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.

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)

Proximal clavicle physeal fracture-separation mimicking an anterior sterno-clavicular dislocation.

Proximal physeal fracture-separation of the clavicle is a very rare injury occurring in the adolescent and in the young adult which involves a contact loss with fracture between the clavicle and its cartilaginous ossification center similar in appearance to a sternoclavicular dislocation. The authors report an unusual case of a proximal physeal fracture-separation of the clavicle with avulsion of sternoclavicular periosteal and ligamentous structures without vasculonervous injury in a 16-year-old young person. A CT scan examination is essential. Surgical management consisted in costoclavicular ligament and periosteum reattachment associated with reduction of the fracture-separation and pin fixation.This repair demonstrated a successful outcome at 8-month follow-up.

[What are the traps of incisional hernia open repair?]. / Quels sont les pièges de la cure de l'éventration par laparotomie?

Open repair of incisional hernia is a simple surgery. Nevertheless, uncountable traps wait for the operator during surgery. They mark out all the stages of the procedure, from incision to skin closure. They are source of intraoperative incidents and postoperative complications. Some of these complications could be very serious and require removing the prosthesis. To avoid these incidents and these complications, the surgeon has to remain watchful throughout the procedure and has to anticipate all the traps that could arise.

Abiotic degradation of imazethapyr in aqueous solution.

The photodegradation of imazethapyr [2-(4,5-dihydro-4-méthyl-4-(1-méthylethyl)-5-oxo-1H-imidazol-2-yl)-5-ethyl-3-pyridinecarboxylic acid] in aqueous solution in the presence of titranium dioxide (TiO2) and humic acids (HA) at different ratios of herbicide/TiO2 and herbicide/humic acids was studied at pH 7.0. Irradiation was carried out with polychromatic light using Heraeus apparatus equipped with xenon lamp to simulate sunlight having a spectral energy distribution similar to solar irradiation (>290 nm). The concentration of remaining herbicide was followed using a High Pressure Liquid Chromatograph (HPLC) equipped with UV detector at 230 nm. In pure aqueous solution imazethapyr degrades slowly and the photodegradation leads to the formation of two metabolites labelled A and B. The presence of TiO2 caused enhancement of the degradation rate. The presence of HA induced an increase of the photodegradation of the pesticide with respect to pure aqueous solution.

[Actinomycosis of the appendix. Report of two cases]. / Actinomycose de l'appendice. Présentation de deux observations.

INTRODUCTION: We report two patients with actinomycosis of the appendix extending to the caecum and the ileum, and diagnosed postoperatively on histological analysis, the authors reviewed the literature. EXEGESIS: Actinomycosis of the appendix can be acute or chronic. Diagnosis may be obtained preoperatively on the analysis of aspiration or biopsy material under CT scan control. It is frequently done postoperatively on the analysis of surgical specimen. Actinomycosis can be treated with antibiotics only during six months if the diagnosis is made preoperative, by surgery followed by antibiotics during 6-12 months, according to the extension of the actinomycosis, if the diagnosis is made after surgery, and by a combination of a surgery and antibiotics in complex forms. CONCLUSION: Actinomycosis of the appendix is an infrequent pathology that merits to be known. With antibiotic therapy, we can avoid surgery or wide resections.

[Indications for laparoscopic treatment of incisional hernias]. / Indicazioni al trattamento laparoscopica dei laparoceli.

OBJECTIVE: The aim of this article is to describe the technique used in the treatment of ventral hernia using the laparoscopic method and at the same time to evaluate the possible advantages of this surgical approach. METHODS: The clinical case we present regards a case of a patient who had undergone a double eventration treated with an application of a new type of prosthesis Parietex Composite of the Sofradim, using the laparoscopic method, we can be applied in intraperitoneal in contact with the intestinal loops. RESULTS: The method we used in the laparoscopic treatment of ventral hernias has highlighted, in a short time, the solidity of the abdominal wall, a noticeable reduction of infections and a reduction of hospitalization. There developed no long term recurrence in our patients treated with this technique. CONCLUSIONS: Laparoscopic ventral hernia treatment is currently used in a limited amount even though this pathology could be approached using the laparoscopic method. Our laparoscopic method, using the Composite prosthesis could represent a very valid method for primary and recurrent ventral hernia. This technique gives the opportunity to repair the eventration applying a prosthesis without any muscular tension, consenting, furthermore a reduction of any complications (infections, seroma, pain) that could arise and of any recurrence after the operation. Furthermore the surgical access is minimum and as we know this is of noticeable importance in aesthetics today.

[Value of celioscopy in treatment of isolated torsion of the Fallopian tube. Review of the literature. Apropos of 3 cases]. / Apport de la coelioscopie dans le traitement de la torsion isolée de la trompe de Fallope. Revue de la littérature. A propos de trois observations.

Isolated fallopian tube torsion (ITT) is infrequent and associated with morphologic and dynamic disturbances. Mr L, 31 years old, suffered from right lower quadrant pain which became worse during the following 48 hours. Laparoscopy revealed a right necrotic ITT which was resected by laparotomy. Mr L, 49 years old, suffered from by left lower quadrant pain with progressive onset. Laparoscopy revealed a left necrotic ITT which was resected. Mr P, 76 years old, suffered from left lower quadrant pain for 14 days. Ultrasonography revealed an adnexal mass. Laparotomy revealed a left necrotic ITT which was resected. On literature review, ITT (81 cases) was revealed by lower quadrant pain, acute onset, which quickly became worse. Pelvis examination revealed a lateral cul-de-sac pain. Ultrasonography identified tubal cystic mass with high-impedance arterial waveform on colour Doppler sonography. Diagnosis was easily established by laparoscopy. In case of clinical symptoms suggestive of ITT, pelvic and endovaginal ultrasonography and laparoscopy are indicated. Tubal preservation must be the rule.

[Cost of appendectomy: laparoscopy versus laparotomy. A retrospective study of two series of 114 cases]. / Coût de l'appendicectomie: coelioscopie vs laparotomie. Etude rétrospective de deux séries de 114 patients.

This retrospective study was designed to compare the cost of laparoscopic appendicectomy (LA) in patients operated in 1991-92 and open appendicectomy (OA) in patients operated in 1989-90. Patients were matched for sex, ASA score and age into 2 homogeneous series: 114 LA and 114 OA. Costs of accommodation, operation and time off work were calculated by the observed costs method: daily cost of the inpatient unit, hourly cost of the operating room-recovery ward, and the patient's consumption. A mean specific cost was added in the case of LA. A significant difference was observed for operating time, time off work and for the cost of postoperative stay, the operation and time off work and the total cost of the disease. The excess cost of the operation in the case of LA was not compensated by the reduction of the accommodation costs A clinical benefit in terms of reduction of pain and local complications has been reported in the literature. The cost of hospitalisation is higher with LA, but the cost of time off work is decreased. LA provides a clinical comfort in all patients and an economic benefit in patients with a professional activity.