Triple Threat Ttrauma: A Rare Case Report of Avulsion Fracture of the Posterior Cruciate Ligament, Lateral Collateral Ligament, and diaphyseal Tibia Fracture.

We present the case of a 24-year-old male who sustained a fall from a motorcycle resulting in a rare combination of injuries, including avulsion fractures of the posterior cruciate ligament (PCL) and femoral lateral collateral ligament (LCL), along with an ipsilateral diaphyseal tibia fracture. This case report aims to highlight the importance of early diagnosis, appropriate management, and comprehensive rehabilitation for such complex knee injuries. We discuss the patient's presentation, radiographic findings, surgical intervention, postoperative care and long-term outcomes. To our knowledge this kind of injury has never been documented in the literature.

Bilateral clavicle fracture: A case report.

Clavicle fractures are among the most common fractures in adults. Nevertheless, bilateral fractures are rarely reported in the literature. We present the case of a 35-year-old male patient who was admitted with a bilateral clavicle fracture following a motorcycle accident. The patient underwent open reduction and bilateral intramedullary fixation with Kirschner wires. After six months of follow-up, the functional result was satisfactory; the patient achieved full range of motion in both shoulders and was free from pain. X-rays showed a complete fusion of the fracture on both sides.

Isolated dorsal dislocation of the distal radioulnar joint: A case report.

Isolated distal radioulnar joint (DRUJ) dislocation is a rare injury. Reports of isolated DRUJ luxations, volar or dorsal, are often case reports and rarely a series of cases. We present a case of an isolated acute dorsal dislocation of the distal radioulnar joint in a 25-year-old man. The patient underwent closed reduction and a transcutaneous radioulnar pinning was done followed by cast immobilization in neutral rotation during 6 weeks. After six months follow -up, the functional result was satisfactory, patient experienced no pain and had no restrictions in work or sports-related activities.

Bilateral anterior shoulder dislocation with bilateral fractures of the greater tuberosity: A case report.

Bilateral anterior dislocation of the shoulders with fractures of both greater tuberosities is very rare. A 76-year-old woman sustained a bilateral anterior dislocation of her shoulders with fractures of the greater tuberosity on both sides after a fall on stairs. Her arms were abducted and externally rotated. Radiological examination revealed the bilateral anterior dislocation and also the bilateral fractures of the greater tuberosity. Prompt closed reduction followed by a 3 weeks immobilization and subsequent rehabilitation allows a good outcome. Results at one-year follow-up were satisfactory with normal range of motion and no redislocations occurring. To our knowledge, this is the first reported case of bilateral anterior shoulder dislocation associated with fractures of both greater tuberosities in elderly woman.

Multifocal bone tuberculosis: a case report.

Multifocal long bones tuberculosis without articular involvement is very rare. Pain and swelling are the common presenting symptoms. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. Radiographs may mimic other diseases. Histopathological study is necessary to establish the diagnosis. The antibacillary chemotherapy produces excellent results. We report a case of a 60-year-old woman afflicted with multifocal tibial tuberculosis.

Open medial ankle dislocation without associated fracture: a case report.

Tibiotalar dislocation without associated fracture is a rare injury. We report a case of an unusual open medial ankle dislocation without any associated bony injury. After reduction and debridement under general anaesthesia, capsule suture and ligaments repair were performed. An external fixator was applied for ankle immobilization. After 3 years follow-up, functional results were excellent without signs of instability or degenerative arthritis.

[Tuberculosis of the hand and wrist: different aspects of 30 cases]. / La tuberculose de la main et du poignet : différents aspects à propos de 30 cas.

Tuberculosis of the hand and wrist is a rare entity. We report 30 cases of tuberculosis of the hand and wrist, including ten cases of wrist osteoarthritis, ten cases of tenosynovitis, four cases of metacarpophalangeal and interphalangeal osteoarthritis and six cases of metacarpal and phalangeal osteitis. The histological study after surgical biopsy revealed caseating giant cell granulomas with epitheloid cells confirming the diagnosis. Antibacillary chemotherapy promoted healing and good outcome in our patients. The aim of our work is to analyze the epidemiological, diagnostic, therapeutic and evolutionary aspects of this disease through a series of 30 cases.

El papel de la escapulectomía en el tratamiento de los tumores de la escápula: a propósito de 6 casos / The role of scapulectomy in the care of the scapular tumors: a report of 6 cases

Este estudio retrospectivo tiene como objetivo mostrar el papel de la escapulectomía en el tratamiento de tumores escapulares analizando los resultados en 6 pacientes tratados en el Servicio de Cirugía Ortopédica del Hospital IBN SINA en Rabat por distintos tumores en la escápula entre los años 1996 y 2009. La evaluación de estos pacientes mediante el sistema de Enneking mostró en el plano funcional, excelentes resultados para 4 pacientes y buenos en los otros dos casos. En el aspecto oncológico, sólo un caso requirió la ampliación de la escapulectomía por recidiva tumoral, teniendo este paciente una buena evolución posterior. Ya que la escapulectomía ampliada es una intervención que lleva a un déficit funcional importante, actualmente el tratamiento de los tumores malignos de la escápula se realiza con una cirugía conservadora de miembro, realizándose una escapulectomía simple. Ésta debe llevarse a cabo tras una buena estadificación del paciente, para lo que es necesario un estudio de imagen completo y buen conocimiento de la anatomía para una correcta indicación quirúrgica (AU)

