Spontaneous flexor tendon rupture secondary to capitate non-union. A case report and review of literature.

Rupture of the flexor digitorum profundus and superficialis tendons of the index finger secondary to non-union of the capitate has not yet been reported to our knowledge. We describe the case of a 48-year-old man with rupture of both flexor tendons of the index finger that occurred 15 years after a capitate fracture. The patient was completely asymptomatic before the rupture. Tendon reconstruction was performed using the palmaris longus. One year after surgery, the patient had acceptable range of motion and was pain-free.

[Aortic prosthesis infection treated by using cryogenically conserved allograft]. / Utilisation d'une allogreffe artérielle cryopréservée dans le cadre d'une infection de prothèse aorto-bifémorale.

Infections of aortic prosthesis are quite unusual. When occurring, they represent a real challenge for both medical and surgical care, and their morbidity and mortality rates are high. Initially, these infections can be treated with antibiotics, but, in case of failure, the infected prosthesis must be removed and a new aorto-iliac system has to be reconstructed surgically. We report, the case of a woman affected by infection of an aortic prosthesis and whose problem has been solved by means of a new aorto-iliac graft by using cryogenically conserved allograft. Epidemiology, potential complications and treatment will be discussed.

Les infections de prothèses aortiques sont rares. Lorsqu'elles surviennent, leur prise en charge est un défi médico-chirurgical associé à un taux de morbi-mortalité élevé. Le traitement repose en première intention sur une antibiothérapie systémique ; le choix de l'antibiotique est empirique dans un premier temps et ciblé par la suite, après identification du germe responsable par des prélèvements bactériologiques. En cas d'échec, l'exérèse de la prothèse infectée et son remplacement par une greffe biologique (veines saphènes ou fémoro-poplitées, allogreffe artérielle) pouvant résister à l'infection est le traitement idéal. En ce qui concerne le choix du greffon, la littérature scientifique ne permet pas de départager l'allogreffe artérielle de l'allo- ou autogreffe veineuse dans l'évolution à long terme. Nous rapportons le cas d'une femme ayant présenté une infection de prothèse aortique, et qui a bénéficié d'une allogreffe aorto-bifémorale cryopréservée. L'épidémiologie, les complications potentielles et la prise en charge thérapeutique sont discutées.

[Mono-arthritis of the hand: case report of osteoid osteoma]. / Mono-arthrite de la main: un cas rapporté d'ostéome ostéïode.

Osteoid osteoma is a rare occurrence at the hand. There is often a long delay before the diagnosis because the clinical signs mimic other frequent affections of the hand. We report the case of a 24-year old female patient suffering from an osteoid osteoma in the first phalanx of a finger. The diagnosis was made four years after the first symptoms. We started by a curettage-biopsy, followed in a second operative step by cauterization and filling up the defect by a bone autograft. Six months after the surgery, the patient was no longer experiencing any symptom. This rare case demonstrates that osteoid osteoma remains a possible diagnosis in chronic pain affecting the hand.

Endovascular Aneurysm Repair (EVAR) : A Ten-Year Retrospective Study in a Low-Volume Center.

BACKGROUND: We evaluated clinical outcomes of EVAR procedures at a low-volume center in Belgium. We also analyzed the time before endoleak appeared. METHODS: We reviewed 77 EVAR procedures performed over 10 years in a low-volume center. Patients were reviewed at intervals of 1, 3, 6, 12, 24 and 36 months. RESULTS: The deployment of the endograft was successful for 76 of the 77 patients (98.7%). Perioperative mortality was 1.3%. Cardiac infarctus was reported in 5.19% of patients, 1.3% suffered hematoma, 1.3% renal insufficiency, 7.8%-respiratory diseases, and 2.6% strokes. The mortality rate during the first postoperative year was 9% and none of these deaths were AAA related. One endograft thrombosis was reported (1.3%) and there were no cases of endograft migration. Type 1 endoleak occurred in 3.9% of patients, and Type 2 in 22.1%. No other type of endoleak was reported. The mean period before endoleak diagnosis was 9.8 months. Two patients needed to be re-operated for a Type 1 endoleak. CONCLUSION: Performing EVAR procedures in a low-volume center did not increase morbidity and mortality risks. This is probably because the primary factor is the volume of procedures carried out by the surgeon, rather than the institution. EVAR follow-up is needed to diagnose endoleak, which can appear several months after.