[Combined fracture of the distal radius and scaphoid in children. Report of two cases]. / Fracture du scaphoïde carpien associée à une fracture de l'extrémité inférieure du radius chez l'enfant. A propos de deux cas.

The authors report two cases of concomitant scaphoid and distal radial fractures, a rare combination of lesions in children. The first case was in a 14-year-old boy who presented a midscaphoid fracture associated with a distal forearm fracture. The second case concerned a 13-year-old boy who presented a midscaphoid fracture associated with a Salter type II distal radial fracture. Both fractures were reduced under general anaesthesia. The total period of immobilisation was 3 months, using a large arm thumb cast. Associated scaphoid fractures should be suspected with all types of distal forearm injuries in children. Reduction of the radius fracture should be done carefully to avoid possible displacement of the scaphoid fracture.

[Median nerve entrapment after fracture dislocation of the elbow: a two-cases report]. / Incarcération du nerf médian après une fracture luxation du coude: à propos de deux cas.

The median nerve entrapment after elbow-dislocation is rare. We report two cases of fracture dislocation elbow completed by entrapment of median nerve occurred after reduction in two children. For both cases, the diagnosis of entrapment was made some months later after injury. Median nerve graft was performed after nerve resection. The nerve recovery was satisfactory at the final follow-up. This nerve complication should be suspected systematically before and after reduction of all dislocation of the elbow in the children. The indication of nerve release or nerve graft depends on the entrapment and the delay of the palsy.

[Idiopathic ulnar nerve entrapment at the elbow: report of 20 cases]. / Le syndrome canalaire du nerf ulnaire au coude d'origine idiopathique : à propos de 20 cas.

We report a retrospective study of 20 patients treated for idiopathic cubital tunnel syndrome in a period of 10 years (2002-2011). The average age was 46 years. A profession at risk was present in the majority of cases. The treatment was surgical in all the cases. The indication for surgery was related to the importance of sensory-motor deficit, the long duration of symptoms, and the failure of conservative treatment. Two surgical techniques were used in this work: isolated neurolysis and neurolysis with anterior transposition of the ulnar nerve. There were no complications or recurrence of symptoms. After a mean follow-up of 12 months, our results evaluated thanks to the classification of Bishop were considered as excellent or good in 85% of cases and fair in 15% of cases. Prognosis factors were advanced age (more than 60 years), severity of the disease, and duration of symptoms (more than one year). The management of this affection must go through a better knowledge of the disease, for early diagnosis and appropriate treatment, only guarantees for a good result.

Obturator dislocation of the hip with ipsilateral femoral neck fracture: A case report.

Obturator dislocation of the hip associated with ipsilateral femoral neck fracture is an unusual injury. We report a case of a 40-year-old man with such a combination of injuries which was treated with an open reduction and internal fixation. He has a good follow-up result. There was no evidence of avascular necrosis on radiographs after 3 years.

Coracoid fracture combined with distal clavicle fracture without coracoclavicular ligament rupture: A case report.

Distal clavicle fracture accompanied by coracoid process one is a rare injury. Surgical and/or conservative treatments are proposed. We report the case of a 49-year-old woman presenting a distal clavicle fracture associated with a coracoid process one due to a fall on the left shoulder. Both injuries are treated surgically. Per operatively, and through an anterior "strap" approach, the coracoclavicular ligament was seen intact. The distal clavicle fracture was fixed with K-wires and cerclage and the coracoid process was secured by a screw. Active-assisted rehabilitation of the shoulder was initiated 3 weeks after surgery. At the last follow-up of twelve months, the patient had painless full shoulder functions and X-rays show bony union. Early recovery to normal life is possible with surgical treatment in patients with distal clavicle fracture combined with coracoid fracture.

Isolated greater tuberosity fracture: Short-term functional outcome following a specific rehabilitation program.

BACKGROUND: Evaluate the functional outcome of a specific program of rehabilitation during conservative treatment of fracture of the greater tuberosity. METHODS: We retrospectively studied the records of 22 patients, with minimally displaced greater tuberosity fracture, according to inclusion criteria. All patients have received an early (one week after the injury) rehabilitation program based on physical analgesic therapy means, techniques for recovering range of motion, strengthening exercises, proprioceptive stabilization exercises and usability advices. The evaluation was done at baseline, one, two and three months of the end of physical treatment. RESULTS: Pain, perceived disability and range of motion were improved significantly since the end of rehabilitation. The improvement of function (Constant score) was significant at different evaluation times. The functional result seems to be poor when patients are aged and pain is severe at baseline. CONCLUSION: During conservative treatment of fracture of the greater tuberosity, earlier rehabilitation allows rapid range of motion and functional recovery limiting care duration. After fracture healing, the rehabilitation program becomes similar to that advocated in rotator cuff disease. Whatever the initial treatment choice, rehabilitation must be considered at the waning of the first week.

