Acute injuries in Badminton from 10 to 66 years of age: an epidemiological study of 140 cases among all types of practice.

PURPOSE: The main objective of this retrospective study was to establish an epidemiological overview of patients admitted to an Emergency department specialized in musculo-skeletal trauma for acute lesions related to Badminton practice in the period from January 1st 2010 to January 1st 2015. METHODS: There were 135 patients with 140 admissions and 146 total number of injuries. There were 67 females (48%) and 73 males (52%). The mean age was 28 ± 13.8 years, ranging 10-66 years. 91 patients (65%) could be contacted by telephone to fill a questionnaire aimed at completing the information provided by the medical records. RESULTS: 129 lesions (88.3%) were located to the lower limbs, 16 (11%) to the upper limbs, and one (0.7%) at the head. For the whole series, there were 89 sprains (60.9%), 32 tendino-muscular lesions (21.9%), 13 fractures (8.9%), 5 dislocations (3.4%), 3 painful contusions (2.1%), 3 meniscal injuries (2.1%) and one wound (0.7%). In the lower limbs, lateral ankle sprain was the most frequent diagnosis (43.4%), followed successively by rupture of the Achilles tendon (13.9%), tennis leg (8.5%), and mid-foot sprain (6.9%). Of the 146 lesions, 117 (80.1%) received non-operative treatment, 28 (19.1%) received surgical treatment in the operation room, and one simple wound (0.7%) was sutured in the emergency room. CONCLUSIONS: Lateral ankle sprains followed by tendino-muscular lesions of the calf are by far the most frequent lesions of badminton. Modification of the shoes of badminton players should be considered to decrease the high incidence of ankle injuries.

Detection of influenza virus in air samples of patient rooms.

BACKGROUND: Understanding the transmission and dispersal of influenza virus and respiratory syncytial virus (RSV) via aerosols is essential for the development of preventative measures in hospital environments and healthcare facilities. METHODS: During the 2017-2018 influenza season, patients with confirmed influenza or RSV infections were enrolled. Room air samples were collected close (0.30 m) to and distant (2.20 m) from patients' heads. Real-time polymerase chain reaction was used to detect and quantify viral particles in the air samples. The plaque assay was used to determine the infectiousness of the detected viruses. FINDINGS: Fifty-one air samples were collected from the rooms of 29 patients with laboratory-confirmed influenza; 51% of the samples tested positive for influenza A virus (IAV). Among the IAV-positive patients, 65% were emitters (had at least one positive air sample), reflecting a higher risk of nosocomial transmission compared with non-emitters. The majority (61.5%) of the IAV-positive air samples were collected 0.3 m from a patient's head, while the remaining IAV-positive air samples were collected 2.2 m from a patient's head. The positivity rate of IAV in air samples was influenced by distance from the patient's head and day of sample collection after hospital admission. Only three patients with RSV infection were recruited and none of them were emitters. CONCLUSION: Influenza virus can be aerosolized beyond 1 m in patient rooms, which is the distance considered to be safe by infection control practices. Further investigations are needed to determine the extent of infectivity of aerosolized virus particles.

Transformation of an Unclassified Myeloproliferative Neoplasm with a Rare BCR-JAK2 Fusion Transcript Resulting from the Translocation (9;22)(p24;q11).

BCR-ABL1 negative myeloproliferative neoplasms (MPNs) are known to contain alterations of the tyrosine kinase JAK2 (located on 9p24) that result in constitutive activation of the encoded protein. JAK2 fusions are reported in acute and chronic leukemias of myeloid and lymphoid phenotypes. Here, we report an unclassified case of MPN (MPN-U) showing a t(9;22)(p24;q11), which generates a BCR-JAK2 fusion gene by fusing the BCR at intron 13 to JAK2 at intron 17 on the derivative chromosome 22. Most reported JAK2 fusions cases reveal an aggressive clinical course and long-term remissions have only been achieved after allogeneic stem cell transplantation (ASCT). To the best of our knowledge, this is the thirteenth case reported worldwide to describe a BCR-JAK2 fusion transcript in MPN-U. The present report revealed a sustained complete clinical, hematologic, and cytogenetic remission 35 months after diagnosis and ~24 months after ASCT. Regarding BCR-ABL1 negative MPN patients this case report provides strong support for a role of JAK2 activation in the oncogenesis and suggests a possible diagnostic and therapeutic target that should be investigated.

