimally invasive management of these fractures has a considerable advantage in preserving the soft tissue and the fracture hematoma. Materials and Methods: We conducted a retrospective study of a series of 28 cases treated at the Orthopedic and Traumatological Surgery Department of the CHU Ibn Sina in Rabat over a period of 3 years and 9 months, from January 2018 to September 2022. Results: After a mean follow-up of 16 months, 26 cases had good clinical results according to the Biga SOFCOT criteria and 24 cases had good radiological results according to the Ovadia and Beals criteria. No cases of osteoarthritis were observed. No skin complications were reported. Conclusion: This study highlights a new approach that deserves to be considered for this type of fracture as long as no consensus has been given.

Corrigendum: Schwannome bénin du nerf grand sciatique, à propos de 2 cas.

[This corrects the article DOI: 10.11604/pamj.2014.18.252.4684.].

Corrigendum: Abcès tuberculeux de la face postérieure de la cuisse: à propos d'un cas.

[This corrects the article DOI: 10.11604/pamj.2014.19.50.4683.].

Tuberculosis of radius diaphysis: Case report and review of literature.

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.

[Pure internal subtalar dislocation: about a case]. / Luxation sous-talienne interne pure: à propos d'un cas.

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.

[Surgical management of sacroiliac joint lesions in unstable pelvic ring fractures using percutaneous iliosacral screw fixation]. / Traitement chirurgical des lésions sacro-iliaques dans les fractures instables de l'anneau pelvien par vissage sacro-iliaque percutané.

Pelvic fractures, usually are multiple, unstable fractures occuring most frequently due to violent traumatic events. Orthopedic treatment of these lesions is often distressing both to patients and medical personnel since it requires bed discharge or sometimes tractions which can have a duration up to 45 days and can compromise the static and the walking mechanisms; open operative management is difficult, carrying a significant burden in terms of morbidity and associated with vascular (venous plexus), nervous (sacred roots) or septic risk to take into account. For this reason it is generally reserved for patients with neurologic and strongly displaced forms. Percutaneous fixation under fluoroscopy in unstable type B and type C pelvic fractures allows the synthesis of posterior lesions causing instability by fixing the hip bone to S1 or S2 body, a rapid recovery and rehabilitation of walking.

[The role of short Telegraph nail in the treatment of fractures of the upper end of the humerus: about 19 cases]. / La place du clou Telegraph court dans le traitement des fractures de l'extrémité supérieure de l'humérus: à propos de 19 cas.

The fracture of the upper end of the humerus is the third most frequent fracture in the elderly and its distribution is bimodal, preferentially affecting osteoporotic elderly patients after low energy trauma or, more rarely, young subjects as a consequence of severe kinetic mechanism The treatment of complex fractures of the proximal humerus is the subject of much controversy. Telegraph nail is a highly effective therapeutic approach for displaced fractures of the upper end of the humerus. Surgical procedure is easy but with a learning curve; it allows to start rehabilitation protocol immediately after surgery. It is an antegrade nailing material, 15 cm long, with full proximal and distal locking. Proximal locking is secured by 4 cancellous screws, long thread, stable in the nail ensuring perfect solidity of the assembly while the distal locking screw is secured to deltoid tuberosity in the avascular zone and where there is no neural pathway. This study reports 19 case of patients with fractures of the humerus treated with short Telegraph nail between 2013 and 2015. It aims to investigate radio-clinical results and to assess the impact of this technique on shoulder function. Telegraph nail that has been used for more than 12 years or so met and continues to meet with strong success. It allows to trat very effectively simple fractures type 2 and 3, but also 4-fragment valgus impacted fractures Osteosynthesis by Telegraph nail is an efficient, rapid and reproducible surgical treatment option of the fractures of the upper end of the humerus even in case of complex fractures and allows for a more rapid return of shoulder mobility.

Locally recurrent subcutaneous and muscular hydatid cysts of the leg: an unusual case report.

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.

Bifocal musculoskeletal tuberculosis in upper limb: Unusual case.

Bifocal musculoskeletal tuberculosis is a rare presentation of the disease. The following report documents the case of a 28-year-old Moroccan man presenting simultaneously with a swelling of the palm of the hand and the sternoclavicular joint. The HIV serology and hepatitis (B, C) serology were negative, as well as the tuberculin skin test. The radiographs of both locations were normal. The histopathology confirmed the diagnosis. The antibacillary chemotherapy produces excellent results. It is therefore indispensable to bear in mind the possibility of such atypical presentations of tuberculosis when making a rapid and pertinent diagnosis and prescribing the appropriate treatment.

Hydatidosis of the pelvic bone: case report and review of the literature.

The authors report three cases of pelvic bone hydatidosis: two men and a woman aged from 25 to 42 years. The lesions were extensive: In two cases, they extended to the entire hemipelvis, and in one case, the extension was to the sacrum, which makes it difficult to carry out a radical surgery. In two cases, computed tomography was evocative and allowed for the completion of a local and precise checkup for a patient through MRI. At the therapeutic level, the first patient was treated by curettage and sterilization with oxygenated water followed by medical treatment, but with recurrence few months later. The second patient was put only under medical treatment because of the extent of the lesions, allowing therefore for clinical and radiological stabilization. Concerning the last patient, she benefitted from the resection of the femoral head and the right iliac wing followed by a medical treatment. The evolution was favorable with a three-year recession. The actual treatment of the osseous echinococcosis would be a combination of albendazole and surgery.