Fracture-dislocation of the radiocarpal joint: bony and capsulo-ligamentar management, outcomes and long-term complications.

PURPOSE: Radiocarpal dislocation fractures (RCDF) are rare injuries that usually occur in a violent trauma setting. Our work aimed to analyze our patients' functional and radiological results after surgery and identify potential medium- and long-term complications while reviewing other series previously reported in the literature. METHODS: We have performed a retrospective study over five years at our university hospital, eleven patients were selected, and the mean follow-up was about 33 months. We used Dumontier's and Moneim's classifications for classifying the injuries. All the patients underwent surgery followed by cast immobilization. The QuickDash score and Green O'Brien score modified by Cooney were used to assess the functional result, while the radiological result was judged on standard wrist radiographs. RESULTS: Out of the eleven patients, only one described a Dumontier type I radiocarpal dislocation; all the others were type II. Following the Moneim classification, two patients were type II. Most cases showed posterior displacement. In 80% of cases, the radiocarpal fracture-dislocation was combined with other bone or ligament injuries. All patients received surgical treatment followed by cast immobilization for 45 days. The mean loss of range of motion at the last follow-up was about 39%, keeping the arch intact in most cases. Quick dash score was 29.54, and Green O'Brien's score was 71.1. Three of the patients showed osteoarthritic remodeling. CONCLUSION: A careful clinical and radiological evaluation, followed by an anatomic surgical reduction of the articulating surface of the distal radius, as well as the handling of the associated lesions, are major conditions for a satisfactory clinical result.

Case report: A rare case of pure tibio-talar dislocation without malleolar clamp fracture in a young athlete: Long-term functional results and recent reviews of the literature.

INTRODUCTION AND IMPORTANCE: Ankle dislocation without fracture is an extremely rare injury, requires high-energy trauma, up to 1995, only 73 cases were reported in the literature and 154 cases up to 2017. It is therefore a post-traumatic ankle disease growing in parallel with the increase in road-traffic accidents requiring the study of incriminated factors such as hypoplasia of the medial malleolus. CASE PRESENTATION: The authors report the case of a young patient, a football player, who presented with a pure, closed dislocation of his ankle following a road-traffic accident. Management consisted of immediate reduction, followed by immobilization in plaster for 1 month, CLINICAL DISCUSSION: The short, medium and long term clinical and radiological results are excellent with no evidence of ankle instability or osteoarthritis. CONCLUSION: Ankle dislocation without associated fracture is an extremely rare injury. The posteromedial dislocation represents the most described variety in the literature. Early management, short-term immobilization, adapted and early rehabilitation seem to be associated with good long-term functional results.

Sclerosing epithelioid fibrosarcoma: rare and serious.

Sclerosing Epithelioid Fibrosarcoma (SEF) is a rare form of soft tissue sarcoma. It is characterized by a slow evolution, with local recurrences and late metastases that are mainly pulmonary and pleural in about 50% of cases. The treatment is based on the surgery which must be as wide as possible. The efficacy of adjuvant therapy in the control of SEF is not yet demonstrated. Chemotherapy is used in recurrences, some have also proposed radiotherapy. Long-term follow-up of patients with SEF is therefore essential.