Orthopedics

SLAP lesions remain a rare entity of the painful pathology of the shoulder under the labrobicipital complex, of difficult diagnosis given the atypical clinical symptomatology often vague with tests of different reliability although directing towards a strong positive presumption. The advent of imaging by injection of contrast product (arthro scanner and especially arthro MRI) has allowed a better understanding of this type of lesion but there are still variants of this complex which are radiologically limited between what is normal or pathological. Arthroscopy has allowed an unequalled precision of diagnosis with the possibility of adequate therapeutic management and very satisfactory results. Through this clinical case of a young patient with a chronically painful shoulder, we draw attention to this type of pathology, which is rare but not negligible.

In this paper, fatigue damage accumulation were studied using three methods i.e. Miner, new non-linear model and experimental method. The prediction of fatigue lifetimes based on Miner method are uneconomic and non-conservative respectively. However satisfactory predictions were obtained by applying the non-linear damage rule (present model) for 5052-H34 aluminum alloy. Many shortcomings of the Miner methods are related to their inability to take into account the surface treatment effect.

The arthroscopic BANKART technique is part of the panel of surgical treatment of anterior shoulder instability, allowing reinsertion of the anterior-inferior labrum as well as the capsule at the level of the anterior glenoid rim. Its indication is based on a set of criteria gathered in the ISIS score, which must be less than or equal to 3 for an optimal result and a lower recurrence rate. Our initial experience has shown the success of this technique with a zero recurrence rate after an average follow-up of 26 months. The perspective remains to enlarge the series with a long follow-up for a better management.

Hereditary multiple exostoses (HME) is an inherited genetic condition characterized by the presence of multiple exostoses (osteochondromas). We report here the management of a rare case of a 29-year-old woman presented with multiple painless bony lumps that had developed insidiously over the past 10 years. The sites of involvement were the knees and the distal thirds of the fore arms and femurs. Radiographs showed well-defined sessile bone-density spurs arising from the metaphyses, with no alterations in the surrounding soft tissues. After surgical resection, histological examination of the operative specimens established the diagnosis of hereditary multiple exostosis.

The hallux valgus is defined as a lateral deviation of the big toe over the first metatarsal. It is the static deformation of the most common forefoot. Our study included a retrospective study of 27 cases of hallux valgus collected at the service of academic orthopedic trauma CHU Ibn Sina Rabat between 2010 -2013 with a mean of 4 years. The average age was 44.8% years. The predominantly female was 85% More than half of the forefeet were Egyptians: 85 2%. The predominant morphology of the feet was hollow: 40 7%. The surgical technique the most used was the MAC BRIDE and its variants: 40.8%, followed by technical SCARF: 18.6%. We found 74, 1% of good result. In light of these results, the surgical techniques the most appropriate are those permanently relieving the patient with first the techniques used on the soft-parts.

Synovial chondromatosis of the knee is a benign synovial dystrophy characterized by the formation of cartilaginous nodules (chondromas). Their early diagnosis and treatment are primordial to preserve the joint and prevent its degeneration. Its treatment remains controversial, adopting many attitudes, arthroscopic chondromas extraction or arthrotomy, arthroscopic synovectomy, high tibial osteotomies or even a prosthetic replacement. The literature reports many sporadic cases of synovial chondromatosis of the knee each one with its clinical and therapeutic particularity ; In this sense we report our historical case of giant synovial chondromatosis neglected source of knee stiffness, operated by open surgery anterior and posterior approachs allow to extract 600 grams of chondromas agglomerated into several diffuse masses. 

The acromioclavicular disjunction is a very frequent reason of consultation which concerns the young subject and which is favored by the sport practice.Our study is a retrospective study of a series of 5 patients who underwent endoscopic surgical treatment with coraco-clavicular lacing by ligamentoplasty within the orthopedic trauma department over a 24-month period between 01/2016 and 12/2017. The postoperative Constant score was 92 on average.No infectious or early or late cutaneous complications were found in the patients of our series.On the radiological level, the measurement of the coraco-clavicular distance in pre- and immediate postoperative, which was on average 30 mm against 18 mm postoperatively. The rapid recovery and the possibility of performing other arthroscopic therapeutic gestures represent the main advantages of this type of treatment.

The association of a posterior dislocation of the radial head with a diaphyseal fracture of the ipsilateral radius is uncommon condition. We report a rare case of a fracture-traumatic luxation of the radial head associated with a diaphysary fracture of homolateral radius in 52 old patient.

The authors report the case of a 25-years-old officer, a victim of an anti-tank mine explosion. The initial lesional assessment revealed an open fracture of the left foot associated with a complex closed fracture at the middle third level of the ipsilateral tibia and fibula. The treatment was conservative, combining, at a first stage, a surgical act with connection of the talar, tibiotalar and subtalar joints with exo-fixation of the tibia. Followed, at the second stage, by a latissimus dorsi flap coverage of the loss of cutaneous substance secondary to infection. The evolution was marked by the skin healing and malunited unkle fractures. However, the patient had some residual pain in the ankle accompanied by disorders of walking was settled by the use of retrograde intramedullary nail. The evolution was marked by bone healing and resumption of walking. The functional score was at 72 at the last check. This result was highly satisfactory with 25 points of functional score improvement.

We report the case of spinal cord compression from pathological fractures of the vertebral bodies with Gammapathy monoclonal in conjunction with multiple myeloma in a 52-year-old man who had recently been examined for paraplegia after two weeks of full pain. In our kwnoledge we thing that is a rare condition and must mainly been reported as a case presentation in the literature.