RESUMEN
INTRODUCTION: Echinococcosis is a relatively widespread anthropozoonosis in endemic regions, preferentially affecting the liver and lungs. Although rare, it can sometimes be localized in the muscles. The clinical symptoms are insidious and not very indicative, often leading to a delayed diagnosis. We reported a case of a hydatid cyst located in the gluteal muscle. OBSERVATION: This was a 52-year-old female patient admitted for the appearance of a swelling in the left buttock region, progressively increasing in size. The radiological exam, revealed a large simple cyst originating from the gluteal muscle with purely liquid content. A surgical excision was performed, and the parasitological examination of the hydatid fluid confirmed the diagnosis. CONCLUSION: Hydatid cysts in soft tissues are rare, slow-developing tumors with local extension. This diagnosis should be considered, especially in individuals from endemic countries. The treatment is primarily surgical, but the best way to combat hydatid disease, regardless of its location, remains prevention.
Asunto(s)
Equinococosis , Enfermedades Musculares , Humanos , Equinococosis/diagnóstico , Equinococosis/cirugía , Femenino , Persona de Mediana Edad , Nalgas/parasitología , Enfermedades Musculares/parasitología , Enfermedades Musculares/diagnóstico , Enfermedades Musculares/cirugía , Músculo Esquelético/parasitología , Músculo Esquelético/patología , Músculo Esquelético/cirugíaRESUMEN
OBJECTIVE: The objective of this study was to evaluate the clinical and radiological results of the treatment of aseptic nonunion of the tibia by plating and bone grafting. MATERIAL AND METHODS: This retrospective study included 40 patients with aseptic nonunion of the tibia, treated in the Trauma-Orthopedic department B4 of CHU Hassan II in Fez-Morocco. The average age was 41 years (range 25-60 years). The initial fractures were in the middle third of the tibia for the majority of our patients. We used the ASAMI criteria to assess the results. RESULTS: We found 45 patients with aseptic nonunion of the tibia who were treated by the same surgical team and followed in postoperative consultation for a fixed period of 10 months. Three patients lost to follow-up and two patients refused the treatment. In 37 patients (92.5%), union was obtained after a mean delay of 4.3 months (range 3-7 months). The average time from initial treatment to treatment for nonunion was eight months (range 6-10 months). According to the ASAMI classification, bone results were excellent in 26, good in 8, fair in 3 and poor in 3; functional results were excellent in 10, good in 16, fair in 11 and poor in 3. CONCLUSIONS: Our study suggests that the combination of screwed plate and autograft in the treatment of aseptic nonunion of the tibia has provided satisfactory results. A well-codified management of the initial fracture remains the gold key to prevent the occurrence of pseudarthrosis.
Asunto(s)
Placas Óseas , Trasplante Óseo , Fracturas de la Tibia , Adulto , Trasplante Óseo/métodos , Fijación Interna de Fracturas/métodos , Curación de Fractura , Fracturas no Consolidadas/diagnóstico por imagen , Fracturas no Consolidadas/cirugía , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Tibia/diagnóstico por imagen , Tibia/cirugía , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Resultado del TratamientoRESUMEN
Coverage of loss of skin substances on the lower third of the leg is a challenging problem. This is due to adjacent soft tissues impairment, shortage of local vascularization and bone exposure. We conducted a retrospective study of a series of 9 cases of skin coverage of the lower third of the leg treated at the University Hospital Hassan II of Fez from 2016 to 2018. This study aims to highlight the characteristic of the loss of skin substances on the lower third of the leg, while emphasizing the difficulty of management.
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Traumatismos de la Pierna/cirugía , Procedimientos de Cirugía Plástica/métodos , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos , Adolescente , Adulto , Femenino , Humanos , Traumatismos de la Pierna/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Piel/patología , Traumatismos de los Tejidos Blandos/patología , Adulto JovenRESUMEN
Joint prostheses are increasingly used in our current practice. Infection is one of the most dreaded complications; it is most often due to germs of the skin flora. Listeria monocytogenes rarely causes this infection. We here report the case of a patient with hip prosthesis infected by this germ. Favorable outcome was obtained by antibiotic therapy and single-stage prosthesis replacement.