[Posterolateral rotatory instability of the elbow secondary to sprain]. / Instabilité postéro-latérale rotatoire du coude secondaire à une entorse.

We present a case of a 23 year-old man who presented to the emergency department after sustaining indirect trauma to the left elbow with unremarkable physical examination and normal radiographs. He presented again three weeks after with repeated episodes of locking and snapping of the left elbow occurring every time he attempted to rise from a chair while pushing the armrests, and when manoeuvring the steering wheel of his vehicle. On physical examination, the patient was apprehensive to the "lateral pivot shift" test as described by O'Driscoll et al. (1991) [1]. MRI of the left elbow demonstrated avulsion of the proximal epicondylar insertion of the lateral collateral ligament complex (LCLC). The "lateral pivot shift test" was positive under general anaesthesia. Lateral elbow radiograph taken during the test showed widening of the ulno-humeral joint space with posterior subluxation of the radial head. The patient underwent surgical treatment for posterolateral rotatory instability (PLRI) of the elbow. This case report aims to highlight the clinical aspects of the PLRI which may occur after a simple elbow sprain and be easily missed if not suspected; it also aims to draw attention to the importance of the "lateral pivot shift test" and the value of the stress lateral elbow radiograph in establishing the diagnosis of this rare and subtle entity.

[Articular coronal fractures of the distal humerus]. / Les fractures articulaires frontales de l'extrémité distale de l'humérus.

INTRODUCTION: The vague term of capitellar fractures is still frequently used to designate articular coronal fractures of the distal humeral epiphysis. The use of eponyms for their descriptions may cause confusion. Recent publications describe a wide variety of fracture types and recommend new classifications based on the operative findings. We report our results of surgical treatment of 12 cases of these fractures in comparison to recent series of the literature. METHODS: Twelve patients (seven female and five male with a mean age of 31 years and 6 months) have been treated for articular coronal fractures of the distal humeral epiphysis between 1994 and 2004. A retrospective analysis of the radiographs and the operative notes permits their differentiation into 3 types according to the classification of Dubberley et al. (2006): ten fractures of type 1, one fracture of type 2 and one fracture of type 3. All fractures underwent open reduction and internal fixation, except for one case, which was initially missed and operated, therefore, by excision of the articular fragment with a delay of 6 weeks. All patients were clinically evaluated according to the index of performance of Morrey et al. (1993). In addition, a radiological assessment based on the scale of Knirk and Jupiter (1986) for elbow osteoarthritis was performed. RESULTS: The mean follow-up was 9 years. The clinical evaluation showed seven excellent results (six cases of type 1 and one case of type 3 with a score of 100 points for each one), two good (type 1 with 80 and 85 points of respective scores) and three fair (two cases of type 1 with 65 and 60 points of respective scores and one case of type 2 with a score of 65 points). The radiological evaluation showed seven elbows of grade 0 (six cases of type 1 and one case of type 3), four elbows of grade 1 (type 1) and one elbow of grade 2 (type 2). DISCUSSION: Articular coronal fractures of the distal humerus are rare. The classification of Dubberley et al. (2006) [7] is comprehensive and allows inclusion of all varieties of these fractures. In addition, it is the only one that indicates the surgical approach according to the fracture type. However, to do so, a preoperative CT-scan is highly recommended. The more the fracture line extends medially to involve the trochlea (types 2 and 3), the less a lateral approach is sufficient and the more a combined lateral and medial or a posterior transolecranon approach is mandatory. An internal fixation using conventional small fragment screws inserted from posterior to anterior is feasible when the articular fragment has a sufficient subchondral bone thickness. A direct anteroposterior fixation is better achieved using headless screws buried beneath the cartilaginous surface; it is particularly helpful when the articular fragment has a thin sub-chondral cancellous bone component. Excision is reserved for comminuted fractures, those not amenable to fixation, very thin or osteoporotic fragments, and for the late diagnosed fracture.

[Surgical management of solitary eosinophilic granuloma of the calvaria. Two case reports]. / Traitement chirurgical des granulomes éosinophiles solitaires de la voûte du crâne. A propos de deux cas.

