Massive traumatic articular bone loss of the capitulum humeri treated by costal osteochondral autograft reconstruction: A case report.

INTRODUCTION: Articular traumatic bone loss is a severe condition with heterogeneous outcomes, often necessitating complex technical solutions and posing challenges in managing both bone and cartilage loss. Thus, some surgeons have used a technique of osteochondral autograft using a rib to fix an articular bone loss to manage both of these tissue losses. PRESENTATION OF CASE: We present the case of a 25-years-old patient, who had a complex open elbow injury. He presented an association of a terrible triad of the elbow injury with an open traumatic bone loss of the capitulum humeri and unfixable lesion of the lateral collateral ligament complex of the elbow. We initially managed these lesions with an external fixator for 2 months followed by a reconstruction of the capitulum humeri using a costal osteochondral autograft. Unfortunately, the patient was lost to follow-up after the 1 month post-operative consultation but he had some encouraging results. DISCUSSION: In this case report, we describe our technique using an osteochondral autograft to address complex bone and cartilaginous losses, thereby expanding the treatment options available to trauma surgeons. CONCLUSION: This case report shows that a reconstruction of the capitellum humeri for a traumatic bone loss with an osteochondral autograft using the eighth rib can be easily performed. More generally, this technique could even help to manage complex traumatic substance loss of both bone and cartilage in other locations.

A hybrid open-arthroscopic latarjet coracoid bone-block technique using "HyLa" instrumentation.

Latarjet coracoid bone-block is a gold-standard procedure for anteroinferior instability of the shoulder. Nowadays, it can be performed as open surgery or entirely under arthroscopy. The pure arthroscopic technique has the advantage of allowing concomitant intra-articular surgery, but involves a long learning curve. Here we present a hybrid concept using dedicated instrumentation comprising a specific guide with or without arthroscopic step, and notably ensuring the safety and reproducibility of the procedure, whatever the modality. This technique offers an alternative to arthroscopic coracoid bone block, performing the more complex steps as open surgery without major change to Latarjet's original technique, so as to enable concomitant intra-articular surgery if needed while getting around some of the limitations of the purely arthroscopic procedure.

Vegetation structure and greenness in Central Africa from Modis multi-temporal data.

African forests within the Congo Basin are generally mapped at a regional scale as broad-leaved evergreen forests, with the main distinction being between terra-firme and swamp forest types. At the same time, commercial forest inventories, as well as national maps, have highlighted a strong spatial heterogeneity of forest types. A detailed vegetation map generated using consistent methods is needed to inform decision makers about spatial forest organization and their relationships with environmental drivers in the context of global change. We propose a multi-temporal remotely sensed data approach to characterize vegetation types using vegetation index annual profiles. The classifications identified 22 vegetation types (six savannas, two swamp forests, 14 forest types) improving existing vegetation maps. Among forest types, we showed strong variations in stand structure and deciduousness, identifying (i) two blocks of dense evergreen forests located in the western part of the study area and in the central part on sandy soils; (ii) semi-deciduous forests are located in the Sangha River interval which has experienced past fragmentation and human activities. For all vegetation types enhanced vegetation index profiles were highly seasonal and strongly correlated to rainfall and to a lesser extent, to light regimes. These results are of importance to predict spatial variations of carbon stocks and fluxes, because evergreen/deciduous forests (i) have contrasted annual dynamics of photosynthetic activity and foliar water content and (ii) differ in community dynamics and ecosystem processes.

Geological substrates shape tree species and trait distributions in African moist forests.

BACKGROUND: Understanding the factors that shape the distribution of tropical tree species at large scales is a central issue in ecology, conservation and forest management. The aims of this study were to (i) assess the importance of environmental factors relative to historical factors for tree species distributions in the semi-evergreen forests of the northern Congo basin; and to (ii) identify potential mechanisms explaining distribution patterns through a trait-based approach. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed the distribution patterns of 31 common tree species in an area of more than 700,000 km(2) spanning the borders of Cameroon, the Central African Republic, and the Republic of Congo using forest inventory data from 56,445 0.5-ha plots. Spatial variation of environmental (climate, topography and geology) and historical factors (human disturbance) were quantified from maps and satellite records. Four key functional traits (leaf phenology, shade tolerance, wood density, and maximum growth rate) were extracted from the literature. The geological substrate was of major importance for the distribution of the focal species, while climate and past human disturbances had a significant but lesser impact. Species distribution patterns were significantly related to functional traits. Species associated with sandy soils typical of sandstone and alluvium were characterized by slow growth rates, shade tolerance, evergreen leaves, and high wood density, traits allowing persistence on resource-poor soils. In contrast, fast-growing pioneer species rarely occurred on sandy soils, except for Lophira alata. CONCLUSIONS/SIGNIFICANCE: The results indicate strong environmental filtering due to differential soil resource availability across geological substrates. Additionally, long-term human disturbances in resource-rich areas may have accentuated the observed patterns of species and trait distributions. Trait differences across geological substrates imply pronounced differences in population and ecosystem processes, and call for different conservation and management strategies.