Asunto(s)
Prótesis de Cadera/microbiología , Listeria monocytogenes/aislamiento & purificación , Listeriosis/diagnóstico , Infecciones Relacionadas con Prótesis/diagnóstico , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Humanos , Listeriosis/complicaciones , Listeriosis/tratamiento farmacológico , Masculino , Falla de Prótesis , Infecciones Relacionadas con Prótesis/complicaciones , Infecciones Relacionadas con Prótesis/tratamiento farmacológicoRESUMEN
Fractures of the upper extremity of the femur are serious because of their morbidity and social and/or economic consequences. They have been the subject of several studies of world literature concerning their hospital treatment, evolution and prevention. The increase in the incidence of this pathology seems unavoidable due to population ageing and to the lengthening life expectancy; it is posing a real long-term public health problem whose importance will be further increased by the need to control health care costs. The results of this study show that the average age of onset of fracture of the proximal extremity of the femur is 68,13 ± 16.9 years, with a male predominance and a sex ratio of 1.14. In our study pertrochanterian fractures represented 69.4% of cases. Direct medical costs of the hospital treatment of fractures of the upper extremity of the femur at the Hassan II University Hospital were £387 714,38 in 222 cases, with an average cost of £1757,4 , including costs for patient's stay in hospital, which represented the majority of expenses ( 77% of total costs). It is desirable to raise staff awareness of the costs of consumables in order to reduce treatment costs and to adopt cost-oriented behaviour. Length of stay should be limited to the maximum extent because it only allows to reduce staff and accommodation costs.
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Fracturas del Fémur/terapia , Costos de la Atención en Salud/estadística & datos numéricos , Costos de Hospital/estadística & datos numéricos , Hospitalización/economía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Fracturas del Fémur/economía , Humanos , Incidencia , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Distribución por Sexo , Adulto JovenRESUMEN
MASSON described glomus tumour as a benign neuromyoarterial proliferation. It represents approximately 1% -5% of all tumors of the hand. Pain is the main clinical sign. Definitive diagnosis is based on a body of evidence: clinical and radiological but only histology will allow confirmation. We conducted a retrospective study of 11 patient whose average age was of 36, 27 years (range 8-48 years), with a mean follow-up period of 34,40 months. All patients underwent surgical excision. This strategy allowed us to achieve satisfactory results.
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Tumor Glómico/patología , Mano/patología , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Tumor Glómico/cirugía , Mano/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
Digital amputations are frequent injuries, the majority of them are caused by workplace accidents. Microsurgical techniques are an alternative option to repair these amputations. This study aims to report our experience in digital replantation through the examination of 18 cases. We conducted a retrospective study of 14 patients with total or subtotal fingers amputation between June 2013 and January 2015. All unidigital and multidigital replantations downstream of the distal insertion of superficial flexor tendon as well as all digital replantations upstream of the distal insertion of superficial flexor tendon were included in our study. These patients underwent surgery according to conventional digital replantation procedures. Five replantations were secondarily regularized. Among the 18 replantations, eight digital replantions evolved favorably since replantation helped restore active range of motion and passive range of motion of the finger operated without revision surgery and early and late secondary complication. In our study we achieved satisfactory results despite the difficult conditions including the initial state of the amputated finger and its delayed management. The development and mastery of microsurgery has helped change the prognosis of these amputations with serious functional and psychological consequences; the results of our study are encouraging with reference to the implementation of the SOS Hand Service in Morocco.