Osteochondritis dissecans of the capitellum: autologous osteochondral mosaicplasty: a case report.

The etiology of osteochondritis dissecans (OCD) of the capitellum is unknown but has generally been attributed to repetitive microtrauma or ischemia. We present a case report of a handball player with OCD of the capitellum. Preoperatively, he complained of elbow pain. CT imaging showed the injury. This patient was treated with mosaicplasty harvested from the lateral femoral condyle. He returned to his full former sports activities within 6months of surgery. The continuity of the cartilage layer between the osteochondral graft and the capitellum was shown on CT arthrogram images at 12months after surgery. We believe that mosaicplasty gives successful results with end-stage OCD of the capitellum.

[Ulnar nerve compression at the elbow and heterotopic ossification: a report of five cases]. / Compression du nerf ulnaire au coude et paraostéoarthropathie neurogène: à propos de cinq cas.

AIM: Heterotopic ossification (HO) is common in head-injured patients. Ulnar nerve compression by HO at the elbow is rare. The purpose of this study was to establish a strategy for the management of ulnar nerve compression secondary to HO at the elbow. PATIENTS AND METHODS: The authors report a retrospective study (2000-2008) of five cases of ulnar nerve compression at the elbow secondary to HO. All patients were male (mean age, 33 years). The HO was secondary to head injury (four cases) and severe burn (one case). According to the Dellon's classification, the ulnar nerve entrapment was severe in two cases and moderate in three. The elbow was ankylosed; the flexion deformity ranged from 60 degrees to 120 degrees. Only in one case was nerve decompression performed before HO maturation. In the other cases, elbow release and nerve decompression were done at the same time, when maturation of HO was achieved. Postoperative outcome assessment was based on the Kleiman and Bishop's score. RESULTS: At 4 years of follow-up, the neurolysis result was excellent in one case, good in three cases, and poor in one. CONCLUSION: It seems that HO is not the direct cause of ulnar nerve compression, but its impairment may be increased by the nerve tension and elbow fixation that it causes. When HO is mature, neurolysis can be combined with elbow release. However, when HO maturation is not achieved early neurolysis associated with anterior transposition should be done without elbow release.

[Acute carpal tunnel syndrome after trauma: a series of 26 cases]. / Le syndrome aigu du canal carpien post-traumatique: à propos de 26 cas.

The aim of the study is to evaluate the results of the median nerve release at wrist as a part of acute carpal tunnel syndrome. This is a retrospective study about 26 cases of acute carpal tunnel syndrome following isolated injury of the wrist. Clinical evaluation of the median nerve function was performed before and after release. A classical median nerve release was performed in emergency eventually associated with stabilization of bone lesions. The population included was young, the mean age was 26 (range 4-52) years, frequently male (sex-ratio 3.5:1). The wrist trauma was direct in 75% of all cases and oftentimes with high velocity. The median nerve was deficient in the first examination. The average time from injury to surgery range from three hours to five days. The release was performed in emergency. The latest follow-up showed a complete recovery of the nerve's function in 85% and an incomplete in the rest (15%).The mean prognosis factor was the release time. Wrist trauma particularly with high velocity should lead to evaluation of median nerve function and to an emergency release when acute median neuropathy appeared.

[Pseudarthrosis of the coracoid process after dislocation of the shoulder]. / Pseudarthrose du processus coracoïde après luxation antérieure de l'épaule.

PURPOSE OF THE STUDY: The aim of this study is to present an unusual lesion combining instability of the shoulder with a fracture of the coracoid process. MATERIAL AND METHODS: The authors have treated one case of recurrent anterior dislocation of the shoulder associated with pseudarthrosis of the coracoid process. The shoulder was stabilised by surgery using the Latarjet procedure. DISCUSSION: The association of an anterior dislocation of the shoulder and pseudarthrosis of the coracoid process is very unusual. It is often unrecognized because of poor knowledge of this lesion or poor quality of the radiographs performed in the emergency room. The most likely mecanism is a direct impact of the humeral head against the coracoid process during the dislocation. The diagnosis requires good quality radiographs. When the shoulder is painful or unstable, surgical treatment is performed and the Latarjet procedure takes care of both the pseudarthrosis and the instability of the shoulder.

Shoulder arthritis as a lung metastatic carcinoma revealer. A case report.

Joint metastasis is very rare. It usually presents as a monoarthritis. It is generally located in the knee and secondary to lung cancer. Prognosis is poor, with a mean survival term of less than six months. We report the case of a right shoulder joint metastasis from a bronchopulmonary squamous cell carcinoma in a 55-year-old male smoker. The patient presented with an atypical chronic post-traumatic arthritis, not improved by symptomatic treatment. The diagnosis was based on synovial biopsy performed during open surgery. The primitive lung cancer was confirmed by chest CT scan and bronchial biopsy.