Langerhans cell histiocytosis is a systemic disease resulting from the oligoclonal proliferation of Langerhans cells, occurring most commonly in children and young adults. The focal form of the disease, also known as eosinophilic granuloma, most frequently involves the calvaria. We present two cases of calvarial eosinophilic granulomas that were surgically removed. These tumors are reputed to have an excellent prognosis, even if local recurrences and systemic dissemination can occur during the follow-up. The authors discuss the pathogenesis and the evolutive profile but also the therapeutic management of solitary eosinophilic granuloma of the calvaria.

Irreducible volar dislocation of the proximal interphalangeal finger joint.

Volar dislocation of the proximal interphalangeal finger joint is rare. The trauma that causes this injury consists in a rotation mechanism in almost all cases. It may be initially missed and diagnosed at a late sequel stage. Closed reduction should always be attempted first but this procedure may result in failure, necessitating a surgical intervention. In irreducible cases, the surgical investigation shows a longitudinal split which separates one of the lateral bands (ulnar or radial) from the central slip of the terminal extensor tendon. In addition, the lateral band is displaced to the volar aspect of the head of the first phalanx, and partially entrapped into the proximal interphalangeal joint, the head of the first phalanx being trapped between the central slip and the displaced lateral band. Surgical relocation of the displaced lateral band gives an immediate reduction of the dislocated joint. We present a case of irreducible dislocation of the proximal interphalangeal joint of the right index finger in a 42-year-old female patient who required a surgical treatment. We present the diagnostic, anatomic and therapeutic aspects of this rare injury, together with a review of the literature.

[Simultaneous bilateral spontaneous rupture of the quadriceps tendon. Apropos of a case of a hemodialysis patient with hyperparathyroidism and review of the literature]. / La rupture spontanée bilatérale simultanée du tendon quadricipital. A propos d'un cas chez une patiente hémodialysée avec hyperparathyroïdie et revue de la littérature.

The bilateral simultaneous spontaneous rupture of the quadriceps tendons is a rare condition. Of the pathologies associated with this condition, in the literature, chronic renal failure with hyperparathyroidism is of special interest. In this context, the frequency of this lesion is related to the chronicity of the renal disease. We report a case treated surgically with a good functional result in a patient under dialysis with hyperparathyroidism.

[Meniscal sutures combined with the reconstruction of the anterior cruciate ligament. Comparative results between sutures of chronic and recent lesions: 102 cases]. / Les sutures méniscales associées à la réfection du ligament croisé antérieur. Résultats comparés des sutures des lésions récentes et chroniques: 102 cas.

The authors report the results of 102 meniscal sutures (53 lateral meniscus and 49 medial meniscus) done on 85 persons (86 knees) with laxity of the knee (54 acute laxities and 32 chronic laxities). All the sutures were done by posterior arthrotomy, while reconstruction of anterior cruciate ligament. Among the operations done on anterior cruciate ligaments, we find 45 reconstructions using MacIntosh procedure, 37 CHO method and 3 reconstructions using Lemaire procedure. 78 per cent of the sutures of the recent injuries were placed in a post-operative plaster cast, on the other hand, none of the chronic injuries was splinted. All the knees (except 1) were followed up within an interval of time of 1 year minimum to 4 years maximum. 3 sutures of fresh medial meniscus tear were reoperated on and one suture of old tear was reoperated. None of the lateral meniscus sutures, old or new was reoperated. 27 "objective" controls were done: 5 by arthrography, 4 by arthroscopy and 18 by magnetic resonance imaging (M.R.I.). Of the 18 controlled sutures by M.R.I., 13 (that is, 76, 5 per cent) presented a high signal as if they had a "wound" or persistent injury, this was found within a context of knees without any symptoms. Therefore the sutures of medial meniscus associated with laxity heal very well. It would be even better if they were in the chronic laxity stage (1 did not succeed out of the 22) than in the acute laxity stage (3 failures out of 27). The sutures of lateral meniscus healed very well in the chronic and in the old laxity stages (total success in both stages). The M.R.I controls for the 18 meniscus sutures presented the problem of the sutured meniscus future.