This retrospective study aims to demonstrate the role of scapulectomy in the treatment of scapular tumours by assessing the results of 6 patients treated for various scapular tumours in the Orthopaedic Department of IBN SINA hospital in Rabat between 1996 and 2009. The evaluation of these patients by the Enneking system showed, on a functional scale, an excellent score for 4 patients and good one for 2 patients; on the oncology scale, a single case required a total scapulectomy after recurrence with a good evolution. Since an enlarged scapulectomy leads to functional deficit, the majority of malignant tumours of the shoulder are currently treated conservatively, by performing a simple scapulectomy. Patient selection must be made after appropriate staging, a complete imaging study and a good knowledge of anatomy for a correct surgical indication (AU)

Upward tibiotalar dislocation without fracture: A case report.

Pure tibiotalar dislocations without associated fracture are rare. The authors report a case of an unusual closed tibiotalar dislocation without fracture involving proximal ascension of the talus. Immediate closed reduction was performed. Repair of the disrupted medial ligament was performed and one syndesmosis screw inserted, followed by 6 weeks of immobilization. After 1 year of follow-up, functional results were excellent.

Antituberculous treatment and total hip arthroplasty in ald tuberculous hip. A case report

We report a case of Total Hip Arthroplasty using cemented Charnley prothesis. This was done in an old tuberculous hip without using antituberculous chemoprophylaxis. The patient developed periprosthetic bacterial infection not related to tuberculous site reactivation. We report our experience with this case and review of relevant literatures

Evaluation of freezing effects on human microvascular-endothelial cells (HMEC).

There is mounting evidence that the endothelium may play an important role in traditional cryosurgical treatments by acting to locally foster thrombi in the microvasculature of various tissues after freezing. In addition, new catheter based cryosurgical probes are being designed for cardiovascular applications where endothelial and smooth muscle cell freezing is involved but not well understood. Therefore, this study was designed to investigate, at the cellular level in human microvascular endothelial cells (hMEC), the various biophysical changes that occur during freezing which can affect post-freeze viability. The hMECs were loaded on a cryomicroscope stage and freezing experiments at 5, 10, 15, 25, 100 and 130 degrees C/min were performed to experimentally evaluate dehydration (water transport) as well as intracellular ice formation (IIF) within this cell system. The dehydration kinetics at 5, 10 and 25 degrees C/min were found to be governed by a membrane permeability L(pg) and activation energy E(Lp) of 0.05 (microm/min.atm) and 14.8 (kcal/mole) respectively [R(2)=0.94]. These parameters were then tested for predictive ability against the experimentally measured behavior at 15 degrees C/min with a good agreement [R(2)=0.98]. Intracellular Ice Formation (IIF) was found to occur at lower temperatures than many cell types (i.e. TIIF 50% approximately -18 degrees C) and at cooling rates greater than or equal to 25 degrees C/min. At cooling rates above 50 degrees C/min, two types of IIF, cell darkening and twitching, were both observed and quantified and were assumed to be governed by Surface Catalyzed Nucleation (SCN). IIF parameters, omega(o) and kappa(o), which fit data from 50, 100 and 130 degrees C/min were found to be 6.8 x 10(-8) (m(2).s)(-1) and 8.3 x 10(-9) (K5) [R(2)=0.94] respectively. Preliminary results show that viability drops precipitously between -20 and -30 degrees C, however, further studies are warranted to address the role of cooling rate, end-temperature, hold time and thawing rate to establish the freeze sensitivity of this cell.

[False iatrogenic aneurysm complicating septic malunion of the femur]. / Faux anévrisme iatrogène compliquant une pseudarthrose septique du fémur.

We report a case of false iatrogenic aneurism of the femoral artery observed after external fixation for septic malunion of the femur subsequent to emergency plate fixation. This false aneurysm ruptured, requiring femoropopliteal arterial repair. In the septic context, the vascular sutures failed making it necessary to ligature the femoral artery. Vascularization was maintained by satisfactory collateral circulation.

[Necrotizing fasciitis of the upper limb. Apropos of 4 cases]. / La fasciite nécrosante du membre supérieur. A propos de quatre cas.

This article is based on the retrospective study of 4 cases of necrotic fasciitis of the upper extremity, in adult patients with a mean age of 57 years (range: 36 to 78 years) and with a male predominance (3 M/1 F). Presenting signs were variable: pain, febrile and inflammatory oedema, ecchymoses with inflammatory masses containing clear or haemorrhagic fluid. Treatment with antibiotics and anti-inflammatory drugs did not prevent progression to painless, necrotic ulcers. Rapid medical and surgical treatment constitutes an element essential of the prognosis and must include wide large debridement, antibiotics and intensive care.