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Amputación Traumática/cirugía , Traumatismos de los Dedos/cirugía , Microcirugia/métodos , Reimplantación/métodos , Accidentes de Trabajo , Adolescente , Adulto , Femenino , Humanos , Masculino , Marruecos , Complicaciones Posoperatorias/epidemiología , Pronóstico , Rango del Movimiento Articular , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
ABSTRACT Objective: The aim of our study is to present the benefit of using the transvers acetabular ligament for intraoperative determination of the anteversion of acetabular component. Methods: Twenty-one total hip arthroplasties were performed. The transverse acetabular ligament was identified and used as a guide to position the acetabular component. Results: The mean anteversion angle was 16.9. None of the patients studied sustained a postoperative dislocation during this short follow-up period. Conclusion: We conclude from this preliminary study that the transverse acetabular ligament can aid positioning of the acetabular component of a THR. It defines the version of the acetabular component without the need for external instrumentation, and is independent of the position of the patient. Level of Evidence IV; Prospective Study.
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Total hip arthroplasty for the treatment of congenital dislocation represents a challenge for the orthopedic surgeon. It is now well established that the treatment of congenital hip dislocation in adults is a real "functional miracle". The evolution of surgical techniques and materials has expanded the indications for prosthetic replacement including the most complex cases and thus going against Charnley and Feagin who wrote in 1973 that there was no place for total hip arthroplasty in inveterate dislocations. We conducted a retrospective study of a series of THP 15 for the treatment of congenital hip dislocation in adults;sociodemographic, clinical, paraclinical and therapeutic data were collected from the medical records of 15 patients and also via a written questionnaire which was completed during their last follow-up visit. The average age of our patients was 28 years; female sex ratio was 2F/1H. Severe dysplasia stage VI according to Crowe's classification was present in 4 cases, type III in 9 cases and type II only in 2 cases. All patients underwent cemented total hip arthroplasty, a reinforcement ring was used in 9 cases and a bone graft in 2 cases. At last follow-up visit PMA functional scores were excellent and very good in 74% of cases. Surgical treatment of congenital hip dislocations in adults must meet strict health standards as congenital hip dislocations often occurs in young female population that is more demanding as to the aesthetic and functional outcomes. Several surgical techniques have tried to solve the problems related to this disease, acetabular and femoral hypoplasia, leg length inequality. Total hip arthroplasty for the treatment of congenital dislocations in adults remains a challenge for the orthopaedic surgeon. This is a difficult surgical procedure which requires technical skills and careful pre-design programming to reduce the occurrence of adverse events especially in the particular case of young female population.
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Artroplastia de Reemplazo de Cadera/métodos , Trasplante Óseo/métodos , Luxación Congénita de la Cadera/cirugía , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: The aim of our study is to present the benefit of using the transvers acetabular ligament for intraoperative determination of the anteversion of acetabular component. METHODS: Twenty-one total hip arthroplasties were performed. The transverse acetabular ligament was identified and used as a guide to position the acetabular component. RESULTS: The mean anteversion angle was 16.9. None of the patients studied sustained a postoperative dislocation during this short follow-up period. CONCLUSION: We conclude from this preliminary study that the transverse acetabular ligament can aid positioning of the acetabular component of a THR. It defines the version of the acetabular component without the need for external instrumentation, and is independent of the position of the patient. Level of Evidence IV; Prospective Study.
Asunto(s)
Enfermedades en Gemelos/cirugía , Prótesis Articulares , Osteonecrosis/cirugía , Implantación de Prótesis/métodos , Articulación del Hombro/cirugía , Anciano , Femenino , Humanos , Osteonecrosis/genética , Recuperación de la Función , Manguito de los Rotadores/patología , Manguito de los Rotadores/cirugíaAsunto(s)
Clavícula/cirugía , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Adolescente , Adulto , Clavos Ortopédicos , Placas Óseas , Clavícula/lesiones , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Estudios Prospectivos , Adulto JovenRESUMEN
Femoral fractures in amputation stump are challenging injuries to manage. The authors describe a case of a 51-year-old patient with a right above knee amputation, who had a right hip femoral neck fracture. In this technical note, we describe a technical and surgical procedure with intraoperative tips and tricks, in which we use commonly available materials, for the safe management in such clinical situations.
