[Retrospective study of Galeazzi fractures in adults hospitalized in the Department of Orthopaedics at the Habib Bourguiba University Hospital, Sfax, Tunisia: about 45 cases]. / Etude rétrospective des fractures de Galeazzi chez l'adulte dans le Département d'Orthopédie du Centre Hospitalier Universitaire Habib Bourguiba Sfax, Tunisie: à propos de 45 cas.

Galeazzi fracture is defined as the association of radius fracture and inferior radioulnar joint dislocation. Its diagnosis is often unrecognized initially. The purpose of our study is to determine the epidemioclinical features of Galeazzi fracture-dislocations in adults and to assess the functional and radiological outcomes of our case series. We conducted a retrospective descriptive study of 45 patients with Galeazzi fractures treated surgically whose data were collected in the Department of Orthopaedics at the Habib Bourguiba University Hospital, Sfax, Tunisia, over a period ranging from 2009 to 2018. We used Mestdagh score for the clinical evaluation of the results. The mean time between fracture and treatment initiation was 5.35 days. Fixation of the radius was performed using screwed plate in 39 cases and fixation of the radio-ulnar joint using a plug in 13 cases. The average time for union was 10.5 weeks. Outcomes were excellent in 35 patients, good in 3 patients, medium in 6 patients and adverse in a patient. We had 3 cases of sepsis at the level of the plug and two cases of malunions. Galeazzi fracture-dislocation is an under diagnosed disorder in some cases. Dynamic intraoperative examination after solid fixation of the radius can allow for good functional results.

[Surgical treatment of complex fractures of the upper end of the humerus: a retrospective study of 25 cases]. / Traitement chirurgical des fractures complexes de l'extrémité supérieure de l'humérus: étude rétrospective à propos de 25 cas.

Fractures of the upper end of the humerus raise a therapeutic problem in particular for three-fragment and 3 and 4-fragment complex fractures. The purpose of our study is to determine the epidemio-clinic features of complex fractures of the upper end of the humerus in adults and to assess the functional and radiological results in our case series. The study involved 25 patients whose data were collected in the Department of Orthopaedics at the Habib Bourguiba University Hospital between 2012 and 2017. We listed the epidemiological data of patients and the circumstances of the occurrence of the traumatism. Treatment was based on surgery: plate or nail osteosynthesis or prosthetics replacement. Post-operative radiographs were used to asses´ reduction. Constant-Murley score was used to assess functional outcomes at the follow-up visit. Twelve men and thirteen women were enrolled, the average age of patients was 55 years, public road accidents were reported in 48% of cases, and 4-fragment fractures were found in 76% of cases. Screwed plate osteosynthesis was used in 40% of cases and anterograde nailing was performed in 40% of cases. A prosthesis was put in place in 5 patients. Mean Constant-Murley score was 65.24, ranging between 35 years and 88 years. Consolidation of the fractures without malunions was reported in 68% of patients. In complex fractures of the upper end of the humerus, osteosynthesis performed according to patients´ needs and fracture types as well as early post-operative rehabilitation allow for acceptable functional outcomes.Domain: Orthopedic surgery.

Animal models of osteoarthritis: characterization of a model induced by Mono-Iodo-Acetate injected in rabbits.

Knee Osteoarthritis is a considerable public health concern, both in terms of life quality and treatment financial impacts. To investigate this disease, animal models are deemed a promising alternative. In fact, although a perfect model is generally farfetched, the creation of models that simulate human disease as accurately as possible remains an important research stake. This study aims to highlight the usefulness of the model induced by injected Mono-Iodo-Acetate and to standardize it for the rabbit species. Osteoarthritis was induced by an infra-patellar injection of 0.2 ml of an MIA solution in the left knee of 24 female New Zealand rabbits. The right knee served as a control by receiving an injection of physiological serum. The rabbits were divided into 4 groups of 6 individuals each according to the dose of MIA received per knee. All rabbits were euthanized 30 days after the injection. After sacrifice, the knees were carefully dissected and macroscopic and microscopic scores of cartilage, meniscal and synovial lesions were attributed to each group. Our study followed the laboratory animal care and management guideline published in 2017 by the Canadian Council of Animal Care. The control knees of all rabbits showed no macroscopic or microscopic lesions. The macroscopic lesions: osteophytes, meniscal lesions, fibrillation and erosion of the cartilage and microscopic lesions: disorganization of the chondrocytes, decrease in proteoglycans and synovial inflammation clinically diagnosed in human pathology were all detected and were similarly reproducible among the knees of the same group. Through this work, we highlighted the merits of the arthritis model induced by MIA, namely its simulation of several aspects of human pathology. Further advantages are low cost, speed, reproducibility. This model notably avoids delicate and risky surgical operations.

Pseudarthrosis of the Calcaneus: Advantages of Regenerative Medicine in the Management of a Rare Entity, A Case Report and Review of Literature.

BACKGROUND: The follow-up of calcaneal fractures has shown that they are difficult to manage and lead to multiple complications such as malunion and subtalar osteoarthritis. Pseudarthrosis of the calcaneus is an extremely rare complication, which was described in the literature through case reports.In the existing literature, only seven studies, including thirteen patients have reported the nonunion. However, to the best of our knowledge, no study elucidates the role of new techniques of regenerative medicine such as Bone Marrow Concentrates (BMC) or Platelet Rich Plasma (PRP) in the management. METHODS: We report a case of a patient with a pseudarthrosis after a calcaneal fracture treated with BMC injection in the non-union site, without the need for surgical approach. RESULTS: Four months after treatment, the patient was ambulant without support and was completely pain-free. Moreover, after one year the radiological follow up by CT scan showed a satisfactory filling of the non union. CONCLUSION: In one case, we try to highlight the advantage of our therapeutic alternatives, which are having a good union while avoiding the complications of surgical approaches and without sacrificing the subtalar joint when it is possible.

Scurvy: When it is a Forgotten Illness the Surgery Makes the Diagnosis.

BACKGROUND: Unlike most of animal species, human beings lack the enzymatic process for the conversion of glucose to ascorbic acid (vitaminC), and therefore getting the vitamin from food sources is essential. The association of the various signs caused by a deficiency of vitamin C is called scurvy or Barlow's disease, an easily treatable disease but can be fatal. It is rare in the developed countries and even economically underdeveloped societies in which the basic diet is already rich in ascorbate. METHODS: We describe here the case of a 4-year-old girl with cerebral palsy, in whom diagnosis concerns were oriented for osteomyelitis, based upon clinical presentation, ultrasonic and magnetic resonance imaging, led to a surgery revealing subperiosteal hematomas that argues in favor of scurvy. RESULTS: After vitamin C therapy, the symptoms are gone and the general condition of the patient improved despite persistent radiological signs. CONCLUSION: Recent studies of sporadic cases report a high incidence of scurvy in children with autism or psychomotor retardation and the fact that musculoskeletal manifestations are more common. The mosaics of the symptoms of scurvy are varied and include dermatological, dental, bone and systemic manifestations, making it a forgotten and misdiagnosed illness. A heightened awareness is needed to avoid an unnecessary surgery, unnecessary tests and procedures and to be able to start treatment for a potentially fatal but easily curable disease.