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This study report the results in 28 patients affected by closed fractures of the neck of the fifth metacarpal bone (boxer's fracture), treated with percutaneous elastic intramedullary nailing using a single wire, to verify the effectiveness of this surgical treatment. We reviewed the results of 28 patients treated with A single Kirschner wire (K-wire) pre-bent in a lazy-S fashion with a mild bend at approximately 5 millimeters, The K-wire is inserted blunt end first in an antegrade manner and the fracture reduced as the wire is passed across the fracture site The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic. The follow-up period averaged of 20,75 months. The parameters evaluated included angulation, rotational alignment, postoperative metacarpophalangeal (MCP) range of motion, and time to union. We opted for this treatment in all cases, regardless volar angulation of the metacarpal head, malrotation of the fifth finger and associated or/no with a severe swelling of the hand. All the patients were reviewed clinically and radiologically at an average of 20,75 months after surgery. At the final follow-up, no patient reported residual pain and All fractures proceeded to bony union but we have one fracture had to be revised for failed fixation and three superficial wound infections needed antibiotic treatment. We recommend that this minimally invasive: percutaneous intramedullary nailing using a single k-wire in all metacarpal neck fracture (boxers' fractures), especially when severe swelling of the hand is present, with good functional results and low morbidity.
Asunto(s)
Fijación Intramedular de Fracturas/métodos , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Huesos del Metacarpo/lesiones , Adolescente , Adulto , Boxeo , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación , Masculino , Huesos del Metacarpo/diagnóstico por imagen , Huesos del Metacarpo/cirugía , Persona de Mediana Edad , Radiografía , Rango del Movimiento Articular , Resultado del Tratamiento , Adulto JovenRESUMEN
Pregnancy complicated by Non Hodgkin lymphoma (NHL) is rare, about 100 cases have been reported. We will describe the case of a multifocal bone lymphoma revealed by a left hyperalgetic and deficient cruralgia in a female in the second trimester of pregnancy.
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Neoplasias Femorales/diagnóstico , Linfoma de Células B Grandes Difuso/etiología , Dolor/etiología , Complicaciones Neoplásicas del Embarazo/diagnóstico , Aborto Terapéutico , Adulto , Anticuerpos Monoclonales de Origen Murino/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Clavos Ortopédicos , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Femenino , Fracturas del Fémur/etiología , Fracturas del Fémur/cirugía , Neoplasias Femorales/tratamiento farmacológico , Fijación Interna de Fracturas , Fracturas Espontáneas/etiología , Fracturas Espontáneas/cirugía , Ingle , Humanos , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Imagen por Resonancia Magnética , Prednisolona/administración & dosificación , Embarazo , Complicaciones Neoplásicas del Embarazo/tratamiento farmacológico , Segundo Trimestre del Embarazo , Rituximab , Vincristina/administración & dosificaciónAsunto(s)
Acetábulo/lesiones , Acetábulo/cirugía , Fijación Interna de Fracturas , Fracturas Óseas/cirugía , Acetábulo/diagnóstico por imagen , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Fracturas Óseas/diagnóstico por imagen , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Índices de Gravedad del Trauma , Resultado del TratamientoAsunto(s)
Tendón Calcáneo/lesiones , Tendón Calcáneo/cirugía , Procedimientos Ortopédicos/métodos , Adolescente , Adulto , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos/efectos adversos , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Rotura/cirugía , Adulto JovenRESUMEN
CONTEXT: Floating knee injuries are uncommon and complex injuries. Management of this injury has been variously described in the literature. AIMS: We present the outcome of the intramedullary nailing using a single knee incision for treatment of extraarticular floating knee. MATERIALS AND METHODS: We report a retrospective series of nine patients with extraarticular floating knee. RESULTS: There were seven men and two women with an average age of 35 years. At least one of the fractures was open in three cases. The average Injury Severity Score was 17. According to Fraser's classification, 100% of the cases are type I. All our patients were treated by the intramedullary nailing using a single knee incision. The mean operating time was 146 min. The mean follow-up is 19 months. According to the Karlström criteria, the end results were excellent in two cases, good in four, acceptable in two, and poor in one. Bone union was achieved in eight cases with an average period of 93 days. CONCLUSIONS: The intramedullary nailing using a single knee incision has shown in this series better results.